Mode of action of intranasal corticosteroids

Mygind, Niels; Nielsen, Lars Peter; Hoffmann, Hans‐Jürgen; Shukla, Alok; Blumberga, G.; Dahl, Ronald; Jacobi, Henrik H.

doi:10.1067/mai.2001.115561

Cited by 108 publications

(78 citation statements)

References 127 publications

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“…GRs, which belong to the superfamily of nuclear hormone receptors, mediate most of known effects of glucocorticoids [9]. The glucocorticoid affinity sites in nasal tissue have been shown to be in epithelium, veins, leukocytes, and glands [10] and we could now see the same distribution in the uvular tissue. In this study, a decrease in the severity of snoring was noted among a few patients treated with MF, indicating a possible future role for some patients for this line of treatment.…”

Section: Discussionsupporting

confidence: 55%

To treat snoring with nasal steroids – effects on more than one level?

Hultcrantz

Harder

Harder³

et al. 2010

Acta Oto-Laryngologica

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Objective: To investigate the effect and safety of a nasal steroid, mometasone furoate (MF), on snoring and related discomfort.Method I: Six patients with social snoring had uvular and nasal biopsies examined using immunohistochemistry to evaluate whether corticosteroid receptors were present. Method II:100 patients with snoring, not earlier using steroids, answered a questionnaire about symptoms, had ENT status assessed and used a diary for seven days reporting sleep and related variables. After randomization to placebo or MF, they used nasal spray for three months. Thereafter the same procedure was repeated. Results: Corticosteroid receptors were present in the mucus membranes and around the blood vessels in all uvulas. No decrease in -mean snoring score‖ was seen. Day-time sleepiness and stuffed nose showed a slight improvement in the MF group and the partners were less disturbed. Minor side effects were reported, equal for both groups.

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Section: Discussionsupporting

confidence: 55%

To treat snoring with nasal steroids – effects on more than one level?

Hultcrantz

Harder

Harder³

et al. 2010

Acta Oto-Laryngologica

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“…By contrast, no evidence has been seen so far that indicates that pDC play a role in lower respiratory tract immunology (40). A number of mechanisms described above could account for the effects of therapeutic treatment strategies such as the use of topical corticosteroids in suppressing the seasonal increases in the number of nasal mucosal CD1 + LC by the inhibition of the release of cytokines such as Granulocyte-Macrophage-Colony-StimulatingFactor (GM-CSF) from the epithelial cells of the respiratory tract and IL-4, which favour the activation and differentiation of DC in vivo and in vitro (39,(41)(42)(43)(44)(45).…”

Section: Antigen Presenting Cells Of the Nasal Mucosamentioning

confidence: 99%

The role of antigen presenting cells at distinct anatomic sites: they accelerate and they slow down allergies

Novak

Allam

Betten

et al. 2003

Allergy

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It has been repeatedly demonstrated that allergic reactions are driven by the continuous flow of antigen uptake and presentation processes, which are perpetuated mainly by dendritic cells (DC). The ability of allergens to cause allergic inflammation is contingent upon the presence of an immunological milieu and microenvironment that either privileges Th2 responses or prohibits these reactions by the induction of contraregulatory anti‐inflammatory activities of the immune system. In the light of recent developments it appears that DC have to manage two opposing tasks: on the one hand they can favor pro‐inflammatory reactions and actively induce a T‐cell response, yet on the other hand they serve an important function as ‘silencers’ in the immune system by sending out anti‐inflammatory, tolerance inducing signals. This unique capacity of DC has opened several exciting possibilities for a role of DC in both – accelerating and slowing down allergic reactions. It is therefore a challenge to understand in which way DC subtypes located at distinct anatomic sites with frequent allergen exposure, such as the skin, the nasal mucosa, the respiratory tree or the mucosa of the intestinal tract can have an impact on mechanisms involved in tolerance induction or effective immunity.

