Corticosteroid treatment regulates mucosal remodeling in chronic rhinosinusitis with nasal polyps. (13th January 2015)

• Record Type: Journal Article
• Authors: de Borja Callejas, Francisco; Martínez‐Antón, Asunción; Picado, César; Alobid, Isam; Pujols, Laura; Valero, Antonio; Roca‐Ferrer, Jordi; Mullol, Joaquim
• Is Part Of: Laryngoscope. Volume 125:Number 5(2015:May)
• Page Start: E158
• Page End: E167
• Publication Date: 2015-01-13
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.25147
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary25147-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To investigate the effect of oral plus intranasal corticosteroid (CS) treatment on nasal polyp (NP) mucosa remodeling from patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP).</p> </sec> <sec id="lary25147-sec-0002" sec-type="section"> <title>Study Design</title> <p>Case series, retrospective study.</p> </sec> <sec id="lary25147-sec-0003" sec-type="section"> <title>Methods</title> <p>Patients (n = 18) with severe CRSwNP were treated with oral prednisone for 2 weeks and intranasal budesonide for 12 weeks. NP biopsies were obtained from patients biopsies before (w0) and after 2 weeks (w2) and 12 weeks (w12) of CS treatment. Matrix metalloprotease 1 (MMP‐1), MMP‐2, MMP‐7, MMP‐9, and tissue inhibitor of metalloprotease type 1 (TIMP‐1) expression was evaluated by immunohistochemistry in cell and tissue structures. Epithelial damage, eosinophil infiltration, and collagen content were also examined in NP tissues before and after CS treatment.</p> </sec> <sec id="lary25147-sec-0004" sec-type="section"> <title>Results</title> <p>Compared to w0: 1) oral plus intranasal CS significantly (<italic>P</italic> < .01) increased presence of submucosal glands at w2, decreased epithelial cell hyperplasia at w12, and decreased tissue eosinophilia at w2 and w12; 2) CS treatment significantly (<italic>P</italic> < .05) increased immunoreactivity for MMP‐1 and MMP‐2 in the epithelium at w2, but decreased immunoreactivity for MMP‐9 in the epithelium at w2 and w12; 3) at w12, CS significantly (<italic>P</italic> < .05) reduced MMP‐9 immunoreactive positivity and intensity in the extracellular matrix, while increasing total collagen amount in the extracellular matrix; and 4) CS treatment significantly (<italic>P</italic> < .01) reduced the number of eosinophils and their MMP and TIMP‐1 immunoreactive expression.</p> </sec> <sec id="lary25147-sec-0005" sec-type="section"> <title>Conclusions</title> <p>CS treatment modulates NP mucosa remodeling, particularly by promoting epithelial repair, regulating tissue remodeling markers, increasing total collagen content, and reducing tissue eosinophil infiltration.</p> </sec> <sec id="lary25147-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4 <italic>Laryngoscope</italic>, 125:E158–E167, 2015</p> </sec> </abstract>