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And P-Selectin Is Preferentially Up-regulated in Diseased Mucosae

Viveka Westergren, MD; Giuseppe Viale, MD; Patrizia Dell'Orto; Catherina Pellegrini; Henrik B. Hellquist, MD, PhD

Arch Otolaryngol Head Neck Surg. 1997;123(10):1103-1110.

Abstract
Objective
To investigate the relationship of the clinical appearance, histological characteristics, bacterial culturing, and messenger RNA (mRNA) expression of RANTES, interleukin 6, and interleukin 12, as well as the occurrence of endothelial adhesion molecules, in inflammatory diseased maxillary sinus mucosa in critically ill patients.

Design
Prospective case series.

Setting
General intensive care unit and neurosurgical intensive care unit of a tertiary care hospital.

Subjects
Seven critically ill patients, nasotracheally intubated or tracheotomized, who received ventilator treatment for more than 7 days and treatment with antibiotics.

Interventions
Bilateral biopsy specimens of antral mucosa were obtained at sinoscopy. Reverse transcriptase—polymerase chain reaction was used to detect the cytokine mRNAs in situ on paraformaldehyde-fixed tissue, and intercellular adhesion molecule 1, vascular cell adhesion molecule 1, E-selectin, and P-selectin were analyzed by immunochemistry on frozen sections. Sampling of secretion and tissue from the antra was performed for bacterial culturing.

Results
Macroscopic and histological appearance varied and showed moderate to pronounced inflammation in 6 antra. All 4 bacterially infected antra showed mRNA RANTES (P=.005). No correlation was found for interleukin 6 and interleukin 12. Up-regulation of P-selectin in all cases and sparse expression of vascular cell adhesion molecule 1 indicate that the inflammation is chronic but nonallergic in type.

Conclusion
We find an indication that RANTES is more prevalent in bacterial sinusitis.

Arch Otolaryngol Head Neck Surg. 1997;123:1103-1110

Author Affiliations
From the Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Hospital, Stockholm, Sweden (Dr Westergren); the Department of Pathology and Laboratory Medicine, Istituto Europeo di Oncologia, University of Milan School of Medicine, Milan, Italy (Dr Viale and Mss Dell'Orto and Pellegrini); and the Department of Pathology II, University Hospital, Linköping, Sweden (Dr Hellquist).

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