Oxidative Stress and Matrix Metalloproteinase-9 in Exacerbation of Chronic Rhinosinusitis without Nasal Polyps

Chronic rhinosinusitis is a persistent inflammation of the sinonasal mucosa, which morphologically can be subdivided depending on the presence or absence of polyps into two types: chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). Features of its pathogenesis are not yet fully elucidated. The purpose of the research was to assess the blood serum levels of lipid peroxidation markers such as 8-isoprostane, thiobarbituric acid reactive substances (TBARs), conjugated dienes, blood serum total antioxidant status (TAS) and concentrations of MMP-9 in patients with CRSsNP. Material and methods. Twenty individuals with CRSsNP treated at Kharkiv Regional Clinical Hospital were enrolled in our research. Diagnosis was verified using clinical, laboratory and instrumental methods in accordance with criteria provided by the WHO expert committee. Control group included twenty relatively healthy subjects with deviated nasal septum (n = 20). Patients with any sign of acute or chronic inflammatory diseases, obesity, tumors, and endocrine pathology were excluded. All manipulations were carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) and Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (ETC 164). Each patient and control subject signed a written informed consent. Serum TAS and levels of TBA-reactive substances, conjugated dienes were determined by spectrophotometric method. Concentrations of MMP-9 and 8-isoprostane in blood serum of both patients with CRSsNP and control individuals were determined using ELISA kits. Optical density of solutions was measured using The Awareness Technology Stat Fax 303 Plus Microstrip Reader (USA). Statistical analysis was carried out using GraphPad Prism 5 software. Mann-Whitney U test was used to compare two independent groups of variables. Numerical values are represented as median and interquartile range. Difference between groups was considered statistically significant at p < 0.05. Results and discussion. It was found щге that the development of the disease was accompanied by an increase in serum lipid peroxidation markers: 8-isoprostane, TBA-reactive substances, conjugated dienes on the background of a decrease in the serum total antioxidant status. Such imbalance indicates the development of disorders of the redox state of patients with CRSsNP in the form of oxidative stress. Oxidative stress is considered to be one of the factors that might lead to an increase in the serum level of MMP-9 in patients. Elevation of MMP-9 concentration indicates the activation of extracellular matrix remodeling processes in CRSsNP. Conclusions. Exacerbation of CRSsNP is accompanied by the increase in serum levels of TBARs, conjugated dienes, 8-isoprostane on the background of the total blood serum antioxidant activity decrease. This indicates the development of oxidative stress. An increase in the content of MMP-9 in blood serum of patients with CRSsNP found in this study may be partially attributed to the development of oxidative stress and indicates the activation of extracellular matrix remodeling processes.