[Immunoglobulin positive cells in paranasal mucosa treated with macrolides]

The present study was carried out to determine the correlation between the efficacy of macrolide therapy and clinical features of chronic sinusitis. We performed an immunohistological study of subepithelial inflammatory cells in the paranasal mucosa from the patients of chronic sinusitis treated with low-dose, long-term administration of macrolides, and obtained the following results. 1) Many IgA and IgE positive cells were observed in subepithelial area, while IgG and IgM positive cells were sparse. 2) The cases with many IgA positive cells in subepithelial layer before the therapy showed good response to macrolides, and a number of IgA positive cells decreased after the therapy. 3) The number of IgE and IgM positive cells showed little change after the therapy. IgG positive cells tended to increase in number after the therapy. 4) The ratio of number of IgA positive cells and IgE positive cells (IgA/E) significantly decreased after the therapy, especially in responders to the therapy. 5) The value of IgA/E was significantly low in eosinophil-dominant cases. These results suggested that macrolides suppress chronic inflammatory response except for eosinophil and IgE-dominant inflammation.