Ratio of cytokines secreted by macrophages, before and after mometasone furoat treatment in patients with allergic rhinitis

In this study, it was aimed to investigate the ratio of cytokines secreted by the macrophages, which are one of the antIg-En presenting cells, in nasal lavage fluid of patients with allergic rhinitis, before and after mometasone furoat nasal spray treatment (MFNS). The effects of MFNS treatment on allergic rhinitis symptoms are planned to be investigated as well. 21 patients, who had consulted to Celal Bayar University Hafsa Sultan Hospital Allergy and Immunology Department with AR diagnosis and met the inclusion and exclusion criterias, were included to this study. During the first examination, the patients were asked to grade the 6 symptoms including consecutive sneezing coughing, nasal discharge, nasal congestion, itching-burning in the eye, nose and palate. Nasal lavage was taken from the patients before the treatment. For treatment, MFNS was given to the patients once daily to both nostrils in the mornings. After 4 weeks of MFNS treatment, statistically significant differences were determined in the average symptom scores of the patients. Nasal lavage samples were taken again from the patients after MFNS treatment (p<0.01). The cytokine level of TNF-α, IL-1β, IL-4, IL-6, IL-10, IL-12, IL-13, IL-23 in the nasal lavage samples were tested by LUMINEX method before and after treatment while the level of TGF- β was tested by ELISA method. Statistically significant decrease was determined in the IL-1β, IL-4, IL-6 levels after MFNS treatment (IL-1 β: p< 0.001; IL-4:p=0,029, IL-6:p=0,005) while liminally significant decrease was determined in TGF- β level after the treatment (p=0,094). In our study, the IL-10 level was seen as the only cytokine showing statistically significant increase after the treatment (p=0,005). Statistically significant decrease was observed in the ratio of TNF-α cytokine after MFNS treatment (p=0,002). IL-12 and IL-23 levels in the nasal lavage could not be measured since they were below the minimum detectable concentrations both before and after MFNS treatment (IL-12:p= 0,317; IL-23: p=1). Statistically significant decrease was determined in the IL-13 levels of the nasal lavage after MFNS treatment (p<0,001). In conclusion, we have shown the change in the pattern of immune cell responses in the nasal mucosa and clinical improvement in the patients with AR due to MFNS and its derivatives. In our study, we have observed that the ratio of M1, M2a macrophage subtypes might decrease and M2c macrophage subtype might increase due to the effects of MFNS treatment on cytokines in the nasal mucosa. Key words: Allergic rhinitis, cytokine, TNF-α, TGF-β, IL-1β, IL-4 IL-6 IL-10, IL-12, IL-13, IL-23, mometasone furoate, macrophage