Topical intranasal corticosteroids and growth velocity in children: a meta‐analysis

Mener, David J.; Shargorodsky, Josef; Varadhan, Ravi; Lin, Sandra Y.

doi:10.1002/alr.21430

Cited by 33 publications

(29 citation statements)

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“…The corticosteroid action may be the result of multifactorial effects on several levels of the inflammatory reaction [25]. On the mucosal level, corticosteroids reduce the number of antigen-presenting cells, lymphocytes, eosinophils, and mast cells.…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged corticosteroid administration reduces the eosinophil infiltration in nasal mucosa by suppressing the production of eosinophil chemokines (RANTES, eotaxins, etc.) [25]. Disturbance of eosinophil infiltration and activation leads to the reduction in release of toxic enzymes (ECP, MBP, EPOs), resulting in lower degree of Clara cell injuries.…”

Section: Discussionmentioning

confidence: 99%

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Eosinophil Chemokines and Clara Cell Protein 16 Production in Nasal Mucosa of Patients with Persistent Allergic Rhinitis

et al. 2017

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Objective: Eotaxin-2 and regulated on activation normal T cell expressed and secreted (RANTES) are involved in the eosinophil trafficking in patients with persistent allergic rhinitis (PAR). Clara cell protein 16 (CC16) is an anti-inflammatory protein mainly produced by the epithelial non-ciliated Clara cells. The aim of this study was to investigate the production of CC16 and chemokines eotaxin-2 and RANTES in nasal mucosa of patients with PAR.Materials and Methods: Twenty-one PAR patients and 20 healthy participants were included. CC16, eotaxin-2, and RANTES concentrations were measured in nasal secretions. PAR patients were administered fluticasone furoate nasal spray (220 μg daily for 14 days). We performed nasal cytology, symptom score assessment, and inflammatory mediator detection before and after the therapy.Results: The level of CC16 in patients with PAR was lower than in the healthy subjects (p=0.023). The eosinophil counts and local concentrations of eotaxin-2 and RANTES were higher in patients with PAR in comparison with controls (p=0.008, p=0.001, p=0.031, respectively). We also found a negative correlation between the CC16 and eotaxin-2 levels in nasal secretions of PAR patients (r=−0.492, p=0.023). After corticosteroid therapy, the patients with PAR had lower nasal symptoms, eosinophil counts, eotaxin-2, and RANTES levels and higher levels of CC16 (p<0.001 for all parameters). Conclusion:Our results suggest the presence of a negative correlation in production of CC16 and eotaxin-2 in nasal mucosa of patients with PAR. Intranasal corticosteroids have a suppressive effect on mucosal eosinophilic inflammation and a stimulating effect on local CC16 production.Keywords: Allergic rhinitis, chemokines, eosinophils, glucocorticoids, inflammation mediators ÖZ Amaç: Eotaksin-2 ve RANTES (aktivasyonla regüle edilen, normal T hücresi ekspresyonu ve sekresyonu) persistan alerjik riniti (PAR) olan hastalarda eozinofil göçünde yer almaktadır. Clara hücresi protein 16 (CC16) çoğunlukla sil içermeyen epitelyal hücreler tarafından üretilirler. Bu çalışmanın amacı PAR hastalarının nazal mukozasında CC16 ve eotaksin-2 ve RANTES kemokinlerinin üretimini araştırmaktır. Gereç ve Yöntemler:Çalışmaya 21 PAR hastası ve 20 sağlıklı katılımcı dahil edildi. Nazal sekresyonlardaki CC16, eotaksin-2 ve RANTES seviyeleri ölçüldü. PAR hastalarına flutikazon furoat nazal sprey uygulandı (14 gün boyunca günlük 220 μg doz). Tedavi öncesi ve sonrasında, nazal sitoloji, semptom skoru değerlendirmesi ve inflamatuar mediyatör taraması yapıldı.Bulgular: CC16 seviyesi PAR hastalarında sağlıklı deneklere kıyasla daha düşük bulundu (p=0,023). Kontrollere göre, eozinofil sayıları ve lokal eotaksin-2 ve RANTES seviyeleri PAR hastalarında daha yüksekti (sırasıyla p=0,008, p=0,001, p=0,031). Ayrıca PAR hastalarının nazal sekresyonlarında CC16 ile eotaksin-2 düzeyleri arasında negatif bir korelasyon bulundu (r=-0,492, p=0,023). Kortikosteroid tedavisi sonrasında, PAR hastalarında daha düşük nazal semptomlar, eozinofil sayıları, eotaksin-...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Eosinophil Chemokines and Clara Cell Protein 16 Production in Nasal Mucosa of Patients with Persistent Allergic Rhinitis

et al. 2017

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“…In the nasal mucosa, glucocorticoids decrease the number of antigen-presenting cells, lymphocytes, mast cells, and eosinophils. Prolonged corticosteroid treatment suppresses the production of eosinophil chemoattractants and eosinophil infiltration in the nasal mucosa (24). This, in turn, lowers the release of toxic enzymes (ECP, MBP, and others) that damage the Clara cells.…”

Section: The Role Of Cc16 In Ar and Crsmentioning

confidence: 99%

Clara cell protein 16 release from the nasal mucosa in allergic rhinitis, chronic rhinosinusitis, and exposure to air pollutants

Perić

Mirković

Vojvodić

2018

Archives of Industrial Hygiene and Toxicology

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Clara cell protein 16 (CC16) is a small protein mainly produced by non-ciliated Clara cells in the respiratory epithelium. It has an anti-inflammatory role in chronic upper and lower airway eosinophilic inflammations. Decreased levels of CC16 are found in the nasal secretions and plasma of patients with chronic eosinophilic inflammatory disorders, such as asthma, allergic rhinitis, and chronic rhinosinusitis with or without nasal polyps, as well as in people exposed to high levels of air pollutants. Intranasal corticosteroid administration suppresses chronic inflammation of the nasal mucosa driven by eosinophils and stimulates local CC16 production. CC16 can be a reliable biomarker of the beneficial effects of perennial allergic rhinitis and chronic rhinosinusitis therapy and of the functional recovery of the nasal mucosa after treatment with topical glucocorticoids.

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“…В обзоре D. Mener и соавт. [24] отмечено, что короткие курсы ИКС при лечении аллергического ринита у детей могут затормаживать краткосрочный рост, но при этом остается неясным, как это сказывается на долгосрочном росте. Кроме этого, ИКС не оказывают влияние на уровень кальция и половых гормонов [17].…”

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The risk of development of the adverse reactions to the application of intranasal corticosteroids

Perich¹,

Perić²

2017

Ross. rinol.

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Topical intranasal corticosteroids and growth velocity in children: a meta‐analysis

Abstract: Meta-analytic pooling of trials suggest that short-term ITC for the treatment of AR in children may decrease short-term growth velocity using knemometry; however, the effect on longer-term growth velocity as measured by stadiometry is unclear.

Cited by 33 publications

References 33 publications

Eosinophil Chemokines and Clara Cell Protein 16 Production in Nasal Mucosa of Patients with Persistent Allergic Rhinitis

Eosinophil Chemokines and Clara Cell Protein 16 Production in Nasal Mucosa of Patients with Persistent Allergic Rhinitis

Clara cell protein 16 release from the nasal mucosa in allergic rhinitis, chronic rhinosinusitis, and exposure to air pollutants

The risk of development of the adverse reactions to the application of intranasal corticosteroids

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