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IL-8 is a pro-inflammatory cytokine produced by a variety of cells such as epithelial cells, fibroblasts, endothelial cells, lymphocytes, mast cells, and macrophages in response to inflammatory mediators [120]

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136 Likewise, acute recurrent rhinosinusitis treated with nasal douche consisting of flunisolide (corticosteroid) and N-acetylcysteine has been associated with a less stuffy nose, reduction in severity of symptoms and rhinosinus signs as assessed by endoscopy, improved cytological grading of neutrophil and eosinophil cells, less exacerbations, and increased mucociliary motility