Nitric oxide: a new concept in chronic sinusitis pathogenesis

Naraghi, Mohsen; Deroee, Armin Farajzadeh; Ebrahimkhani, MohammadReza; Kiani, Samira; Dehpour, AhmadReza

doi:10.1016/j.amjoto.2006.10.014

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 28, Issue 5 , Pages 334-337, September 2007

Nitric oxide: a new concept in chronic sinusitis pathogenesis☆

This article was first presented as a poster in the 50th annual meeting of the American Rhinologic Society, September 2004, New York. The continuation of the study led to its oral presentation in the Sixth Symposium of Experimental International Rhinology and Allergy of the Nose and the European Association of Allergology and Clinical Immunology (ENT section), February 2006, Barcelona.

Mohsen Naraghi, MD
- Iranian Rhinology Research Society, Department of Otorhinolaryngology, Head and Neck surgery & Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author. No. 1281,Valie-Asr Avenue, Tehran 15178, Iran. Tel.: +98 21 8888 1376; fax: +98 21 8888 1376.
Armin Farajzadeh Deroee, MD
- Iranian Rhinology Research Society, Department of Otorhinolaryngology, Head and Neck surgery & Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
MohammadReza Ebrahimkhani, MD
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Samira Kiani, MD
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
AhmadReza Dehpour, PhD
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Received 22 August 2006

Abstract

Purpose

Exhaled NO is produced mainly in paranasal sinuses and nasal mucosa. Nasal NO has been suggested to have a variety of effects in nasal cavity. Decreased exhaled NO is found in chronic sinusitis, and NO metabolite levels are increased in animal models of chronic sinusitis, suggesting a role for them in sinusitis pathogenesis. There was no data available on human NO metabolite level.

Materials and methods

We lavaged maxillary sinuses in a control and 2 patient groups. The control group was patients who underwent functional endoscopic sinus surgery (FESS) due to any other reason than chronic sinusitis. The patient groups had chronic rhinosinusitis with and without polyposis who underwent FESS. Maxillary sinuses were lavaged during FESS, and NO metabolites (nitrate and nitrite) were lavaged in the lavage fluid.

Results

Nitric oxide metabolite levels (mean ± SEM) were 8.085 ± 1.43 μmol/L in healthy maxillary sinus lavage fluid and 18.04 ± 3.51 and 16.78 ± 2.91 μmol/L in chronic rhinosinusitis with and without polyposis, respectively. Lavage fluid of sinuses with chronic sinusitis had elevated levels of NO metabolites, which were significantly higher than the control group. The difference between the chronic sinusitis with and without polyposis groups was not significant.

Conclusions

Nitric oxide metabolites were significantly higher in maxillary sinuses of patients with chronic sinusitis. Elevated levels of NO and NO metabolites in sinusitis might damage healthy sinus epithelium. NO metabolites may have an important role in sinusitis pathogenesis.