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Immunologic changes after diode laser inferior turbinoplasty in allergic rhinitis

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Abstract

Objectives

It was suggested previously that turbinoplasty by laser improves the symptomatology of allergic rhinitis (AR) not only by a mechanical effect but also by inhibiting the local allergic reaction at the level of the inferior turbinates. The aim of this study was to determine whether the short-term immunologic effects of diode laser, when used to perform inferior turbinoplasty in AR, can also be detected at the systemic level.

Patients and methods

Twenty patients, seeking a treatment by laser for AR manifestations refractory to local and systemic medical therapy, were included in a prospective study. Blood picture, total immunoglobulin E, interleukin (IL)-4, IL-5, and interferon-γ levels were assessed immediately before and 1 month after diode laser inferior turbinoplasty (DLIT).

Results

One month after DLIT, the total leukocytic count increased with relative eosinopenia. Total immunoglobulin E and IL-5 decreased, together with insignificant changes in IL-4 and interferon-γ.

Conclusion

It is not impossible that DLIT modifies the clinical course of AR not only by a mechanical effect but also by its local or even by a systemic immunologic effect. The laser modulation of T-cell functions in the engorged turbinate submucosa is a plausible biomolecular interpretation of the observed effect.

References

  1. 1

    Caffier PP, Scherer H, Neumann K, Luck S, Enzmann H, Haisch A. Diode laser treatment in therapy-resistant allergic rhinitis: impact on nasal obstruction and associated symptoms. Lasers Med Sci 2011; 26: 57–67.

    Article  Google Scholar 

  2. 2

    Ibiapina Cda C, Sarinho ES, Camargos PA, Andrade CR, Cruz Filho AA. Allergic rhinitis: epidemiological aspects, diagnosis and treatment. J Bras Pneumol 2008; 34:230–240.

    Article  Google Scholar 

  3. 3

    Mullol J, Bachert C, Bousquet J. Management of persistent allergic rhinitis: evidence-based treatment with levocetirizine. Ther Clin Risk Manag 2005; 1: 265–271.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. 4

    Mullol J, Valero A, Alobid I et al. Allergic rhinitis and its impact on asthma update (ARIA 2008). The perspective from Spain. J Investig Allergol Clin Immunol 2008; 18: 327–334.

    CAS  PubMed  Google Scholar 

  5. 5

    Meltzer EO, Blaiss MS, Derebery MJ et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol 2009; 124: S43–S70.

    Article  Google Scholar 

  6. 6

    Settipane RA, Charnock DR. Epidemiology of rhinitis: allergic and nonallergic. Clin Allergy Immunol 2007; 19: 23–34.

    PubMed  Google Scholar 

  7. 7

    Farmer SE, Eccles R. Chronic inferior turbinate enlargement and the implications for surgical intervention. Rhinology 2006; 44: 234–238.

    CAS  PubMed  Google Scholar 

  8. 8

    Leong SC, Eccles R. Inferior turbinate surgery and nasal airflow: evidence-based management. Curr Opin Otolaryngol Head Neck Surg 2010; 18: 54–59.

    Article  Google Scholar 

  9. 9

    Cassano M, Granieri C, D el Giudice AM, Mora F, Fiocca-Matthews E, Cassano P. Restoration of nasal cytology after endoscopic turbinoplasty versus laser-assisted turbinoplasty. Am J Rhinol Allergy 2010; 24: 310–314.

    Article  Google Scholar 

  10. 10

    Passali D, Passali FM, Damiani V, Passali GC, Bellussi L. Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 2003; 112: 683–688.

    Article  Google Scholar 

  11. 11

    Lagerholm S, Harsten G, Emgard P, Olsson B. Laser-turbinectomy: long-term results. J Laryngol Otol 1999; 113: 529–531.

    CAS  Article  Google Scholar 

  12. 12

    Lippert BM, Werner JA. CO2 laser surgery of hypertrophied inferior turbinates. Rhinology 1997; 35: 33–36.

    CAS  PubMed  Google Scholar 

  13. 13

    Janda P, Sroka R, Baumgartner R, Grevers G, Leunig A. Laser treatment of hyperplastic inferior nasal turbinates: a review. Lasers Surg Med 2001; 28: 404–413.

