Does vitamin D have protective effect on human nasal polyposis: histological and immunohistochemical study

Abstract

Background: Nasal polyps (NPs) are benign pedicled mucosal protrusions into the nasal cavity of multifactorial origin. Vitamin D has been demonstrated as having potential immunomodulatory activity and act as an antiproliferative agents. Aim of the work: To determine the possible antiproliferative effect and immunomodulatory activity of VD on human nasal polyposis. Material and methods: Based on thirty patients and divided equally into 3 groups. Group Ι (healthy subjects). Group ΙΙ were received low daily oral dose of VD(1000 IU) for 4 weeks. Group ΙΙΙ were received high daily oral dose of VD(4000 IU) for 4 weeks.Each group ΙΙ and ΙΙΙ divided into 2 subgroups; group b: patients with NP before taking VD and group a: patients with NP after taking. Nasal biopsies were obtained of all groups for histological examination and immunohistochemical detection of Toll-like receptors 9 expression. Results: patients of nasal polyps before VD taking (groups IIb and IIIb) presented with symptoms of Visual Analogue Scale, VAS score (facial pain, headache, nasal blockage, nasal discharge, post-nasal drip and olfactory disturbance) and endoscopic appearance of Lund and Mackey score (polypi, edema and discharge), damage of respiratory epithelium, extensive accumulation of collagen fibers in lamina propria and highly expressed TLR-9. The high dose VD group (IIIa) showed near normal respiratory epithelium, significant decrease (P<0.05) in all symptoms of VAS score, endoscopic appearance of Lund and Mackey score. The mean area % of submucosal accumulation of collagen fibers and TLR-9 expression were also significant decreased but decrease was insignificant (P<0.05) in the low dose VD group (IIa). Conclusion: VD participate significantly in protection against human nasal polyposis when used by high therapeutic dose, by reducing the size of nasal polyps, relieving the symptoms and signs of nasal polyposis.

The Effect of Vitamin D Supplement on the Relapsing Incidence of Rhinosinusitis with Nasal Polyposis after Fuctional Endoscpoic Sinus Surgery

“…Therefore, it was concluded that high-dose VD 3 supplementation may be more effective in the clinical improvement, relief of NP symptoms, and postoperative nasal mucosa repair due to its anti-inflammatory role in the body. [ 18 ]…”

“…On the other hand, the use of VD at high therapeutic doses has been known to reduce the size of the NPs, relieve the symptoms of NPs, and restore nasal mucosa to its normal state. [ 16 17 18 ] Therefore, these findings may be useful in two ways, first to allow more effective types of NP treatment, especially in patients with poor conditions or in patients who refuse surgery, and secondly to prescribe VD as a posttreatment supplement after surgery to prevent NP recurrence. However, given the uncertainty in this area, further studies seem to be necessary.…”

Association between serum vitamin D and chronic rhinosinusitis: a meta-analysis

“…This analysis result was in accord with a study by Faruk, which indicated that vitamin D is protective against the development of sinusitis and that the lack of vitamin D might induce the development of pre-septal cellulitis. Meanwhile the symptoms and signs of CRS could be relieved by administration of vitamin D. 28 …”

Comparative Study between Vitamin D and Placebo in Patients with Nasal Polyps

“…Faruk et al [18] investigated the efficacy of a large -dose [4000 IU/day] and a low-dose [1000 IU/day] vitamin D3 in lowering the size of nasal polyps and alleviating illness symptoms. The group that got high-dose vitamin D3 demonstrated a considerable reduction in all visual analogue scale symptoms [VAS] and endoscopic scores, which was almost identical to the results of the current investigation.…”