BACKGROUND Chronic upper respiratory tract infections (cURTI) are very frequent illnesses which occur at any age of life. In elderly, cURTI are complicated by immunosenescence, with involvement of lung immune responsiveness. RESULTS In the present study, 51 elderly (age range: 66-86) and 51 young (age range 24-58) cURTI patients underwent a single cycle (two weeks) of inhalatory therapy with salt-bromide-iodine thermal water in the thermal station "Margherita di Savoia" (Margherita di Savoia, BAT, Italy). Peripheral blood serum cytokines and clinical assessment were performed before therapy (T0) and after six months (T1) and 12 months (T2) from inhalatory treatment. In both elderly and young patients, at baseline an increased release of T helper (h)1-related cytokines [interleukin (IL)-2 and interferon-γ] and of Th2-related cytokine (IL-4) was documented. Inhalatory treatment reduced the excessive secretion of all the above-cited cytokines. IL-10 values were above normality at all times considered in both groups of patients. In addition, an increase in IL-17 and IL-21 serum levels following therapy was observed in both groups of patients. Pro-inflammatory cytokine (IL-1β, IL-6, IL-8 and tumor necrosis factor-α) baseline values were lower than normal values at T0 in both elderly and young cURTI patients. Their levels increased following inhalatory treatment. Clinically, at T2 a dramatic reduction of frequency of upper respiratory tract infections was recorded in both groups of patients. CONCLUSION Thermal water inhalation is able to modulate systemic immune response in elderly and young cURTI patients, thus reducing excessive production of Th1 and Th2-related cytokines, on the one hand. On the other hand, increased levels of IL-21 (an inducer of Th17 cells) and of IL-17 may be interpreted as a protective mechanism, which likely leads to neutrophil recruitment in cURTI patients. Also restoration of pro-inflammatory cytokine release following inhalatory therapy may result in microbe eradication. Quite importantly, the maintenance of high levels of IL-10 during the follow-up would suggest a consistent regulatory role of this cytokine in attenuating the pro-inflammatory arm of the immune response.

中文翻译：

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吸入热水对老年和青年患者的慢性上呼吸道感染的影响。

背景技术慢性上呼吸道感染（cURTI）是非常普遍的疾病，其发生在任何年龄的人。在老年人中，cURTI伴有免疫衰老，并伴有肺部免疫反应。结果在本研究中，对51名老年人（年龄范围：66-86岁）和51名年轻人（年龄范围24-58岁）的cURTI患者进行了单周期（两周）的吸入疗法，即在盐水中加入盐-溴-碘热水站“ Margherita di Savoia”（Margherita di Savoia，英美烟草，意大利）。在治疗前（T0），吸入治疗后六个月（T1）和十二个月（T2）后进行外周血血清细胞因子和临床评估。在老年患者和年轻患者中，在基线时，已记录到T辅助（h）1相关细胞因子[白介素（IL）-2和干扰素-γ]和Th2相关细胞因子（IL-4）的释放增加。吸入治疗减少了所有上述细胞因子的过度分泌。两组患者在任何时候都认为IL-10值高于正常值。另外，两组患者在治疗后均观察到IL-17和IL-21血清水平升高。老年和年轻cURTI患者的促炎细胞因子（IL-1β，IL-6，IL-8和肿瘤坏死因子-α）基线值均低于T0时的正常值。吸入治疗后其水平升高。临床上，两组患者在T2时上呼吸道感染的频率均显着降低。结论吸入热水能够调节老年和年轻cURTI患者的全身免疫反应，从而一方面减少Th1和Th2相关细胞因子的过量产生。另一方面，IL-21（Th17细胞的诱导剂）和IL-17的水平升高可能被解释为一种保护机制，这可能导致cURTI患者中性粒细胞募集。吸入疗法后恢复促炎性细胞因子释放也可能导致微生物根除。非常重要的是，在随访期间维持高水平的IL-10将表明该细胞因子在减弱免疫反应的促炎作用方面具有一致的调节作用。一方面。另一方面，IL-21（Th17细胞的诱导剂）和IL-17的水平升高可能被解释为一种保护机制，这可能导致cURTI患者中性粒细胞募集。吸入疗法后恢复促炎性细胞因子释放也可能导致微生物根除。非常重要的是，在随访期间维持高水平的IL-10将表明该细胞因子在减弱免疫反应的促炎作用方面具有一致的调节作用。一方面。另一方面，IL-21（Th17细胞的诱导剂）和IL-17的水平升高可能被解释为一种保护机制，这可能导致cURTI患者中性粒细胞募集。吸入疗法后恢复促炎性细胞因子释放也可能导致微生物根除。非常重要的是，在随访期间维持高水平的IL-10将表明该细胞因子在减弱免疫反应的促炎作用方面具有一致的调节作用。