pulmicort and Carcinoma--Squamous-Cell

 Endoscopic resection is the treatment of choice for early esophageal cancers. However, resections comprising more than 70-80 % of the circumference are associated with a high risk of stricture formation. Currently, repetitive local injections and/or systemic steroids are given for prevention..  We present here the case of a 78-year-old male patient who had a near circumferential endoscopic submucosal dissection for a pT1a mm, L0, V0, R0, G2 esophageal squamous cell cancer. At the end of endoscopic resection, 80 mg of triamcinolone was injected locally. The patient was then treated with oro-dispersible budesonide tablets (2 × 1 mg/day) and nystatin (4 × 100 000 I.E.) for 8 weeks. This treatment resulted in complete healing without any stricture formation and did not result in any complications..  Treatment with orodispersible budesonide tablets could help prevent strictures after large endoscopic resections in the esophagus..  Die endoskopische Resektion von Ösophagusfrühkarzinomen ist der aktuelle Therapiestandard. Allerdings sind Resektionen von mehr als 70–80 % der Zirkumferenz mit einem sehr hohen Strukturrisiko behaftet. Aktuell werden zur Prävention wiederholte lokale Steroidinjektionen und/oder systemische Steroide eingesetzt..  Wir berichten über einen 78-jährigen Mann, bei dem wegen eines Plattenepithelfrühkarzinoms (pT1a mm, L0, V0, R0, G2) eine subtotal zirkumferentielle endoskopische Submukosadissektion durchgeführt worden war. Am Ende der Resektion wurde einmalig 80 mg Triamcinolon lokal injiziert. Anschließend wurde über 8 Wochen mit oro-dispersiblen Budesonid Tabletten (2 × 1 mg) und Nystatin (4 × 100 000 I.E.) behandelt. Diese Therapie führte zu einer kompletten Ausheilung ohne Ausbildung einer Striktur. Komplikationen wurden nicht beobachtet..  Die Therapie mit orodispersiblen Budesonid Tabletten könnte zur Prävention von Strikturen nach ausgedehnten endoskopischen Resektionen im Ösophagus hilfreich sein.

Topics: Aged; Budesonide; Carcinoma, Squamous Cell; Constriction, Pathologic; Esophageal Neoplasms; Esophageal Stenosis; Esophagoscopy; Humans; Male; Postoperative Complications; Tablets

Topics: Acute Disease; Adult; Alanine Transaminase; Anti-Inflammatory Agents; Anus Neoplasms; Aryl Hydrocarbon Hydroxylases; Budesonide; Carcinoma, Squamous Cell; Chemical and Drug Induced Liver Injury; Cytochrome P-450 CYP3A; Cytochrome P-450 Enzyme Inhibitors; Cytochrome P-450 Enzyme System; Drug Therapy, Combination; HIV Infections; HIV Protease Inhibitors; Humans; Middle Aged; Oxidoreductases, N-Demethylating; Ritonavir

Inhaled corticosteroids in the treatment of asthma have been shown to produce marked reductions in the number of inflammatory cells (mainly mast cells and eosinophils) and their products at bronchial level (such as cytokines). Recently, it has been demonstrated that epithelial cells express ICAM-1/CD54 in allergic patients both during natural allergen exposure and after allergen challenge. We have previously demonstrated that deflazacort (a systemic steroid) reduces the expression of ICAM-1 on conjunctival epithelial cells. The present study aimed to evaluate the effects exerted by budesonide on adhesion molecule expression by a human epithelial cell line (lung carcinoma: DM) and on soluble ICAM-1. Budesonide was added at concentrations corresponding to 10(-8), 10(-7), and 10(-6) mol/l in cultured epithelial cells, either in the absence of any stimulus or in the presence of interferon-gamma (IFN-gamma) at 500 U/ml. After 24 h of incubation, cytofluorometric analysis was performed for ICAM-1 and CD29/VLA beta 1. The 24-h supernatants of the same cultures were collected and then evaluated for soluble ICAM-1 (sICAM-1). The results showed that budesonide inhibits ICAM-1 and CD29 basal expression on the cells studied (P < 0.05): budesonide was effective in a dose-dependent manner. In addition, budesonide reduced surface ICAM-1 upregulation induced by IFN-gamma at 500 U/ml (P < 0.05). Finally, cell cultures with budesonide showed decreased levels of soluble ICAM-1 in basal condition, but not after IFN-gamma stimulation.

Topics: Anti-Inflammatory Agents; Asthma; Bronchodilator Agents; Budesonide; Carcinoma, Squamous Cell; Drug Evaluation, Preclinical; Humans; Integrin beta1; Intercellular Adhesion Molecule-1; Interferon-gamma; Lung Neoplasms; Tumor Cells, Cultured

The transcription factor Fos is involved in cell proliferation and differentiation. Its expression in normal and pathological adult human tissues and cells has rarely been studied. We therefore studied bronchial biopsies obtained from 14 normal subjects (NS), 18 non-steroid-treated asthmatics, 10 corticosteroid-treated asthmatics and 10 patients with chronic bronchitis (CB), in addition to 34 patients with lung cancer (LC), by immunofluorescence for Fos immunoreactivity, using a highly specific polyclonal antibody. Bronchial tissue of 0/10 NS, 11/18 non-steroid-treated asthmatics, 1/10 steroid-treated asthmatics, 0/10 CB and 1/34 LC expressed Fos. In asthmatic patients, the expression was heterogeneous, localized to epithelial cells and correlated with the epithelium shedding (tau = 0.45, P = 0.0001). Corticosteroid-treated patients rarely expressed Fos, suggesting a role for this proto-oncogene in asthmatic bronchial inflammation. Fos was rarely expressed in the normal and pathological (CB, LC) proliferative compartment of the human bronchi, suggesting its low role in cell proliferation of the large airways.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Aged, 80 and over; Asthma; Beclomethasone; Bronchi; Bronchitis; Budesonide; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Chronic Disease; Female; Fluorescent Antibody Technique; Humans; Lung Neoplasms; Male; Middle Aged; Pregnenediones; Proto-Oncogene Mas; Proto-Oncogene Proteins c-fos