Topical nasal steroids for treating nasal polyposis in people with cystic fibrosis

Beer, Helen; Southern, Kevin W; Swift, A. C.

doi:10.1002/14651858.cd008253.pub2

Cited by 9 publications

(4 citation statements)

References 16 publications

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“…Overall, there is no evidence for using topical steroids in patients with CF and nasal polyposis. 27 However, we recommend topical steroids as a part of the postoperative treatment, because they may reduce inflammation and the size of polyps and have limited side effects. 27 Adding baby shampoo to the saline, 28,29 using nebulizers for irrigations, and use of mucolytics [30][31][32] are all modalities that have been suggested by others as postoperative treatments.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Sinus Surgery with Intensive follow-up on Pathogenic Sinus Bacteria in Patients with Cystic Fibrosis

Aanæs

Buchwald

Hjuler

et al. 2013

Am J Rhinol�Allergy

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Section: Discussionmentioning

confidence: 99%

The Effect of Sinus Surgery with Intensive follow-up on Pathogenic Sinus Bacteria in Patients with Cystic Fibrosis

Aanæs

Buchwald

Hjuler

et al. 2013

Am J Rhinol�Allergy

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“…Various postinjury treatments with oral and topical corticosteroids are widely employed as anti-inflammatory agents for airway inflammatory diseases in our practice and others. [11][12][13] Previous studies have developed animal nasal mucosal injury models through mechanical injury and further assessment of the effects of glucocorticoids on wound healing. 2,15 Khalmuratova et al 2 showed that systemic administration of the corticosteroid, dexamethasone, after mucosal injury may lessen subepithelial edema and adhesion formation.…”

Section: Discussionmentioning

confidence: 99%

Topical Corticosteroid Pretreatment Mitigates Cellular Damage After Caustic Injury to the Nasal Upper Airway Epithelium

Huang

Velasquez

Nguyen

et al. 2019

Am J Rhinol�Allergy

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Background Topical corticosteroids are currently employed to reduce established airway inflammation; their prophylactic use might help limit cellular damage against harmful stimuli. Objectives To determine the effects of a prophylactic topical application of budesonide (BD) on an in vivo nasal epithelium injury model induced by trichloroacetic acid (TCA). Methods C57Bl/6 mice were exposed to intranasal TCA topical application. Three groups received topical intranasal BD, saline solution, or no intervention prior to a single topical exposure to TCA. Controls were not exposed to TCA. Whole nasal cavity coronal sections were analyzed at 1, 3, and 6 days postinjury at tissue and cellular levels using histopathological analysis, immunofluorescent staining, and fresh tissue RNA microarray analysis. Results Prophylactic topical corticosteroid exposure protected the nasal epithelium from acute damage, maintaining epithelial thickness and cell survival. Six days following TCA exposure, epithelial and cellular changes were less pronounced on the BD-treated group compared to all exposure groups. The microarray analysis was used to evaluate the gene transcripts in all treatment groups. Ciliary tip protein, Sentan, and submucosal protein S100b were identified as potential factors in epithelial airway protection; immunofluorescent staining corroborated their presence and location within the respiratory epithelium. Conclusion Topical corticosteroid treatment to the nasal epithelium can mitigate several of the early deleterious effects of acute epithelial damage in experimental airway injuries caused by TCA. These findings suggest a novel, direct cytoprotective effect of corticosteroids on the nasal epithelium, and the potential of expanding the use of prophylactic periprocedural topical corticosteroids for respiratory epithelial tissues.

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“…One double-blind, placebo-controlled, randomized study by Hadfield et al [52] revealed improvement in CF NP size with betamethasone nasal drops compared with placebo. However, the risk of bias was high in this study, as over 50% of patients did not complete follow-up [53]. Given the potential benefits of nasal saline irrigation as a delivery device, low absorption topical steroids (e.g., mometasone and budesonide) are commonly mixed with saline and prescribed for both non-CF and CF CRS.…”

Section: Corticosteroidsmentioning

confidence: 99%

Management of the upper airway in cystic fibrosis

Illing

Woodworth

2014

Current Opinion in Pulmonary Medicine

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Purpose of Review Upper airway disease engenders significant morbidity for patients with cystic fibrosis and is increasingly recognized as having a much greater role in pulmonary outcomes and quality of life than originally believed. Widespread disparate therapeutic strategies for cystic fibrosis chronic rhinosinusitis underscore the absence of a standardized treatment paradigm. This review outlines the most recent evidence-based trends in the management of upper airway disease in cystic fibrosis. Recent Findings The unified airway theory proposes that the sinuses are a focus of initial bacterial colonization which seeds the lower airway and may play a large role in maintaining lung infections. Mounting evidence suggests more aggressive treatment of the sinuses may confer significant improvement in pulmonary disease and quality of life outcomes in cystic fibrosis patients. However, there is a lack of high-level evidence regarding medical and surgical management of cystic fibrosis chronic rhinosinusitis that makes generalizations difficult. Summary Well designed clinical trials with long-term follow-up concerning medical and surgical interventions for cystic fibrosis sinus disease are required to establish standardized treatment protocols, but increased interest in the sinuses as a bacterial reservoir for pulmonary infections has generated considerable attention.

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Topical nasal steroids for treating nasal polyposis in people with cystic fibrosis

Cited by 9 publications

References 16 publications

The Effect of Sinus Surgery with Intensive follow-up on Pathogenic Sinus Bacteria in Patients with Cystic Fibrosis

The Effect of Sinus Surgery with Intensive follow-up on Pathogenic Sinus Bacteria in Patients with Cystic Fibrosis

Topical Corticosteroid Pretreatment Mitigates Cellular Damage After Caustic Injury to the Nasal Upper Airway Epithelium

Management of the upper airway in cystic fibrosis

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