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Myeloperoxidase in nasal secretion as a cell-activation marker in acute sinusitis
Boris R Haxel1, Claudia Woywode, Torsten Mewes
1Department of Otorhinolaryngology, Mainz Medical School, Mainz, Germany.
Background:
Acute bacterial infections of the upper respiratory tract, including the nasal sinuses, lead to an activation of neutrophil granulocytes. The protein myeloperoxidase (MPO) is released by this cell type only and therefore can act as a marker for activity of inflammation.
Methods:
In a prospective multicenter study, 45 patients with acute bacterial sinusitis (diagnosed by clinical examination, ultrasonography, and X ray or computed tomography scan) were treated with two different antibiotics (Cefditoren or Cefuroxim twice a day for 10 days). Nasal secretions were collected with absorbing foam-rubber samplers and a concentration of MPO was evaluated before the therapy and after 7 +/- 1 days and 14 +/- 2 days of antibiotic treatment. The concentrations of MPO were measured by a radioimmunoassay method and the dilution factors were determined by the lithium method.
Results:
Significant differences in the MPO concentration in nasal secretions between the first and third visit could be found in both groups (p < 0.01 each). No significant difference was seen within the two different antibiotics used.
Conclusion:
Measurement of MPO concentration in nasal secretions showed a significant change after antibiotic treatment of acute bacterial rhinosinusitis. The reduction of MPO levels correlated with the observed clinical and radiological improvement of the disease. Additional investigations are needed to achieve more knowledge about basal concentrations of MPO in healthy persons and different activation patterns before it can be determined whether the MPO measurement could be a suitable method for monitoring the success of an antibiotic treatment in acute bacterial sinusitis.
Insights
Myeloperoxidase (MPO) levels in nasal secretions significantly decreased after antibiotic treatment for acute bacterial rhinosinusitis. This reduction in MPO indicates inflammation activity and correlates with clinical improvement.
Area of Science:
- Otorhinolaryngology
- Clinical Immunology
- Pharmacology
Background:
- Acute bacterial infections, such as sinusitis, activate neutrophil granulocytes.
- Myeloperoxidase (MPO) is a protein released exclusively by neutrophils, making it a specific marker for inflammation activity.
- Understanding MPO's role in sinusitis can lead to better diagnostic and monitoring tools.
Purpose of the Study:
- To evaluate the change in MPO concentration in nasal secretions following antibiotic treatment for acute bacterial rhinosinusitis.
- To determine if MPO levels correlate with clinical and radiological improvements.
- To assess the potential of MPO measurement as a method for monitoring treatment success.
Main Methods:
- A prospective multicenter study involving 45 patients diagnosed with acute bacterial sinusitis.
- Patients received either Cefditoren or Cefuroxim for 10 days.
- Nasal secretions were analyzed for MPO concentration using radioimmunoassay at baseline, day 7, and day 14.
Main Results:
- A statistically significant decrease in MPO concentration was observed in nasal secretions from the first to the third visit in both antibiotic groups (p < 0.01).
- No significant difference in MPO reduction was found between the two antibiotics used.
- The reduction in MPO levels correlated with observed clinical and radiological improvements.
Conclusions:
- MPO concentration in nasal secretions significantly changes after antibiotic therapy for acute bacterial rhinosinusitis.
- The observed reduction in MPO levels is linked to clinical and radiological disease improvement.
- Further research is needed to establish MPO measurement as a reliable method for monitoring antibiotic treatment efficacy in sinusitis.
