Mechanism of action of glucocorticoids in nasal polyposis

Fernandes, Atílio Maximino; Valera, Fabiana Cardoso Pereira; Anselmo‐Lima, Wilma Terezinha

doi:10.1016/s1808-8694(15)31101-0

Cited by 21 publications

(36 citation statements)

References 22 publications

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“…Nasal polyposis has been known since the time of Hippocrates. 1 Benson stated that this variation may result from differences in the expression of glucocorticoid receptors. Upon histopathological examination, various inflammatory cells are observed, with eosinophils predominant, within an oedematous stroma.…”

Section: Discussionmentioning

confidence: 99%

“…1 For the treatment of nasal polyposis, they are used via the oral, intranasal and systemic routes. In the human body, they are produced by the adrenal glands under the control of the hypothalamic-pituitary-adrenal axis.…”

Section: Introductionmentioning

confidence: 99%

“…1 Apart from glucocorticoids, intranasal capsaicin, macrolides, amphotericin B nasal spray and intranasal lysine-acetylsalicylic acid have all been used as medical therapy. Although they are not effective in all nasal polyposis patients, a therapeutic effect is seen in 60-80 per cent of cases.…”

Section: Introductionmentioning

confidence: 99%

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Effect of glucocorticoids on nasal polyposis, with detection of inflammatory response by measurement of nitric oxide levels in nasal polyp tissue

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of glucocorticoids on nasal polyposis, with detection of inflammatory response by measurement of nitric oxide levels in nasal polyp tissue

et al. 2013

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“…However, its mechanism of action in the regression of clinical symptoms and polyps is not fully understood. The topical or systemic use of glucocorticoids leads to the variable expression of cytokines, chemokines and lymphokines, as well as, changes in cells [14].…”

Section: Discussionmentioning

confidence: 99%

Hydroxyproline levels in nasal polyps

Cincik

Kapucu

İpçioğlu

et al. 2011

Eur Arch Otorhinolaryngol

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The aim of this study was to evaluate hydroxyproline levels in nasal specimens from patients with nasal polyps, and to examine hydroxyproline levels after nasal steroid spray and oral steroid treatments. This study was performed on 41 patients. The subjects were divided into four groups: no medication group (group A, n 11), oral methylprednisolone group (group B, n 8), topical steroid spray group (group C, n 8) and control group (group D, n 14). Nasal polyp samples were collected endoscopically. Healthy subjects were studied as a control group, and their nasal samples were taken during turbine reduction surgery. All samples were analyzed using the immunocytochemistry method. Hydroxyproline levels were investigated and compared with the control group. Mean hydroxyproline levels in groups A-D were 98.48, 24.20, 8.97 and 4.52, respectively. The hydroxyproline levels were significantly higher in group A compared with that of group D. The treatment that revealed significant decreases in hydroxyproline levels was group C. Although there was also a noticeable reduction in group B, there were no statistically significant differences between group B and group A. Our study revealed a significant correlation between nasal polyp and hydroxyproline levels. The hydroxyproline levels were significantly higher in nasal polyps. Both oral and topical steroid treatments decrease hydroxyproline levels in nasal polyps. Thus, in theory, steroid treatment can directly decrease hydroxyproline levels by inhibiting proline hydroxylase and indirectly by lowering the inflammatory process.

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“…Dexamethasone and fluticasone propionate, which are synthetic glucocorticoids (GCs), possess potent anti-inflammatory and immunosuppressive properties and are used to treat asthma, allergic rhinitis, nasal polyps, and skin disorders 17 . Dexamethasone treatment suppresses EMT-related morphological changes and protein alteration through Smad and non-Smad signaling pathways in hepatocytes 18 .…”

Section: Introductionmentioning

confidence: 99%

Glucocorticoids ameliorate TGF-β1-mediated epithelial-to-mesenchymal transition of airway epithelium through MAPK and Snail/Slug signaling pathways

Yang

Lee

Shin

et al. 2017

Sci Rep

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Chronic rhinosinusitis with nasal polyps (CRSwNP) is closely associated with tissue remodeling. Epithelial-to-mesenchymal transition (EMT), a process of tissue remodeling, can be a therapeutic target of CRSwNP. Glucocorticoids are a type of steroid hormone that is used primarily in medical therapy for patients with CRSwNP; however, their effects on EMT in the airway epithelium remain unknown. To investigate the effects of dexamethasone and fluticasone propionate, a class of glucocorticoids, on transforming growth factor-β1 (TGF-β1) -induced EMT, we used A549 cells, human primary nasal epithelial cells (hPNECs) and ex vivo organ culture of the inferior turbinate. TGF-β1 induced changes in cell morphology, suppressed the expression of E-cadherin and enhanced the expression of a-smooth muscle actin, vimentin and fibronectin in A549 cells. However, glucocorticoids inhibited EMT, migration and invasion enhancement by TGF-β1. We found that the induction of phosphorylated ERK, p38 and the activity of Snail and Slug transcription factors by TGF-β1 were suppressed by glucocorticoids. Glucocorticoids also had a similar effect in hPNECs and ex vivo organ cultures of the inferior turbinate. These findings suggest that glucocorticoids might be a useful therapy for preventing tissue remodeling by blocking the EMT initiated by TGF-β1-induced MAPK and Snail/Slug signaling pathways in CRSwNP.

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Mechanism of action of glucocorticoids in nasal polyposis

Abstract: Understanding the mechanism of action of GC in nasal polyposis will aid in the development of new, more efficient, drugs.

Cited by 21 publications

References 22 publications

Effect of glucocorticoids on nasal polyposis, with detection of inflammatory response by measurement of nitric oxide levels in nasal polyp tissue

Effect of glucocorticoids on nasal polyposis, with detection of inflammatory response by measurement of nitric oxide levels in nasal polyp tissue

Hydroxyproline levels in nasal polyps

Glucocorticoids ameliorate TGF-β1-mediated epithelial-to-mesenchymal transition of airway epithelium through MAPK and Snail/Slug signaling pathways

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