The Effects of Systemic, Topical, and Intralesional Steroid Treatments on Apoptosis Level of Nasal Polyps

Kapucu, Burak; Cekin, Engin; Erkul, Evren; Cincik, Hakan; Güngör, Atila; Berber, Ufuk

doi:10.1177/0194599812446678

Cited by 19 publications

(14 citation statements)

References 24 publications

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“…Interestingly, a clinical study found remarkable differences in the outcomes of topical steroid-treated patients versus those receiving systemic treatment. It has also been reported that systemic GCs are beneficial to OE regeneration or olfactory nerve recovery ( Carbone et al, 2003 ; Heilmann et al, 2004 ; Kapucu et al, 2012 ). The route of administration seems to be very important for reproducing DEX effects, which appears to be hazardous to neuronal recovery independently of the OE lesion model.…”

Section: Discussionmentioning

confidence: 98%

Topical Dexamethasone Administration Impairs Protein Synthesis and Neuronal Regeneration in the Olfactory Epithelium

Crisafulli

Xavier

Santos

et al. 2018

Front. Mol. Neurosci.

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Chronic inflammatory process in the nasal mucosa is correlated with poor smell perception. Over-activation of immune cells in the olfactory epithelium (OE) is generally associated with loss of olfactory function, and topical steroidal anti-inflammatory drugs have been largely used for treating such condition. Whether this therapeutic strategy could directly affect the regenerative process in the OE remains unclear. In this study, we show that nasal topical application of dexamethasone (DEX; 200 or 800 ng/nostril), a potent synthetic anti-inflammatory steroid, attenuates OE lesion caused by Gram-negative bacteria lipopolysaccharide (LPS) intranasal infusion. In contrast, repeated DEX (400 ng/nostril) local application after lesion establishment limited the regeneration of olfactory sensory neurons after injury promoted by LPS or methimazole. Remarkably, DEX effects were observed when the drug was infused as 3 consecutive days regimen. The anti-inflammatory drug does not induce OE progenitor cell death, however, disturbance in mammalian target of rapamycin downstream signaling pathway and impairment of protein synthesis were observed during the course of DEX treatment. In addition, in vitro studies conducted with OE neurospheres in the absence of an inflammatory environment showed that glucocorticoid receptor engagement directly reduces OE progenitor cells proliferation. Our results suggest that DEX can interfere with the intrinsic regenerative cellular mechanisms of the OE, raising concerns on the use of topical anti-inflammatory steroids as a risk factor for progressive olfactory function impairment.

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Section: Discussionmentioning

confidence: 98%

Topical Dexamethasone Administration Impairs Protein Synthesis and Neuronal Regeneration in the Olfactory Epithelium

Crisafulli

Xavier

Santos

et al. 2018

Front. Mol. Neurosci.

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“…On the other hands, several studies have indicated that induction of apoptosis in in ammatory cells of the NP, particularly eosinophils, can play a signi cant role in improving the disease conditions [21,28].…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Sambucus Ebulus Fruits Extract Ameliorates Eosinophilic Nasal Polyposis: An in vitro Study

Faghani¹,

Pourgholamali²,

Ansar³

et al. 2020

Preprint

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Background: The Sambucus Ebulus (ES) L. has an anti-inflammatory role by reducing the expression of pro-inflammatory genes and free radicals. The aim of this study was to evaluate the anti-inflammatory effect of hydroalcoholic extract of SE fruits on eosinophilic nasal polyposis (NP) in Vitro.Method: The chemical composition of SE fruits extract was determined by gas chromatography-mass spectrometry. Polyp Samples were collected from 40 patients and were cut into four pieces (control and case groups). Tissue fragments were treated with 0 (control), 50, 315 and 1000µg/ml of SE FRUIT extract in a culture medium for 24 hours. Apoptosis was detected by TUNEL reaction reagent. Real time-PCR was employed to evaluate the expression of Bax and Bad genes. ELISA was used for assay of IL-5 and GM-CSF.Results: Our findings showed SE fruits extract increased apoptosis in nasal polyp tissues compared to the control group (P<0.001). Also, GM-CSF level in the experimental groups was significantly lower than that in the control group (P<0.001). In contrast, the level of IL-5 was not significantly different in the treatment and control groups (P>0.05). Bax and Bad expression showed a significant increase in the experimental groups compared to the control group (P<0.001).Conclusion: Our findings showed that SE fruits hydroalcoholic extract ameliorates NP trough elevation of apoptosis and reduction of inflammatory markers. Our experimental data revealed that SE fruits extract plays an important role in the treatment of nasal polyp through inducing apoptosis and reducing the survival of inflammatory cells.

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“…Five studies were included in this review -two randomized clinical trials (RCTs) and three retrospective studies (Table 1). [20][21][22][23][24] Inclusion criteria, characteristics and comorbidities for patients in the studies are summarized in Table 2, whereas effects found in the studies are summarized in Table 3. In each of the five studies triamcinolone acetonide (TAA, Kenalog 40 V R ) was injected.…”

Section: Resultsmentioning

confidence: 99%

Injection of Steroid in Nasal Polyps: A Systematic Review

Hansen

Alanin

2020

Am J Rhinol�Allergy

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Background Chronic rhinosinusitis (CRS) is a common chronic condition classically divided into two phenotypes according to the presence or absence of nasal polyps. The effects of both medical and surgical treatment are often temporary, encouraging research into new treatment options. Methods We performed a systematic review related to dosages, effects, side effects, and safety of intrapolyp steroid injection in patients with nasal polyps. We identified five studies with a total of 386 patients and 2490 intrapolyp steroid injections. Results Treatment with intrapolyp steroid injection leads to a decrease in the Total Nasal Polyps Score (TNPS), Total Nasal Symptom Score (TNSS), and Lund-Mackay Score. The dosage regimens vary from 10 to 40 mg triamcinolone acetonide. Only two cases of temporary visual complications were reported. Conclusion This review found that intrapolyp steroid injection may be an effective and safe treatment for patients with nasal polyps. However, there exist no large, randomized, clinical trials. We found no association between dose and effect, or dose and the risk of visual complications.

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The Effects of Systemic, Topical, and Intralesional Steroid Treatments on Apoptosis Level of Nasal Polyps

Abstract: The apoptotic index in nasal polyps treated with systemic, topical, and intrapolyp injection forms of glucocorticoids was higher than that in the control group. Systemic steroid treatment induced the most apoptosis.

Cited by 19 publications

References 24 publications

Topical Dexamethasone Administration Impairs Protein Synthesis and Neuronal Regeneration in the Olfactory Epithelium

Topical Dexamethasone Administration Impairs Protein Synthesis and Neuronal Regeneration in the Olfactory Epithelium

WITHDRAWN: Sambucus Ebulus Fruits Extract Ameliorates Eosinophilic Nasal Polyposis: An in vitro Study

Injection of Steroid in Nasal Polyps: A Systematic Review

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