Is Steroids good for Nasal Polyps ? ( How to Cure Nasal Polyps without Steroids )

Human nasal mucosa was obtained from 32 healthy subjects (20 males) aged 30.3 + 2.4 years, undergoing nasal corrective surgery for turbinate hypertrophy or septal dismorphy. None of the subjects were treated with steroids. The skin-prick test for common allergens was positive in five subjects (16%) and negative in 27 (84%). 

Nasal polyps were obtained from 27 patients (19 males) aged 47+ 2.6 years, undergoing nasal polypectomy. At the time when polypectomy was carried out, eight patients (30%) were receiving intranasal steroids (fluticasone or budesonide, 200-400mg/day), one (4%) was receiving oral prednisone (40 mg/day), and six (22%) were receiving both intranasal (budesonide or fluticasone, 400 mg/day) and oral steroids (prednisone or deflazacort, 20-40 mg/day). The remaining 12 patients (44%) had not received steroid treatment for at least 1 month prior to surgery. Twelve subjects (44%) had asthma, half of these were aspirin-intolerant. The skin- prick test was positive in five patients (18%), negative in 16 (59%), and it could not be determined in the remaining six patients (22%). The study was approved by the Ethics Committee of Institution.

Results : This study is well established that some patients with nasal polyps fail to respond to steroids therapy . On the basis of our previous studies suggesting a relative resistance of nasal polyp epithelial cells to the antiinflammatory effect of steroids,  the study hypothesized that nasal polyp epithelial cells might mediate part of this resistance through overexpression of the GRb is oform.

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