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“…ГКС уменьшают срок жизни эозинофилов, снижают количество Т-клеток в эпи-телии, ингибируют продукцию IgE. ГКС не действуют на нейтрофилы и макрофаги, никак не изменяя иммунный ответ на бактериальную инфекцию [11,41,[46][47][48][49].…”

Section: игксunclassified

“…При ОРС ИГКС уменьшают воспаление, связанное с такими симптомами, как заложенность носа, головная боль и лицевая боль [46,50].…”

Section: игксunclassified

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Place of Topical Steroid Therapy in the Treatment of Acute Rhinosinusitis

Косяков¹,

Минавнина²

2017

Medicinskij sovet

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С.Я. КОСЯКОВ, д.м.н., профессор, Ю.В. МИНАВНИНА Российская медицинская академия непрерывного профессионального образования, Москва МЕСТО ТОПИЧЕСКОЙ СТЕРОИДНОЙ ТЕРАПИИ В ЛЕЧЕНИИ ОСТРОГО РИНОСИНУСИТАОстрый риносинусит -это распространенное воспаление носа и околоносовых пазух. Диагноз «синусит» основывается на сочетании клинических данных с осмотром, данными инструментальных исследований. На вирусные ОРС приходится свыше 90% случаев заболевания. Бактериальная этиология синусита имеет место примерно в 55-65% случаев. Целью лечения острого РС является ликвидация очага инфекции, восстановление пассажа в области остиомеатального комплекса, налаживание дренажной функции, уменьшение воспаления и облегчение симптомов, таких как боль и заложенность носа. Основными направлениями лечения являются антибактериальная терапия, ирригация, противовоспалительная терапия. Топические кортикостероиды -препараты первой линии, наряду с ирригацией. Они могут использоваться как в качестве монотерапии, так и в дополнение к антибактериальной терапии. При легких формах ОРС мометазон в дозе 400 мкг/сут оказался значительно более эффективным, чем плацебо и амоксициллин. А добавление топических кортикостероидов (МФ) к стандартному курсу системной антибиотикотерапии (амоксициллин/клавуланат, цефуроксим) значительно быстрее по сравнению с плацебо облегчало симптомы острого РС и ускоряло выздоровление. Интраназальные стероиды помогают в лечении дневного кашля. При сравнении с лечением другими ИГКС мометазон обладает большей эффективностью, безо-пасностью, лучшим разрешением симптомов, меньшей стоимостью лечения. Мометазон может использоваться беременны-ми женщинами без опасения системных проявлений. Ключевые слова: острый риносинусит, топические стероиды, мометазона фуроат. S.Ia. KOSYAKOV, PhD in medicine, professor, J.V. MINAVNINA, FSBEI FPE Russian Medical Academy of Continuous Professional Education, Moscow PLACE OF TOPICAL STEROID THERAPY IN THE TREATMENT OF ACUTE RHINOSINUSITISAcute rhinosinusitis is a common inflammation of the nose and paranasal sinuses. The sinusitis diagnosis is based on a combination of clinical data with examination, data of instrumental studies. Viral ARS accounts for more than 90 per cent of cases. The bacterial etiology of sinusitis occurs in around 55-65% of cases. The purpose of the treatment of the acute RS is to eliminate the focus of infection, restore the ostiomeatal complex, regulate a drainage function, reduce inflammation and alleviate symptoms such as pain and nasal congestion. The main areas of treatment are antibacterial therapy, irrigation, anti-inflammatory therapy. Topical corticosteroids -first line drugs, along with irrigation. They can be used both as monotherapy as well as in addition to antibacterial therapy. In the light forms of ARS mometazone at a dosage of 400 μg per day was much more efficient than placebo and amoxicillin. And the addition of topical corticosteroids (MF) to the standard course of system antibiotic therapy (amoxicillin/clavulanate, cefuroxime) was much faster than the placebo...

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Mode of action of intranasal corticosteroids

Cited by 108 publications

References 127 publications

To treat snoring with nasal steroids – effects on more than one level?

To treat snoring with nasal steroids – effects on more than one level?

The role of antigen presenting cells at distinct anatomic sites: they accelerate and they slow down allergies

Place of Topical Steroid Therapy in the Treatment of Acute Rhinosinusitis

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