Zhang Y Y, Lou H F, Wang C S, Zhang L
Deparment of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institude of Otorhinolaryngology, Beijing 100005, China.
Deparment of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institude of Otorhinolaryngology, Beijing 100005, China; Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Feb 7;53(2):154-160. doi: 10.3760/cma.j.issn.1673-0860.2018.02.017.
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.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）是一种发生于鼻腔和鼻窦黏膜的慢性炎症性疾病，是耳鼻咽喉科的常见疾病。目前，CRSwNP可通过糖皮质激素（GC）有效治疗。GC与鼻黏膜中的GC受体结合，影响炎症基因的表达，抑制嗜酸性粒细胞的活化和作用、鼻息肉中T细胞相关的炎症反应以及组织重塑。然而，有一些患者对GC治疗无反应，即所谓的GC抵抗。研究表明，CRSwNP发生GC抵抗的可能机制主要与GC受体异常、细胞因子和转录因子（如Th细胞和IL-8）的作用有关。此外，GC信号通路中的丝裂原活化蛋白激酶相关激酶和组蛋白去乙酰化酶在GC抵抗过程中也起重要作用。本文综述了GC治疗CRSwNP的机制、GC抵抗的机制以及GC的替代治疗。
