Abstract
To clarify clinicopharmacological roles of roxithromycin (RXM) in the pathogenesis of chronic sinusitis, we measured levels of various inflammatory cytokines, such as IL-1β, IL-2, IL-4, IL-6, IL-8 and TNF-α, in nasal secretions before and after medication of RXM, and also investigated clinical improvements of objective symptoms, subjective signs and X-ray findings. Thirty patients with chronic sinusitis were given300 mg/day of RXM during 4 weeks. Objective symptoms were improved in 80% of 30 cases, and subjective signs were improved in 43%. Clinical improvements in objective symptoms and subjective signs were achieved in 63%. X-ray improvements were achieved in 20%. After RXM medication, IL-1β and IL-8 levels were significantly decreased (P<0.05). The decreases of those cytokines were statistically significant in patients with clinical improvements of objective symptoms and subjective signs. These findings suggest that high levels of inflam-matory cytokines in nasal secretions may reflect an imbalance of the cytokine network on the nasal mucosa of chronic sinusitis. RXM may be effective for chronic paranasal sinus infection through the correction of imbalance in the cytokine network.
