Evaluation of neutrophil functional activity for rhinosinusitis diagnosis.

Bacterial rhinosinusitis (BRS) is a complicated form of rhinosinusitis, characterized by its acute course and tendency to chronicity. A significant role in pathogenetic mechanisms of HRS is played by functional state of neutrophils responsible for inflammation development at HRS. Investigation of neutrophils metabolic activity on external stimuli by chemiluminescence method in patients with acute and chronic forms of the disease will enable to develop method of differential diagnostics of BRS forms. The examination of 65 patients with BRS which were divided into patients with acute form (n=35) and chronic form of the disease (n=30) was carried out. The control group consisted of 30 healthy subjects. Functional activity of neutrophils was studied in whole blood by chemiluminescence with double stimulation (phorbol-12-myristate-13-acetate (PMA) and N-formylmethionyl-leucyl-phenylalanine (fMLP). In patients with the acute form of BRS we found an increase in parameters of specific maximum intensity of neutrophils luminescence, light sum of spontaneous and stimulated luminol-dependent chemiluminescence and a decrease in time to maximum output. Patients with the chronic form of BRS revealed a decrease in the luminescence of spontaneous, stimulated neutrophil production and maximum luminescence intensity. On the basis of significant differences in chemiluminescence indices of neutrophils, a method of differential diagnosis of the BRS forms was developed. The results obtained testify to increased production of reactive oxygen species (ROS) by neutrophils in the process of killing in patients with acute form of LRS and depletion of cell function and reserve in patients with the chronic form. Developed on the basis of the studied indicators method of diagnosing the forms of BRS by chemiluminescence will allow to differentiate acute and chronic forms of the disease, which will increase the effectiveness of treatment of patients.