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

Bulbul, Tahir; Bülbül, Özlem Gümüştekin; Güçlü, Oğuz; Bilsel, A Serpil; Gürsan, S Önal

doi:10.1017/s002221511300073x

Cited by 13 publications

(7 citation statements)

References 22 publications

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“…Another trial considered oral GCS versus placebo as an adjunct to treatment with intranasal GCS in CRSwNP patients [65]. This study recruited 30 participants and was considered at high risk of bias because of lack of blinding and lack of information on randomization.…”

Section: Evidence For Efficacy Of Systemic Gcs In Different Inflammatmentioning

confidence: 99%

Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Hox

Lourijsen

Jordens

et al. 2020

Clin Transl Allergy

132

111

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Because of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that—potentially severe—side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.

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Section: Evidence For Efficacy Of Systemic Gcs In Different Inflammatmentioning

confidence: 99%

Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Hox

Lourijsen

Jordens

et al. 2020

Clin Transl Allergy

132

111

View full text Add to dashboard Cite

show abstract

“…The mechanism of corticosteroid action may be a multifactorial effect on various aspects of the inflammatory reaction, initiated by steroid binding to a specific cytoplasmic glucocorticoid receptor. 28 Specific effects of fluticasone furoate seen in experimental sensitized rats included activation of the glucocorticoid response element, inhibition of transcription factors such as nuclear factor kappa-B (NFκB), and inhibition of antigen-induced eosinophilia. 29 Our previous investigation demonstrated that RANTES levels in nasal secretions could be a useful path in the assessment of effects of macrolide antibiotic treatment in both allergic and nonallergic patients with nasal polyposis.…”

Section: Discussionmentioning

confidence: 99%

Effects of Fluticasone Furoate Nasal Spray on Parameters of Eosinophilic Inflammation in Patients With Nasal Polyposis and Perennial Allergic Rhinitis

Mirković

Perić

Đurđević

et al. 2017

Ann Otol Rhinol Laryngol

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“…38 Additionally, the included studies focused on the resolution of individual symptoms instead of overall effect on quality of life or endoscopic exams, and did not identify if an underlying CRS condition was present. 20,39 A recent study by Ho et al showed that patients with eosinophilic CRSwNP and aspirin sensitivity tend to require systemic therapy with OCS and/or biologic agents after ESS because of acute exacerbation of the disease in the postoperative setting. 40 However, no study has reviewed INCS in addition to OCS in the immediate postoperative setting for CRSwNP patients with positive bacterial cultures.…”

Section: Discussionmentioning

confidence: 99%

Sinonasal Outcomes Using Oral Corticosteroids in Patients with Chronic Rhinosinusitis with Nasal Polyps and Positive Sinonasal Cultures

Martinez-Paredes

Donaldson

Marino

et al. 2022

Int Arch Otorhinolaryngol

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Introduction Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and positive sinonasal bacterial cultures may be recalcitrant to topical therapy alone due to the additional local inflammatory burden associated with bacterial infection/colonization. Objective To evaluate sinonasal outcomes in CRSwNP patients with a positive perioperative bacterial culture, who were treated with postoperative intranasal corticosteroids (INCS) alone versus INCS in combination with a short-term course of oral corticosteroids (OCS). Methods This is a retrospective chart review of CRSwNP patients. A total of 59 patients met inclusion criteria, including positive perioperative bacterial culture and treatment with INCS with or without concomitant use of OCS. Two cohorts were formed based on the chosen postoperative medical treatment; 32 patients underwent postoperative INCS alone, while 27 underwent INCS plus a ≤ 2-week course of OCS. The 22-item sinonasal outcome test (SNOT-22) scores and Lund-Kennedy scores (LKS) were assessed preoperatively, and at 2-week, 4-week, and 4 to 6 months after endoscopic sinus surgery (ESS). Results There were no statistically significant differences in postoperative sinonasal symptoms or endoscopic scores between the cohorts treated with INCS plus OCS versus those prescribed INCS alone (p > 0.05). Our regression model failed to demonstrate a relationship between the use of OCS and better sinonasal outcomes at 2-week, 4-week, and 4 to 6 months after ESS (p > 0.05). Conclusion Our study suggests that in a cohort of CRSwNP patients with recent bacterial infections, the postoperative use of combined OCS and INCS did not result in a statistical improvement of endoscopic and symptomatic outcomes over INCS irrigation alone. However, both treatment groups had a clinically significant improvement based on the Minimal Clinically Important Difference.

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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

Cited by 13 publications

References 22 publications

Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Effects of Fluticasone Furoate Nasal Spray on Parameters of Eosinophilic Inflammation in Patients With Nasal Polyposis and Perennial Allergic Rhinitis

Sinonasal Outcomes Using Oral Corticosteroids in Patients with Chronic Rhinosinusitis with Nasal Polyps and Positive Sinonasal Cultures

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