engleski

Eosinophil and mast cell activation after endosinusal treatment of chronic rhinosinusitis in asthmatics

Systemic and topic steroid treatment in nasal polyp patients significantly reduces infiltration and decreases activation of eosinophils and reduces nasal polyp size and symptoms. The study tested the hypothesis that reduction in eosinophils in the polyp tissue after steroid treatment is correlated with clinical improvement. Twenty adult patients with bilateral nasal polyps (14 males, 6 females, 3 asthma, 1 aspirin intolerance, 8 recurrent) scheduled for surgery were treated with oral methylprednisolon (1mg /kg) for 7 days preoperatively. Subjective nasal symptom scores, polyp size at endoscopy and polyp biopsy were done before the treatment and just before surgery. Polyps were fixed, paraffin embedded and stained with haematoxylin and eosin. Number of eosinophils was counted in the 10 high power fields (400x) in the polyp biopsies before and after treatment. Significant improvement in subjective scores, the reduction in the endoscopic scores and eosinophil count were found after the treatment. However, correlation between eosinophil count reduction and subjective improvement was not significant. The reduction in eosinophil count (2 to 10 times) in 15 and slight increase in 5 patients was found. Subjective improvement was found in 3 out of 5 patients without reduction in eosinophil count. Five out of 15 patients with eosinophil reduction did not have endoscopic size reduction and two did not have subjective improvement. Oral steroid treatment in nasal polyp patients significantly improves subjective scores, nasal polyp size and eosinophil count in the polyp tissue. Improvement is not related only to the reduction in eosinophil activation.

Chronic rhinosinusitis; asthma; endosinusal treatment

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