title: Corticosteroid treatment regulates mucosal remodeling in chronic rhinosinusitis with nasal polyps.
abstract: OBJECTIVE
  To investigate the effect of oral plus intranasal corticosteroid (CS) treatment on nasal polyp (NP) mucosa remodeling from patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP).
  
  
  METHODS
  Case series, retrospective study.
  
  
  METHODS
  Patients (n = 18) with severe CRSwNP were treated with oral prednisone for 2 weeks and intranasal budesonide for 12 weeks. NP biopsies were obtained from patients biopsies before (w0) and after 2 weeks (w2) and 12 weeks (w12) of CS treatment. Matrix metalloprotease 1 (MMP-1), MMP-2, MMP-7, MMP-9, and tissue inhibitor of metalloprotease type 1 (TIMP-1) expression was evaluated by immunohistochemistry in cell and tissue structures. Epithelial damage, eosinophil infiltration, and collagen content were also examined in NP tissues before and after CS treatment.
  
  
  RESULTS
  Compared to w0: 1) oral plus intranasal CS significantly (P < .01) increased presence of submucosal glands at w2, decreased epithelial cell hyperplasia at w12, and decreased tissue eosinophilia at w2 and w12; 2) CS treatment significantly (P < .05) increased immunoreactivity for MMP-1 and MMP-2 in the epithelium at w2, but decreased immunoreactivity for MMP-9 in the epithelium at w2 and w12; 3) at w12, CS significantly (P < .05) reduced MMP-9 immunoreactive positivity and intensity in the extracellular matrix, while increasing total collagen amount in the extracellular matrix; and 4) CS treatment significantly (P < .01) reduced the number of eosinophils and their MMP and TIMP-1 immunoreactive expression.
  
  
  CONCLUSIONS
  CS treatment modulates NP mucosa remodeling, particularly by promoting epithelial repair, regulating tissue remodeling markers, increasing total collagen content, and reducing tissue eosinophil infiltration.
  
  
  METHODS
  4
authors: Department of Clinical and Experimental Respiratory Immunoallergy, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Centers for Biomedical Research Network in Respiratory Diseases, Barcelona, Spain.
authors: Francisco
authors: F
authors: de Borja Callejas
authors: Asunción
authors: A
authors: Martínez-Antón
authors: César
authors: C
authors: Picado
authors: Isam
authors: I
authors: Alobid
authors: Laura
authors: L
authors: Pujols
authors: Antonio
authors: A
authors: Valero
authors: Jordi
authors: J
authors: Roca-Ferrer
authors: Joaquim
authors: J
authors: Mullol
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D001706:Biopsy; D019819:Budesonide / Q000008:administration & dosage; D002908:Chronic Disease; D017364:Collagenases / Q000096:biosynthesis*; D004359:Drug Therapy, Combination; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000201:enzymology / Q000473:pathology*; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D019714:Tissue Inhibitor of Metalloproteinases / Q000096:biosynthesis*
chemical_list: D005938:Glucocorticoids; D019714:Tissue Inhibitor of Metalloproteinases; D019819:Budesonide; D017364:Collagenases; D011241:Prednisone
keywords: Corticosteroids; chronic rhinosinusitis with nasal polyp; eosinophilic inflammation; matrix metalloproteases; remodeling