Lijie Jiang1, Min Zhou1, Jie Deng1, Yueqi Sun1, Kejun Zuo1, Rui Zheng1, Jianbo Shi2, Yinyan Lai3. 1. The Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou, People's Republic of China. 2. The Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou, People's Republic of China. shijb@mail.sysu.edu.cn. 3. The Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou, People's Republic of China. Lai_yinyan@163.com.
Abstract
BACKGROUND: Glucocorticoids are the first-line medical treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), whose local metabolism is catalyzed by 11β-HSD1 and 11β-HSD2. This study investigates the role of 11β-HSD1 and 11β-HSD2 on the glucocorticoid response of CRSwNP patients and the pathogenic mechanism of these polyps. METHODS: Forty-three adult CRSwNP patients were enrolled in this study. We evaluated the endoscopic scores by a nasal polyp grading system before and after treatment. We estimated the response to glucocorticoids by the total endoscopic scores. The logistic regression models and inflammatory characteristic curves were conducted to explore the prediction of the response to glucocorticoid in CRSwNP. The expression of 11β-HSD1 and 11β-HSD2 on human sinonasal epithelial cells (HSECS) was measured under the stimulation of toll-like receptor agonists and dexamethasone. RESULTS: The endoscopic scores in the CRSwNP group declined, the expression of 11β-HSD1/11β-HSD2 increased (r = 0.5276, P = 0.0011), and the cutoff value of the ratio of 11β-HSD1/11β-HSD2 was 0.4654 (sensitivity 79.17%, specificity 88.89%). Dexamethasone induced a decrease in the ratio of 11β-HSD1/11β-HSD2 (P = 0.049) by the stimulation of PGN-BS. CONCLUSION: We found a strong correlation between the response to glucocorticoids and the ratio of 11β-HSD1/11β-HSD2, which could be used as a marker in predicting the level of tissue response to glucocorticoid therapy in CRSwNP. In addition, PGN-BS could also be a therapeutic target, as it is the negative factor that will decrease the sensitivity of glucocorticoids by reducing the ratio of 11β-HSD1/11β-HSD2.
BACKGROUND: Glucocorticoids are the first-line medical treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), whose local metabolism is catalyzed by 11β-HSD1 and 11β-HSD2. This study investigates the role of 11β-HSD1 and 11β-HSD2 on the glucocorticoid response of CRSwNP patients and the pathogenic mechanism of these polyps. METHODS: Forty-three adult CRSwNP patients were enrolled in this study. We evaluated the endoscopic scores by a nasal polyp grading system before and after treatment. We estimated the response to glucocorticoids by the total endoscopic scores. The logistic regression models and inflammatory characteristic curves were conducted to explore the prediction of the response to glucocorticoid in CRSwNP. The expression of 11β-HSD1 and 11β-HSD2 on human sinonasal epithelial cells (HSECS) was measured under the stimulation of toll-like receptor agonists and dexamethasone. RESULTS: The endoscopic scores in the CRSwNP group declined, the expression of 11β-HSD1/11β-HSD2 increased (r = 0.5276, P = 0.0011), and the cutoff value of the ratio of 11β-HSD1/11β-HSD2 was 0.4654 (sensitivity 79.17%, specificity 88.89%). Dexamethasone induced a decrease in the ratio of 11β-HSD1/11β-HSD2 (P = 0.049) by the stimulation of PGN-BS. CONCLUSION: We found a strong correlation between the response to glucocorticoids and the ratio of 11β-HSD1/11β-HSD2, which could be used as a marker in predicting the level of tissue response to glucocorticoid therapy in CRSwNP. In addition, PGN-BS could also be a therapeutic target, as it is the negative factor that will decrease the sensitivity of glucocorticoids by reducing the ratio of 11β-HSD1/11β-HSD2.
Authors: M Bresciani; L Paradis; A Des Roches; H Vernhet; I Vachier; P Godard; J Bousquet; P Chanez Journal: J Allergy Clin Immunol Date: 2001-01 Impact factor: 10.793
Authors: Eli O Meltzer; Daniel L Hamilos; James A Hadley; Donald C Lanza; Bradley F Marple; Richard A Nicklas; Allen D Adinoff; Claus Bachert; Larry Borish; Vernon M Chinchilli; Melvyn R Danzig; Berrylin J Ferguson; Wytske J Fokkens; Stephen G Jenkins; Valerie J Lund; Mahmood F Mafee; Robert M Naclerio; Ruby Pawankar; Jens U Ponikau; Mark S Schubert; Raymond G Slavin; Michael G Stewart; Alkis Togias; Ellen R Wald; Birgit Winther Journal: J Allergy Clin Immunol Date: 2006-11 Impact factor: 10.793
Authors: Karen E Chapman; Agnes Coutinho; Mohini Gray; James S Gilmour; John S Savill; Jonathan R Seckl Journal: Ann N Y Acad Sci Date: 2006-11 Impact factor: 5.691
Authors: Jongdae Lee; Tsung-Hsien Chuang; Vanessa Redecke; Liping She; Paula M Pitha; Dennis A Carson; Eyal Raz; Howard B Cottam Journal: Proc Natl Acad Sci U S A Date: 2003-05-08 Impact factor: 11.205