Crenotherapy modulates the expression of proinflammatory cytokines and immunoregulatory peptides in nasal secretions of children with chronic rhinosinusitis

Am J Rhinol Allergy. Jan-Feb 2012;26(1):e15-9. doi: 10.2500/ajra.2012.26.3733.

Abstract

Background: The effect of crenotherapy on major mucosal markers of inflammation, TNF alpha, human beta-defensins 2 (hBD-2), and calprotectin, are largely unexplored in pediatric chronic rhinosinusitis (CRS). The aim of this study was to investigate the effects of crenotherapy with sulfate-sodium-chloride water on mucosal markers of inflammation in children with CRS.

Methods: Children with CRS received 15-day crenotherapy consisting of sulfate-sodium-chloride thermal water inhalations by nasal aerosol (15 minutes/day). Concentrations of nasal mucosal markers of inflammation (TNF alpha, hBD-2, and calprotectin) were measured before and after crenotherapy. Presence of specific symptoms (nasal obstruction, nasal discharge, facial pain, sense of smell, and cough), value of symptoms score sino-nasal 5 (SN5), quality of life (QoL) score (1 [worse] to 10 [optimal]) were also assessed.

Results: After crenotherapy a significant reduction was observed in TNF alpha (from 0.14 ± 0.02 to 0.08 ± 0.01; p < 0.001), calprotectin (from 2.9 ± 1.0 to 1.9 ± 0.5; p < 9.001), and hBD-2 (from 2.0 ± 0.1 to 0.9 ± 0.6; p < 0.001) concentrations. A significant (p < 0.05) reduction in number of subjects presenting symptoms of nasal obstruction (100% versus 40%), nasal discharge (33% versus 13%), facial pain (30% versus 10%), and sense of smell (60% versus 20%) was observed. A significant improvement of SN5 (from 3.07 ± 0.76 to 2.08 ± 0.42; p < 0.001) was observed after the crenotherapy. QoL also improved after crenotherapy (from 4.2 ± 1.1 to 6.6 ± 1.0; p < 0.001).

Conclusion: Crenotherapy induced a down-regulation of nasal mucosal inflammatory mediators in children with CRS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Balneology*
  • Child, Preschool
  • Chronic Disease
  • Down-Regulation
  • Female
  • Humans
  • Immunomodulation
  • Inflammation Mediators / metabolism
  • Leukocyte L1 Antigen Complex / genetics
  • Leukocyte L1 Antigen Complex / metabolism
  • Male
  • Mineral Waters / administration & dosage*
  • Mineral Waters / adverse effects
  • Nasal Mucosa / drug effects
  • Nasal Mucosa / immunology
  • Nasal Mucosa / metabolism*
  • Nasal Mucosa / pathology
  • Nasal Sprays
  • Quality of Life
  • Rhinitis / immunology
  • Rhinitis / physiopathology
  • Rhinitis / therapy*
  • Sinusitis / immunology
  • Sinusitis / physiopathology
  • Sinusitis / therapy*
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / metabolism
  • beta-Defensins / genetics
  • beta-Defensins / metabolism

Substances

  • DEFB4A protein, human
  • Inflammation Mediators
  • Leukocyte L1 Antigen Complex
  • Mineral Waters
  • Nasal Sprays
  • Tumor Necrosis Factor-alpha
  • beta-Defensins