Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-26T22:59:07.491Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  15 April 2013

T Bülbül ,
Ö Gümüştekin Bülbül ,
O Güçlü ,
A Serpil Bilsel  and
S Önal Gürsan
T Bülbül
Affiliation:
Department of Otorhinolaryngology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey
Ö Gümüştekin Bülbül
Affiliation:
Department of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
O Güçlü*
Affiliation:
Department of Otorhinolaryngology, Çanakkale Onsekiz Mart University Faculty of Medicine, Turkey
A Serpil Bilsel
Affiliation:
Department of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
S Önal Gürsan
Affiliation:
Department of Otorhinolaryngology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey
*
Address for correspondence: Assist Prof Dr Oğuz Güçlü, Department of Otorhinolaryngology, Çanakkale Onsekiz Mart University Faculty of Medicine, 17100 Çanakkale, Turkey, Fax: +90 286 2180393 E-mail: droguzguclu@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate endoscopic staging, and nitric oxide levels in the polyp tissue, in patients with nasal polyposis undergoing glucocorticoid therapy.

Methods:

Nasal polyposis was evaluated using endoscopic staging and measurement of polyp tissue nitric oxide levels (chemiluminescence method). Forty-five nasal polyposis patients received either nasal therapy (n = 15), oral therapy (n = 15) or combined therapy (n = 15). Pre-treatment and post-treatment staging and nitric oxide levels were evaluated.

Results:

Endoscopic grading indicated significant post-treatment staging improvements in the oral (p = 0.016) and combined (p = 0.016) groups. Post-treatment staging differed significantly between the three groups (p = 0.041), with greater improvements in the oral and combined groups. All groups showed significantly lower post-treatment nitric oxide levels, compared with baseline, but post-treatment levels did not differ significantly between groups. A significant association was found between treatment response and nitric oxide level alteration.

Conclusion:

This study demonstrates the favourable effects of glucocorticoids on nasal polyposis, and alteration in nitric oxide tissue levels post-treatment. Nitric oxide level in nasal polyp tissue could be an indicator of treatment response, and may aid surgical decision-making by detecting cases that probably will not respond to medical treatment.

