Department of Ophthalmology, Otorhinolaryngology and Head and neck Surgery, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil.
Rhinology. 2010 Dec;48(4):408-41. doi: 10.4193/Rhino09.161.
To correlate clinical prognosis to the expression of p65, c-Fos, GRalpha and GRbeta in patients with nasal polyps.
A biopsy was obtained at the first evaluation for patients with nasal polyps (20), and at rhinoplasty for control mucosa (8). Patients with nasal polyps were treated with glucocorticoids and followed for at least 30 months. The expression of each gene (p65, c-Fos, GRalpha and GRbeta) was determined by Real Time-PCR and correlated to clinical outcome. The indication for surgery was considered the end-point of resistance to glucocorticoid therapy.
Patients with nasal polyps presented a higher expression of p65 (P<0.05), and a lower expression of GRalpha (P<0.0001), and of GRalpha/GRbeta relation (P<0.0001) than controls. The nasal polyps patients with higher expression of p65 correlated with a poorer response to glucocorticoids (P<0.05), with a four-fold higher risk for surgery to control symptoms.
Patients with nasal polyps presented higher gene expression of p65, and a reduced expression of GRalpha and of GRalpha/GRbeta relation than controls. Higher p65 (NFkappaB) expression at diagnosis was also associated to a worst response to medical treatment, suggesting this could be considered as one mechanism of cell resistance to glucocorticoid treatment in patients with nasal polyps.
将 p65、c-Fos、GRalpha 和 GRbeta 的表达与鼻息肉患者的临床预后相关联。
对鼻息肉患者（20 例）进行首次评估时和鼻整形术时获取活检，对对照粘膜进行 8 例。对鼻息肉患者用糖皮质激素治疗并至少随访 30 个月。通过实时 PCR 确定每个基因（p65、c-Fos、GRalpha 和 GRbeta）的表达，并将其与临床结果相关联。手术的指征被认为是对糖皮质激素治疗的耐药性的终点。
鼻息肉患者的 p65 表达较高（P<0.05），GRalpha（P<0.0001）和 GRalpha/GRbeta 比值（P<0.0001）较低。p65 表达较高的鼻息肉患者与对糖皮质激素反应较差相关（P<0.05），手术控制症状的风险增加了四倍。
鼻息肉患者的 p65 基因表达较高，GRalpha 和 GRalpha/GRbeta 比值表达降低。诊断时更高的 p65（NFkappaB）表达也与对药物治疗的反应较差相关，这表明这可能被认为是鼻息肉患者对糖皮质激素治疗的细胞耐药机制之一。
