mometasone-furoate and Hyperplasia

To demonstrate the long-term efficacy of intranasal furosemide, an inhibitor of the sodium chloride cotransporter channel at the basolateral surface of the respiratory epithelial cell, vs no therapeutic intervention vs intranasal mometasone furoate, a corticosteroid, in preventing relapses of chronic hyperplastic sinusitis with nasal polyposis.. Randomized prospective controlled study. Patients were examined every 6 months during follow-up (range, 1-9 years).. One hundred seventy patients with bilateral obstructive or minimally obstructive chronic hyperplastic sinusitis with nasal polyposis.. All patients were surgically treated in the ENT Department, University of Siena Medical School. One month after surgery, group 1 patients (n = 97) started treatment with intranasal furosemide, group 2 (n = 40) received no therapeutic treatment, and group 3 (n = 33) were treated with mometasone.. Clinical and instrumental evaluation of postoperative outcomes.. Seventeen (17.5%) of 97 patients in group 1, 12 (30.0%) of 40 patients in group 2, and 8 (24.2%) of 33 patients in group 3 experienced nasal polyposis relapses. We noted a prevalence of early-stage relapse in patients treated with furosemide or mometasone, whereas patients who did not receive any treatment experienced more severe grades of chronic hyperplastic sinusitis with nasal polyposis (P<.005).. Use of intranasal furosemide represents a valid therapeutic treatment in the prevention of chronic hyperplastic sinusitis with nasal polyposis.

Topics: Administration, Intranasal; Adult; Anti-Inflammatory Agents; Chronic Disease; Diuretics; Female; Furosemide; Humans; Hyperplasia; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Nasal Polyps; Paranasal Sinuses; Pregnadienediols; Prospective Studies; Secondary Prevention; Sinusitis; Sodium Chloride Symporters; Symporters; Treatment Outcome

The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 (EMP1) in the nasal mucosa of patients with nasal polyps (NP), and to determine what changes occur in response to glucocorticosteroid (GC) treatment.. NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs (i.e. these 18 patients had NP biopsies taken before and after treatment). Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls. Quantitative PCR and immunohistochemistry were performed to determine the expression levels of EMP1. EMP1 mRNA expression was significantly lower (2.77-fold) in tissues from NP patients before GC treatment when compared to controls, but was increased in these patients after GC treatment. EMP1 staining in nasal epithelium co-localized with both basal (p63(+)) and differentiated (CK18(+)) epithelial cells. Their immunoreactivity was significantly greater in controls than NP patients. EMP1 mRNA levels were lower in the epithelium with severe hyperplasia (1.79-fold) or with metaplasia (1.85-fold) as compared to those with mild to moderate hyperplasia or non-metaplastic epithelium, respectively. Positive correlations between EMP1 and other epithelial cell-related gene (e.g. JUN, PTGS2, AREG etc.) mRNAs were observed.. EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa (e.g. NP).

Topics: Adult; Anti-Inflammatory Agents; Down-Regulation; Epithelium; Female; Humans; Hyperplasia; Male; Metaplasia; Middle Aged; Mometasone Furoate; Nasal Mucosa; Nasal Polyps; Neoplasm Proteins; Pregnadienediols; Receptors, Cell Surface

Topics: Alopecia; Child; Dermatologic Agents; Humans; Hyperplasia; Hypohidrosis; India; Male; Mometasone Furoate; Pregnadienediols; PUVA Therapy; Skin