Fernandes Atílio Maximino, Valera Fabiana Cardoso Pereira, Anselmo-Lima Wilma T
Doutorado USP/Ribeirão Preto, Brazil.
Braz J Otorhinolaryngol. 2008 Mar-Apr;74(2):279-83. doi: 10.1016/s1808-8694(15)31101-0.
Glucocorticoids (GC) are the drugs of choice for the clinical treatment of nasal polyposis, according to the medical literature. Its mechanism of action in the regression of clinical symptoms and polyps, however, is not fully understood. The topical and/or systemic use of glucocorticoids lead to variable expression of cytokines, chemokines and lymphokines, as well as changes in cells. It is known that GC suppresses the expression of pro-inflammatory cytokines, chemokines and adhesion molecules such as ICAM-1 and E-selectin; GC also stimulate the transcription of anti-inflammatory cytokines such as TGF-b. GC suppress pro-fibrotic cytokines related to polyp growth, such as IL-11, the basic fibroblast growth factor (b-FGF), and the vascular endotelial growth factor (VEGF). The action of GC depends fundamentally on their interaction with receptors (GR); certain subjects have a degree of resistance to its effect, which appears to be related with the presence of a b isoform of GR. GC also act variably on the genes involved in immunoglobulin production, presentation, and antigen processing.
We present a review of the literature on the mechanisms of GC action in nasal polyosis.
Understanding the mechanism of action of GC in nasal polyposis will aid in the development of new, more efficient, drugs.
根据医学文献,糖皮质激素(GC)是鼻息肉临床治疗的首选药物。然而,其在缓解临床症状和息肉消退方面的作用机制尚未完全明确。糖皮质激素的局部和/或全身使用会导致细胞因子、趋化因子和淋巴因子的表达变化以及细胞改变。已知GC可抑制促炎细胞因子、趋化因子和黏附分子如ICAM-1和E-选择素的表达;GC还可刺激抗炎细胞因子如TGF-β的转录。GC可抑制与息肉生长相关的促纤维化细胞因子,如IL-11、碱性成纤维细胞生长因子(b-FGF)和血管内皮生长因子(VEGF)。GC的作用主要取决于它们与受体(GR)的相互作用;某些个体对其作用存在一定程度的抵抗,这似乎与GR的β亚型的存在有关。GC对参与免疫球蛋白产生、呈递和抗原加工的基因也有不同作用。
我们对糖皮质激素在鼻息肉病中的作用机制的文献进行综述。
了解糖皮质激素在鼻息肉病中的作用机制将有助于开发新的、更有效的药物。