Science and Innovations in MedicineScience and Innovations in Medicine2500-13882618-754XFSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation8944810.35693/2500-1388-2021-6-4-9-13Research ArticleConcentration of essential chemical elements in whole blood and in paranasal sinuses mucosa is related to chronic rhinosinusitis severity in childrenAlekseenkoSvetlana I.<p>PhD, Associate professor, Chief researcher at the Department of high-technology treatment methodology development; Associate professor of the Chair of Otorhinolaryngology; Head of the ENT department</p>svolga-lor@mail.ruhttps://orcid.org/0000-0002-3377-8711DvoryanchikovVladimir V.<p>PhD, Professor, Director</p>v.v.dvoryanchikov@mail.ruhttps://orcid.org/0000-0002-0925-7596SkalnyAnatolii V.<p>PhD, Professor, Head of the Department of Medical Elementology; Head of the Laboratory of Molecular Dietetics</p>skalny3@microelements.ruhttps://orcid.org/0000-0001-7838-1366AnikinIgor A.<p>PhD, Professor; Head of the Department of high-technology treatment methodology development</p>dr-anikin@mail.ruhttps://orcid.org/0000-0003-2977-2656IsachenkoVadim S.<p>PhD, Associate professor of the Chair of Otorhinolaryngology</p>lor_vma@mail.ruhttps://orcid.org/0000-0001-9090-0413TinkovAleksei A.<p>PhD, Associate professor, Department of Medical Elementology; Chief researcher at the Laboratory of Molecular Dietetics</p>tinkov.a.a@gmail.comhttps://orcid.org/0000-0003-0348-6192St. Petersburg Research Institute of Ear, Throat, Nose and SpeechNorth-Western State Medical University named after I.I. MechnikovSt. Petersburg Children’s municipal multi-specialty clinical center of high medical technology named after K.A. RauhfusSechenov First Moscow State Medical UniversityRUDN UniversityMilitary Medical Academy named after S.M. Kirov15122021649133011202107122021Copyright © 2021, Alekseenko S.I., Dvoryanchikov V.V., Skalny A.V., Anikin I.A., Isachenko V.S., Tinkov A.A.2021<p><strong>Objectives </strong> to evaluate the association between essential chemical element levels in whole blood and in pathologic mucosa and chronic rhinosinusitis severity in children.</p>
<p><strong>Material and methods.</strong> A total of 154 children aged from 6 to 17 years were examined. Among them, 88 children had chronic rhinosinusitis (CRS) and underwent functional endoscopic sinus surgery (FESS). The 66 healthy children were included in the control group. Life quality was assessed using SNOT-20 (Sino-Nasal Outcome Test-20). Endoscopic and computer tomography findings were evaluated using Lund Kennedy and Lund Mackay scales, respectively. The assessment of essential element levels in whole blood samples was performed using inductively-coupled plasma mass-spectrometry.</p>
<p><strong>Results.</strong> The obtained data demonstrate that total SNOT-20 scores in CRS patients were 68% higher than in controls. At the same time, whole blood calcium, selenium, zinc, and magnesium levels were 6%, 28%, 20%, and 3% lower than the respective control values. The analysis of pathologic mucosa demonstrated that the chemical element contents were reducing in the following order: Ca Mg = Fe Zn Cu Mn Se. However, only whole blood selenium level correlated significantly with its tissue level. In multiple regression models, the whole blood Se level was inversely associated with SNOT-20 and Lund Mackay total scores.</p>
<p><strong>Conclusion. </strong>Therefore, the obtained data allow to propose the potential role of altered calcium, magnesium, zinc and selenium metabolism in CRS progression.</p>seleniumzincsinonasal pathologyinflammationsinuses mucosaселенцинксиноназальная патологиявоспалениеслизистая оболочка околоносовых пазух[London NR Jr, Lane AP. Innate immunity and chronic rhinosinusitis: What we have learned from animal models. Laryngoscope Investigative Otolaryngology. 2016;1(3):49-56. doi: 10.1002/lio2.21][Wessels I, Maywald M, Rink L. Zinc as a Gatekeeper of Immune Function. Nutrients. 2017;9(12):1286. doi: 10.3390/nu9121286][Avery JC, Hoffmann PR. Selenium, Selenoproteins, and Immunity. Nutrients. 2018;10(9):1203. doi: 10.3390/nu10091203][Healy C, Munoz-Wolf N, Strydom J, et al. Nutritional immunity: the impact of metals on lung immune cells and the airway microbiome during chronic respiratory disease. Respiratory Research. 2021;22(1):133. doi: 10.1186/s12931-021-01722-y][Unal M, Tamer L, Pata YS, Kilic S, et al. Serum levels of antioxidant vitamins, copper, zinc and magnesium in children with chronic rhinosinusitis. Journal of Trace Elements in Medicine and Biology. 2004;18(2):189-92. doi: 10.1016/j.jtemb.2004.07.005][Okur E, Gul A, Kilinc M, Kilic MA, et al. Trace elements in nasal polyps. European Archives of Oto-Rhino-Laryngology. 2013;270(8):2245-8. doi: 10.1007/s00405-012-2319-6][Kim DH, Yeo SW. Effects of normal saline and selenium-enriched hot spring water on experimentally induced rhinosinusitis in rats. International Journal of Pediatric Otorhinolaryngology. 2013;77(1):117-22. doi: 10.1016/j.ijporl.2012.10.008][Jaspers I, Zhang W, Brighton LE, et al. Selenium deficiency alters epithelial cell morphology and responses to influenza. Free Radical Biology and Medicine. 2007;42(12):1826-37. doi: 10.1016/j.freeradbiomed.2007.03.017][Suzuki M, Suzuki T, Watanabe M, et al. Role of intracellular zinc in molecular and cellular function in allergic inflammatory diseases. Allergology International. 2021;70(2):190-200. doi: 10.1016/j.alit.2020.09.007][Woodworth BA, Zhang S, Tamashiro E, et al. Zinc increases ciliary beat frequency in a calcium-dependent manner. American Journal of Rhinology & Allergy. 2010;24(1):6-10. doi: 10.2500/ajra.2010.24.3379][Roscioli E, Jersmann HP, Lester S, et al. Zinc deficiency as a codeterminant for airway epithelial barrier dysfunction in an ex vivo model of COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2017;12:3503-3510. doi: 10.2147/COPD.S149589][Price ME, Sisson JH. Redox regulation of motile cilia in airway disease. Redox Biol. 2019;27:101146. doi: 10.1016/j.redox.2019.101146][Deveci E, Yorgancilar E, Ekinci C, et al. Effects of manganese ethylene-bis-dithiocarbamate (maneb) on rat nasal respiratory mucosa. Acta Medica Mediterranea. 2013;29:875-878.][Alekseenko SI, Skalny AV, Ajsuvakova OP, et al. Mucociliary transport as a link between chronic rhinosinusitis and trace element dysbalance. Medical Hypotheses. 2019;127:5-10. doi: 10.1016/j.mehy.2019.03.007]