a1 Rhinology Unit, Department of Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
a2 Division of Clinical Immunology, Institute of Medical Research, Military Medical Academy, Belgrade, Serbia
a3 Department of Ear, Nose and Throat, Innland Hospital, Elverum, Norway
Background: Little is known about the effects of macrolides on the cytokines and chemokines that modulate the function of eosinophils in nasal polyposis.
Methods: Twenty-two non-allergic and 18 allergic patients with nasal polyps were administered clarithromycin 500 mg/day (single oral dose) for eight weeks. We measured the nasal secretion levels of the T helper 2 (also known as Th2) cytokines interleukin 4, 5 and 6, the ‘regulated on activation, normal T cell expressed and secreted’ (also known as RANTES) chemokine, and the eosinophilic cationic protein, before and after treatment.
Results: After clarithromycin treatment, we found reduced levels of the ‘regulated on activation, normal T cell expressed and secreted’ chemokine in samples from both non-allergic and allergic patients (p < 0.05). Clarithromycin treatment decreased the levels of eosinophilic cationic protein only in non-allergic patients (p < 0.05), and decreased the level of interleukin 6 only in allergic patients (p < 0.05). Decreased levels of the ‘regulated on activation, normal T cell expressed and secreted’ chemokine were associated with a reduction in polyp size both in non-allergic and allergic patients.
Conclusion: Clarithromycin has a strong anti-inflammatory effect in nasal polyposis, but has different immunomodulatory effects in allergic and non-allergic nasal polyposis patients.
(Accepted August 10 2011)
Dr A Perić takes responsibility for the integrity of the content of the paper
Competing interests: None declared