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Weak Immunity May Drive Tough-to-Treat Sinusitis

For small group of patients, drugs and surgery don't work

TUESDAY, Sept. 19, 2006 (HealthDay News) -- Weakened immune responses inside the nose may help explain chronic sinusitis that does not respond to treatment, according to new research.

Chronic sinusitis is persistent inflammation of the moist tissue that lines the nose and sinus cavities, resulting in clogged passages and recurrent infections.

This condition is usually treated with antibiotics, decongestants and steroids, but when medications fail, surgery can help keep the passages open. Unfortunately, nearly one in 10 of people treated with medications or surgery see symptoms return within weeks or months.

In a new study, a Johns Hopkins University team compared cells of the mucous membrane lining the nose from nine patients who benefited from surgery with nine who did not. They will present the findings Tuesday at the annual scientific sessions of the American Academy of Otolaryngology, Head and Neck Surgery.

The team found that, in people who did not benefit from surgery, the activity of at least four genes in the body's nasal immune defense system were severely decreased, and their production of two proteins critical to this defense was 20 to 200 times below normal.

"The nose's first line of defense is the epithelium [lining], and when the local innate immune function is curtailed, infections can get a head start, which might serve to worsen the sinus inflammation," Andrew Lane, associate professor at Johns Hopkins University School of Medicine and director of its rhinology and sinus surgery center, explained in a prepared statement.

More information

The American Academy of Family Physicians has more about sinusitis.

SOURCE: Johns Hopkins Medical Institutions, news release, Sept. 15, 2006
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