^ Possible Role Of Cytokines In Pathogenesis Of Chronic Rhinitis
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(MIF), tumor necrosis factor-a (TNF-ot) and interleukin-lf3 (IL-l @) in chronically inflamed ntucosa of patients with dironic rhinitis and their correlation with the severity of symptoms so as to evaluate their role in the pathogenesis of chronic rhinitis. Patients & Methods : The study comprised 30 patients (Patients group) and 10 volunteers (Control group). Patients underwent clinical examination and symptoms including rhinorrhea, xoatery eyes, nasal itching, sneezing and nasal blockade were evaluated and graded : 0- no symptoms, l^mild, 2=moderate and 3=severe. Nasal mucosa biopsy was obtained under local anesthesia from both patients and controls and nasal tissue extract (NTE) of MIF, TNF- a and IL-l /3 were estimated in supernatant fluid using ELISA technique. Results : 77k total symptom score was 8.93 1.96, with rhinorrhea and nasal obstruction being the most common symptoms that were reported in the 20 patients with a mean score of 257 0.73 and 2.17 0.83, respectix'ely. Sneezing teas reported in 18 patients, nasal itching in 16 and watery eye in 13 patients. Tliere was a significant (p<0.05) increase of mean levels of the three cytokines in patients compared to controls. Moreover, there was a positive significant correlation betioeen total patients symptom score and patients NTE levels of MIF, (r ^= 0.602, p<0.001), TNF-a (r = 0586, p = 0.001) and IL-l J3(r = 0.536, p = 0.0021; such correlation was most significant with rhinorrliea, sneezing and nasal itching and nasal obstruction. Furthermore, nasal tissue MJF extract levels showed a positive significant correlation with NTE levels of TNF-a, (r - 0.479, p = 0.007) and 111 fi, (r = 0.536, p = 0.002). Conclusion : It could be concluded that upregulated expression and release of MIF with its subsequent stimulatory effect for release of destructive cylokines as IL-l fi and TNF-a play an important role in pathpgewsis of allergic rhinitis and may be responsible for its chronicity and resistance to treatment.