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Nitric oxide: a new concept in chronic sinusitis pathogenesis.

Mohsen Naraghi1, Armin Farajzadeh Deroee, MohammadReza Ebrahimkhani

  • 1Iranian Rhinology Research Society, Department of Otorhinolaryngology, Head and Neck surgery & Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran. info@naraghi.ir

American Journal of Otolaryngology
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Levels of nitric oxide (NO) metabolites were significantly higher in the maxillary sinuses of patients with chronic sinusitis. These elevated NO metabolites may play a role in the pathogenesis of sinusitis.

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Area of Science:

  • Otorhinolaryngology
  • Immunology
  • Biochemistry

Background:

  • Nitric oxide (NO) is produced in the nasal cavity and paranasal sinuses, influencing their function.
  • Reduced exhaled NO is observed in chronic sinusitis, and NO metabolites are elevated in animal models, suggesting a role in disease pathogenesis.
  • Human data on NO metabolite levels in chronic sinusitis were previously unavailable.

Purpose of the Study:

  • To investigate and quantify nitric oxide (NO) metabolite levels in the maxillary sinuses of patients with chronic sinusitis.
  • To compare NO metabolite levels between healthy individuals and those with chronic rhinosinusitis, with and without polyposis.

Main Methods:

  • Maxillary sinus lavage was performed during functional endoscopic sinus surgery (FESS) on three groups: healthy controls, chronic rhinosinusitis with polyposis, and chronic rhinosinusitis without polyposis.
  • Nitrate and nitrite, key NO metabolites, were measured in the collected lavage fluid.

Main Results:

  • Mean nitric oxide metabolite levels were significantly higher in patients with chronic sinusitis (18.04 ± 3.51 μmol/L with polyposis, 16.78 ± 2.91 μmol/L without polyposis) compared to healthy controls (8.085 ± 1.43 μmol/L).
  • Elevated NO metabolite levels were observed in both chronic sinusitis patient groups.
  • No significant difference in NO metabolite levels was found between chronic sinusitis patients with and without polyposis.

Conclusions:

  • Nitric oxide (NO) metabolites are significantly elevated in the maxillary sinuses of individuals suffering from chronic sinusitis.
  • Increased NO metabolites in sinusitis may contribute to epithelial damage.
  • These findings suggest a potential role for NO metabolites in the pathogenesis of chronic sinusitis.