Serum and nasal fetuin-a levels before and after immunotheraphy at allergic rhinitis patients

INTRODUCTION AND OBJECTIVE: Allergic Rhinitis (AR) is an IgE-mediated inflammation that develops in nasal mucosa against allergens. It is the one, most frequently seen among allergic diseases and its incidence becomes increasingly prevalent. Its early diagnosis and treatment is very important because its effects the quality of life when it is established and led to diseases such as sinusitis and otitis. A variety of clinical and laboratory parameters are used when evaluating the severity of disease and response to therapy and studies on this topic continue. In our study we aimed to identify the role played by a protein called Fetuin A (which provided significant results in evaluating the severity and response to therapy of a number of systemic diseases) in allergic rhinitis. PATIENTS AND METHODS: In our study 30 patients (18 years old and above), who have referred to the Polyclinic of Department of Allergic Immunology, Department of Internal Diseases, Celal Bayar University Medical Faculty Hospital between September 2010 and December 2010 and for whom immunotherapy was planned because they were diagnosed with AR and 30 healthy volunteers (in similar age group) were enrolled. In both groups various laboratory tests were carried out to exclude additional systemic and chronic diseases. The allergens that the patient group is responsive were determined through skin prick test. Immunotherapy was planned for the patient group with medium-heavy persistent AR. Patient and control groups? pre-treatment serum and nasal lavage Fetuin A values and symptom scores were recorded. Patient group?s serum and nasal lavage Fetuin A values reevaluated and symptom scores rerecorded at 6 months after immunotherapy. These values were compared and statistical analysis was performed. FINDINGS: The mean age of patient group (73.3 % women) was found to be as 27.9 ± 8 years and control group?s (66.7 % women) as 29.3 ± 4.2 years. Both groups were similar in terms of age and gender. Patient group?s the mean serum Fetuin A level was found as 1010.44 ± 679.84 and control group?s as 350.30 ± 210.87. A statistical significant difference was observed between patient and control groups (P<0.001). Patient group?s the mean nasal Fetuin A level was 946.52 ± 127.123, whereas control group?s was 743.19 ± 217.99. The difference between both groups was statistically significant (P<0.001). When AR-patients pre-and post-therapy serum and nasal Fetuin A levels were compared, a statistically significant decline was detected in post-therapy serum (P=0.046) and nasal Fetuin A (P<0.001) levels. Similarly, a significant decline was observed in patients? symptom scores after therapy (P<0.001). When the relationships between age, gender, serum Fetuin A and nasal Fetuin A values in both patient and control groups were studied, a statistical significant negative relationship was found between allergic rhinitis patients? serum Fetuin A and nasal Fetuin A levels and the age (P<0.01). In the analysis performed related to the diagnostic sensitivity of serum Fetuin A in allergic rhinitis, sensitivity was found to be 80 % and specificity to be 80 %. This cut-off value?s positive and negative predictive value was found to be 80 %. CONCLUSION: The significantly elevated pre-treatment nasal and serum Fetuin A levels detected in AR-patients compared to control group and this statistically significant elevation indicates the presence of a systemic and local inflammation. A statistically significant decline observed in AR-patients? post-immunotherapy serum Fetuin A and nasal lavage Fetuin A values (compared to pre-treatment) indicates a regression in systemic and local inflammation. The regression seen in nasal symptom score used in clinic evaluation supports these results. These results are very important in terms of objective assessment of the severity of disease and the effectiveness of immunotherapy. In order for our knowledge about the effects of this glycoprotein in AR and other allergic diseases to become definite further studies are needed.