ALBUMIN AND IMMUNOGLOBULIN LEVELS IN NASAL SECRETIONS OF PATIENTS WITH NASAL POLYPS TREATED WITH ENDOSCOPIC SINUS SURGERY AND TOPICAL CORTICOSTEROIDS

Background: Nasal polyposis is principally treated by surgery, which may be combined with administration of topical corticosteroids to postpone or prevent recurrences. Objective: In this study endoscopic sinus surgery and subsequent use of topical corticosteroids (budesonide) for I year was evaluated. Methods: Clinical data of 41 patients with nasal polyps were evaluated, and their nasal secretions were compared with those of 26 healthy persons (control subjects). Results: The patients had much higher initial total protein, albumin, IgM, secretory IgA (S-IgA) (p < 0.001 for all), and IgG concentrations (p < 0.05) than the control subjects. Treatment resulted in a significant decrease of S-IgA (p < 0.001) within 6 months. IgM and IgG concentrations decreased more slowly (p < 0.001 and p < 0.05 at 1 year, respectively). IgE levels decreased but we could Plot demonstrate significance. Relative to total protein levels, the albumin and S-IgA levels decreased within 6 months (p < 0.005 and p < 0.001, respectively). The excretion of all proteins remained higher in patients than in the control subjects, even after I year of topical corticosteroid treatment. Clinical evaluation showed slightly higher S-IgA levels in patients with an IgE-mediated allergy than in those without such a condition, and the recurrence rate was highest in the former group (75% vs 48%). Conclusion: The data support the hypothesis that inflammatory reactions in the nasal mucosa play a role in the pathogenesis of nasal polyps but also suggest an additional causative factor.