La crenoterapia sulfurea nel trattamento della poliposi naso-sinusale. Azione sulle IgA secretorie

Background and aims. Inflammatory pathology and allergic and hyperergic manifestations in the upper airways are a widespread and steadily increasing phenomenon. The main immune defence against infections and antigenic immunoexclusion at the level of mucosa is locally produced and SIgA mediated. Experience document the existence of SIgA deficits in a number of ENT pathology. This is countered by the positive effect of chrenotherapy on these disorders. The therapeutic effects of sulfureus chrenotherapy may partly be ascribed to increased SIgA levels. This study aimed to use sulfureus chrenotherapy not in the treatment of macropolyposis (the elective management of this pathology is still surgery), but in the prophylaxis of postsurgical recidivations of so-called 'inflammatory' polyps. Methods. While waiting for surgery, 30 patients with non-allergic polyposis underwent a cycle of endonarinal lavages for 21 days with sulfurous water (15 patients) or saline solution (15 patients). Nasal secretions were collected using a modified washing method at the basal control and at the end of treatment and SIgA assay was performed using a personal method of ImmunoIsoElectrofocusing. Results. Basal controls showed 29/30 patients with lower SIgA levels compared to laboratory internal standards. At the end of treatment, a mean increase was noted in SIgA levels which was, as expected, higher in the group treated with sulphurous water.