Intranasal steroids decrease eosinophils but not mucin expression in nasal polyps

The aim of this paper is to present an up-to-date information about therapeutical options in chronic rhinosinusitis with nasal polyps. First choice therapy is a long term regular application of intranasal steroids in combination with salinic solution douches. If this treatment is not eff ective enough, then the pulses of systemic steroids are indicated. If the sufficient control of the disease is not achieved, then surgery is a therapeutic choice; it means functional endoscopic sinus surgery in the extent corresponding to the extension of the sinus disease. However, there remains a certain group of patients in whom the results with this treatment are not optimal. The type 2 immunopathological response affects relevantly the course of the disease. Nowadays, the research is done in this field. Specific agents, which are able to block circulating inflammatory mediators or bind receptors for these mediators are developed and studied. The results of the studies having been completed by now are promising. Keywords: biological therapy – chronic rhinosinusitis – nasal polyps – dupilumab – immunoglobulin E – interleukin

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Major Secretory Mucin Expression in Chronic Sinusitis

Otolaryngology ◽

10.1016/j.otohns.2005.06.005 ◽

2005 ◽

Vol 133 (3) ◽

pp. 423-428 ◽

Cited By ~ 16

Author(s):

Mahmoud S. Ali ◽

David A. Hutton ◽

Janet A. Wilson ◽

Jeffrey P. Pearson

Keyword(s):

Surgical Treatment ◽

Prospective Studies ◽

Nasal Polyps ◽

Inverse Relationship ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Prognostic Indicators ◽

Nasal Mucus ◽

Mucin Expression

OBJECTIVE: The aim of this study was to investigate mucin expression in chronic sinusitis compared to that in normal nasal mucus. STUDY DESIGN AND SETTING: Sinus mucus samples were collected during functional endoscopic sinus surgery (FESS). The expression of 3 airway mucins, MUC2, MUC5AC, and MUC5B, was determined by ELISA. RESULTS: The 3 mucins are expressed in chronic sinusitis and in normal nasal mucus. MUC5AC and MUC5B represent a major component in sinus mucins while MUC5B and MUC2 predominated in normal nasal mucin. In sinus mucins, upregulation of MUC5AC was associated with downregulation of MUC2 and vice versa. This inverse relationship was strengthened in the presence of nasal polyps. CONCLUSION: At least 3 mucins are expressed at various levels in chronic sinusitis. An inverse relationship was identified between expression of MUC5AC and MUC2. Large prospective studies are required to unravel the complexities of sinus mucus in chronic sinusitis. SIGNIFICANCE: Mucins may be used as markers for assessment of disease severity and may also help as prognostic indicators following medical or surgical treatment.

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Mucin Expression and Corticosteroid Efficacy in Chronic Rhinosinusitis with Nasal Polyps

Journal of Steroids & Hormonal Science ◽

10.4172/2157-7536.s12-007 ◽

2013 ◽

Vol s12 (01) ◽

Author(s):

Cortijo J Armengot M

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Mucin Expression

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Corticosteroid therapy increases membrane-tethered while decreases secreted mucin expression in nasal polyps

Allergy ◽

10.1111/j.1398-9995.2008.01678.x ◽

2008 ◽

Vol 63 (10) ◽

pp. 1368-1376 ◽

Cited By ~ 23

Author(s):

A. Martínez-Antón ◽

C. de Bolós ◽

I. Alobid ◽

P. Benítez ◽

J. Roca-Ferrer ◽

...

Keyword(s):

Corticosteroid Therapy ◽

Nasal Polyps ◽

Mucin Expression

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Intranasal Corticosteroids for the Medical Management of Nasal Polyps in Adults: a Meta-Analysis

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v22i1-2.787 ◽

2007 ◽

Vol 22 (1-2) ◽

pp. 5-11 ◽

Cited By ~ 1

Author(s):

Natividad A. Almazan-Aguilar

Keyword(s):

Ordinal Data ◽

Nasal Polyps ◽

Meta Analysis ◽

P Value ◽

Controlled Trials ◽

Significant Heterogeneity ◽

Polyp Size ◽

Intranasal Corticosteroids ◽

Validity Assessment ◽

Intranasal Steroids

Background: This systematic review aims to strengthen evidence of beneficial effects of intranasal corticosteroids on the medical treatment of adults diagnosed with nasal polyps. Objectives: (1) To determine the efficacy of short term (2 to 4 weeks) and long term (4 to 12 weeks and > 12 weeks) of intranasal corticosteroids in the reduction of polyp size and rhinitis symptoms. (2). To determine the difference in efficacy of a 400 ug and 800 ug dose. (3) To determine adverse effects of intranasal steroids. Study Design and Selection Criteria: Meta-analysis of randomized controlled trials on intranasal steroids for nasal polyps. Patient-oriented outcomes were reduction of polyp size and overall reduction of rhinitis symptoms. Search Strategy: Comprehensive search of Cochrane's Controlled Trials Registry (CCTR) Issue 2, 2003, Medline 1966 to 2002, and Embase 1974 - 2002 bibliographic review, requests for information from authors and pharmaceutical companies. Data collection and analysis: Sixteen studies were evaluated for inclusion, and trial quality, validity assessment, and completion of data extraction were done. Ordinal data on rhinitis and polyp scores for each study were pooled to generate relative risks. Homogeneity was assessed using approximate chi-square tests. Preset p value of < 0.10 was deemed significant for heterogeneity. Data were analyzed using software program Revman 4.1(Update Software, Oxford). Sensitivity analysis was done for those outcomes with significant heterogeneity. Results and Conclusion: Fourteen studies found significant benefit for the use of intranasal steroids in reduction of polyp size with 2-4 weeks treatment (RR=3.00; 95% Cl: 2.39, 3.77). Overall rhinitis symptoms decreased significantly (RR=1.64; 95% Cl: 1.25, 2.14) with 4-12 weeks treatment, with a tendency for reduction of rhinitis symptoms (RR=1.41; 95% Cl: 1.05, 1.91) with more than 12 weeks treatment. Throat irritation was significantly increased (RR=2.06; 95% Cl 1.31, 3.25). There was no difference in overall rhinitis symptoms (RR=0.91; 95% Cl:0.77, 1.07) with 400 ug and 800 ug doses. Keywords: polyp, nose, steroids, intranasal steroids, glucocorticosteroid

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