Experimentally induced acute sinusitis and efficacy of vitamin A

Although antibiotics are the mainstays for treatment of sinusitis, they do not specifically treat tissue damage due to free radicals. We propose that antioxidant, anti-infective, immunomodulator vitamin A may be a useful addition in the management of sinusitis.

Acute sinusitis is one of the most common diseases in humans. Vitamin A is a fat-soluble vitamin and essential for immunity, cellular differentiation, and maintenance of respiratory and gastrointestinal epithelial surfaces, growth, reproduction, and vision. The objective of this study was to investigate the therapeutic role of vitamin A on healing of acute sinusitis.

This was a prospective controlled animal trial. Experimental sinusitis was induced by blocking the right nose and inoculating Streptococcus pneumoniae into the right maxillary sinuses. Left maxillary sinuses were used as controls. Rabbits were divided in to two groups. At 48 h after inoculation, group I received only parenteral ampicillin-sulbactam (50 mg/kg), group II was treated with parenteral ampicillin-sulbactam (50 mg/kg) and parenteral a dose of 100,000 IU vitamin A in palmitate form. All animals were sacrificed on the 10th day. Mucosal samples were excised from the infected and control sinuses for histopathologic examination, for measurement of activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT), and for evaluation of levels of malondialdehyde (MDA) and nitric oxide (NO).

All the infected sinuses displayed signs of inflammation, but there was no statistically significant difference between the study and control groups. In our study, epithelial integrity as well as NO and MDA levels were better in the group receiving both antibiotic and vitamin A than the group receiving antibiotic alone. Nevertheless, SOD activity was significantly increased in the group receiving only antibiotics, compared with the control mucosal SOD activity. There was no difference between the groups as regards CAT and GSH activity.