Keywords

Nasal PolypsNitric OxideGlucocorticoidsCorticosteroidsChemiluminescence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 6 , June 2013 , pp. 584 - 589
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fernandes, AM, Valera, FC, Anselmo-Lima, WT. Mechanism of action of glucocorticoids in nasal polyposis. Braz J Otorhinolaryngol 2008;74:279–83CrossRefGoogle ScholarPubMed
2Mladina, R, Clement, P, Lopadin, A, Mann, W, Passali, D. International Consensus on Nasal Polyposis 2002–2004. Eur Arch Otorhinolaryngol 2005;262:519–21CrossRefGoogle ScholarPubMed
3Seethala, RR, Pant, H. Pathology of nasal polyps. In: Onerci, TM, Ferguson, BJ, eds. Nasal Polyposis. Berlin, Heidelberg: Springer Verlag, 2010;17–26CrossRefGoogle Scholar
4Pearlman, AN, Chandra, RK, Conley, DB, Kern, RC. Epidemiology of nasal polyps. In: Onerci, TM, Ferguson, BJ, eds. Nasal Polyposis. Berlin, Heidelberg: Springer Verlag, 2010;9–16CrossRefGoogle Scholar
5Patiar, S, Reece, P. Oral steroids for nasal polyps. Cochrane Database Syst Rev 2007;(1):CD005232CrossRefGoogle ScholarPubMed
6Becker, SS, Duncavage, JA. The role of steroid injection in the management of sinonasal polyps. Curr Opin Otolaryngol Head Neck Surg 2008;16:38–43CrossRefGoogle ScholarPubMed
7Watkins, DN, Lewis, RH, Basclain, KA, Fisher, PH, Peroni, DJ, Garlepp, MJ et al. Expression and localization of the inducible isoform of nitric oxide synthase in nasal polyp epithelium. Clin Exp Allergy 1998;28:211–9CrossRefGoogle ScholarPubMed
8Kimberly, B, Nejadnik, B, Giraud, GD, Holden, WE. Nasal contribution to exhaled nitric oxide at rest and during breathholding in humans. Am J Respir Crit Care Med 1996;153:829–36CrossRefGoogle ScholarPubMed
9Oh, CK, Miman, MC, Duncavage, JA. Current value of nasal nitric oxide measurement in rhinology. Curr Opin Otolaryngol Head Neck Surg 2004;12:30–3CrossRefGoogle ScholarPubMed
10Lundberg, JO. Nitric oxide and the paranasal sinuses. Anat Rec (Hoboken) 2008;291:1479–84CrossRefGoogle ScholarPubMed
11Lundberg, JO, Weitzberg, E. Nasal nitric oxide in man. Thorax 1999;54:947–52CrossRefGoogle ScholarPubMed
12Benson, M. Pathophysiological effects of glucocorticoids on nasal polyps: an update. Curr Opin Allergy Clin Immunol 2005;5:31–5CrossRefGoogle ScholarPubMed
13Hamilos, DL, Leung, DY, Muro, S, Kahn, AM, Hamilos, SS, Thawley, SE et al. GRbeta expression in nasal polyp inflammatory cells and its relationship to the anti-inflammatory effects of intranasal fluticasone. J Allergy Clin Immunol 2001;108:59–68CrossRefGoogle Scholar
14Pujols, L, Alobid, I, Benítez, P, Martínez-Antón, A, Roca-Ferrer, J, Fokkens, WJ et al. Regulation of glucocorticoid receptor in nasal polyps by systemic and intranasal glucocorticoids. Allergy 2008;63:1377–86CrossRefGoogle ScholarPubMed
15Karataş, A, Koç, A, Bilgili, M. Preoperative systemic steroid therapy and results in sinonasal polyposis [in Turkish]. Türkiye Klinikleri J ENT 2004;4:90–4Google Scholar
16Özcan, C, Apa, DD, Pata, YS, Görür, K, Akbaş, Y. Expression of inducible nitric oxide synthase in antrochoanal polyps. Int J Pediatr Otorhinolaryngol 2003;67:383–8CrossRefGoogle ScholarPubMed
17Joe, SA, Thambi, R, Huang, J. A systematic review of the use of intranasal steroids in the treatment of chronic rhinosinusitis. Otolaryngol Head Neck Surg 2008;139:340–7CrossRefGoogle ScholarPubMed
18Damm, M, Jungehülsing, M, Eckel, HE, Schmidt, M, Theissen, P. Effects of systemic steroid treatment in chronic polypoid rhinosinusitis evaluated with magnetic resonance imaging. Otolaryngol Head Neck Surg 1999;120:517–23CrossRefGoogle ScholarPubMed
19Tuncer, U, Soylu, L, Aydogan, B, Karakus, F, Akcali, C. The effectiveness of steroid treatment in nasal polyposis. Auris Nasus Larynx 2003;30:263–8CrossRefGoogle ScholarPubMed
20Alobid, I, Benítez, P, Bernal-Sprekelsen, M, Roca, J, Alonso, J, Picado, C et al. Nasal polyposis and its impact on quality of life: comparison between the effects of medical and surgical treatments. Allergy 2005;60:452–8CrossRefGoogle ScholarPubMed
21Ramis, I, Lorente, J, Roselló-Catafau, J, Quesada, P, Gelpí, E, Bulbena, O. Differential activity of nitric oxide synthase in human nasal mucosa and polyps. Eur Respir J 1996;9:202–6CrossRefGoogle ScholarPubMed
22Maniscalco, M, Sofia, M, Pelaia, G. Nitric oxide in upper airways inflammatory diseases. Inflamm Res 2007;56:58–69CrossRefGoogle ScholarPubMed