Affiliation:
1. Nanjing 4th Retired Cadres Retreat Jiangsu Military Region Nanjing Jiangsu China
2. Department of Otorhinolaryngology and Head and Neck Surgery, Changhai Hospital Naval Medical University Shanghai China
3. Department of Otorhinolaryngology and Head and Neck Surgery No. 905 Hospital of PLA Navy Shanghai China
4. Department of Urology, The 903rd PLA Hospital Hangzhou Medical College Hangzhou Zhejiang China
Abstract
AbstractObjectiveMacrolide antibiotics are often used to prevent infection and inflammation after functional endoscopic sinus surgery for the treatment of chronic rhinosinusitis (CRS). The purpose of this study was to investigate the anti‐inflammatory and antibacterial effects of the clarithromycin‐loaded poly(‐lactide) (CLA‐PLLA) membrane and its mechanism.Study DesignRandomized controlled trial.SettingAnimal Experiment Center.MethodsWe compared the difference between poly(l‐lactide) (PLLA) and CLA‐PLLA membranes by observing the morphology of fibrous scaffolds, measuring water contact angle, tensile strength, and drug release capacity, and evaluating the antimicrobial activity of CLA‐PLLA. Twenty‐four rabbits were divided into a PLLA group and a CLA‐PLLA group after establishing CRS models. Another 5 normal rabbits comprised the control group. After 3 months, we placed the PLLA membrane in the nasal cavity of the PLLA group and the CLA‐PLLA membrane in the CLA‐PLLA group. Then, 14 days later, we evaluated the histological and ultrastructural changes in the sinus mucosa, protein, and messenger RNA (mRNA) levels of interleukin (IL)‐4, IL‐8, tumor necrosis factor‐α, transforming growth factor‐β1, α‐smooth muscle actin, and type I collagen.ResultsThe CLA‐PLLA membrane showed no significant difference in physical performance to the PLLA membrane, which continuously released 95% of the clarithromycin (CLA) for 2 months. The CLA‐PLLA membrane had significant bacteriostatic properties that can improve the morphology of mucosal tissues, and inhibit protein and mRNA expression of inflammatory cytokines. In addition, CLA‐PLLA also inhibited the expression of fibrosis‐associated marker molecules.ConclusionThe CLA‐PLLA membrane released CLA slowly and continuously, providing antibacterial, anti‐inflammatory, and antifibrotic effects in a rabbit model of postoperative CRS.
Subject
Otorhinolaryngology,Surgery