Mechanisms underlying glucocorticoid resistance in chronic rhinosinusitis with nasal polyps
10.3760/cma.j.issn.1673-0860.2018.02.017
- VernacularTitle: 慢性鼻-鼻窦炎伴鼻息肉治疗中糖皮质激素抵抗的机制
- Author:
Yunyun ZHANG
1
,
2
;
Hongfei LOU
1
,
2
;
Chengshuo WANG
1
,
2
;
Luo ZHANG
1
,
2
,
3
Author Information
1. Deparment of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
2. Beijing Key Laboratory of Nasal Diseases, Beijing Institude of Otorhinolaryngology, Beijing 100005, China
3. Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
- Publication Type:Review
- Keywords:
Nasal polyps;
Glucocorticoids;
Immunity
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2018;53(2):154-160
- CountryChina
- Language:Chinese
-
Abstract:
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease that occurs in the nasal and sinus mucosa, which is a common disease in otorhinolaryngology. At present, CRSwNP can be effectively treated by glucocorticoids (GC). GC binds to GC receptors in the nasal mucosa, affects the expression of inflammatory genes, inhibits the activation and action of eosinophils, T cell-associated inflammatory responses in nasal polyps, as well as tissue remodeling. However, there are some patients fall reponse to GC, so called GC resistance. The study suggests that the possible mechanism of CRSwNP GC resistance is mainly related to GC receptor abnormal, the role of cytokines and transcription factors, such as Th cells and IL-8. In addition, MAPK-related kinases and histone deacetylase in the GC signaling pathway also play important roles in the GC resistance process. This paper reviews the mechanism of GC treatment of CRSwNP, the mechanism of GC resistance and alternative treatment of GC.