    CAS  Article  Google Scholar 

  14. 14

    Kawamura S, Fukutake T, Kubo N, Yamashita T, Kumazawa T. Subjective results of laser surgery for allergic rhinitis. Acta Otolaryngol Suppl 1993; 500: 109–112.

    CAS  Article  Google Scholar 

  15. 15

    Fukutake T, Yamashita T, Tomoda K, Kumazawa T. Laser surgery for allergic rhinitis. Arch Otolaryngol Head Neck Surg 1986; 112: 1280–1282.

    CAS  Article  Google Scholar 

  16. 16

    Takeno S, Osada R, Furukido K, Yajin K. Analysis of local cytokine gene expression in patients with allergic rhinitis treated with CO2 laser surgery. Laryngoscope 2000; 110: 1968–1974.

    CAS  Article  Google Scholar 

  17. 17

    Furukido K, Takeno S, Osada R, Ishino T, Yajin K. Study of eosinophil activation in nasal mucosa in patients with perennial nasal allergy: effects of CO2 laser surgery. Am J Rhinol 2002; 16: 1–6.

    Article  Google Scholar 

  18. 18

    Siegel GJ, Seiberling KA, Haines KG, Haines KG, Aguado AS. Office CO2 laser turbinoplasty. Ear Nose Throat J 2008; 87: 386–390.

    Article  Google Scholar 

  19. 19

    Tsai YL, Su CC, Lee HS, Chen HC, Chen MK. Symptoms treatment for allergic rhinitis using diode laser: results after 6-year follow-up. Lasers Med Sci 2009; 24: 230–233.

    Article  Google Scholar 

  20. 20

    Elwany S, Abel Salaam S. Laser surgery for allergic rhinitis: the effect on seromucinous glands. Otolaryngol Head Neck Surg 1999; 120: 742–744.

    CAS  Article  Google Scholar 

  21. 21

    Inouye T, Tanabe T, Nakanoboh M, Ogura M. Laser surgery for allergic and hypertrophic rhinitis. Ann Otol Rhinol Laryngol Suppl 1999; 180: 3–19.

    CAS  Article  Google Scholar 

  22. 22

    Mosmann TR, Sad S. The expanding universe of T-cell subsets: Th1, Th2 and more. Immunol Today 1996; 17: 138–146.

    CAS  Article  Google Scholar 

  23. 23

    Mori K, Tamura M, Kawamoto M et al. Modulation of T-cell functions by laser surgery in patients with allergic rhinitis. Acta Otolaryngol 2003; 123: 704–708.

    Article  Google Scholar 

  24. 24

    Berger G, Ophir D. The histopathology of the hypertrophic inferior turbinate. Arch Otolaryngol Head Neck Surg 2006; 132: 588–594.

    Article  Google Scholar 

  25. 25

    Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003; 23: 2131–2137.

    CAS  Article  Google Scholar 

  26. 26

    Weyrich AS, Zimmerman GA. Platelets: signaling cells in the immune continuum. Trends Immunol 2004; 25: 489–495.

    CAS  Article  Google Scholar 

  27. 27

    Iannacone M, Sitia G, Isogawa M et al. Platelets mediate cytotoxic T lymphocyte-induced liver damage. Nat Med 2005; 11: 1167–1169.

    CAS  Article  Google Scholar 

  28. 28

    Hou JF, Zhang H, Yuan X, Li J, Wei YJ, Hu SS. In vitro effects of low-level laser irradiation for bone marrow mesenchymal stem cells: proliferation, growth factors secretion and myogenic differentiation. Lasers Surg Med 2008; 40: 726–733.

    Article  Google Scholar 

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Correspondence to Dr Hazem M. A. Saleh.

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Saleh, H.M.A., Ibrahim, D.R., Michael, M.I. et al. Immunologic changes after diode laser inferior turbinoplasty in allergic rhinitis. Egypt J Otolaryngol 32, 141–146 (2016). https://doi.org/10.4103/1012-5574.186535

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Keywords

  • cytokines
  • hematology
  • immunology
  • inferior turbinates
  • interleukins
  • reduction
  • semiconductor