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Effects of intranasal steroid treatment on the presence of biofilms in non-allergic patients with chronic rhinosinusitis with nasal polyposis

  • Rhinology
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Abstract

Microbial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal application of corticosteroids (INCS) is a reliable option in the management of CRSwNP. INCS medication has been suspected to influence the presence and thickness of microbial biofilms and inflammatory cell patterns in CRSwNP. Two series of identical nasal polyps obtained from non-allergic patients with CRSwNP (n = 56), who underwent endoscopic sinus surgery (ESS), were processed to hematoxylin–eosin (H.E.) and Gram staining, respectively. Patients were recruited into three groups. Group A (n = 21) consisted of patients with continuous preoperative INCS treatment. In group B (n = 17), patients were never treated by INCS, while in group C (n = 18) INCS medication was stopped at least 6 months before ESS. Biofilm positivity varied from 76.4 to 88.8 % in different subject groups. These values and average thickness of biofilms did not reach statistically significant levels (Mann–Whitney’s U probe, p > 0.05) in different patient groups. In contrast, microscopic pattern and numbers of predominant inflammatory cell populations displayed obvious differences according to INCS treatment (Mann–Whitney’s U probe, p < 0.001). According to these observations, INCS treatment does not affect the presence and thickness of microbial biofilms in CRSwNP. In contrast, it has significant effects on the pattern of inflammatory cells infiltrating the subepithelial layer, which might result in beneficially altered extracellular matrix production and cytokine release.

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Acknowledgments

This work was supported by the grants of Hungarian Scientific Research Fund (OTKA PD75371 and OTKA K108292).

Conflict of Interest

Authors have no conflicts of interest.

Ethical Standard

This study was approved by the Institutional Ethical Committee.

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Authors and Affiliations

  1. Department of Rheumatology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary

    Péter Csomor

  2. Department of Otolaryngology and Head and Neck Surgery, Medical and Health Science Center, University of Debrecen, Nagyerdei Krt. 98., Debrecen, 4032, Hungary

    István Sziklai & Tamás Karosi

Authors
  1. Péter Csomor
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  2. István Sziklai
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  3. Tamás Karosi
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Corresponding author

Correspondence to Tamás Karosi.

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All authors contributed equally to this work.

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Csomor, P., Sziklai, I. & Karosi, T. Effects of intranasal steroid treatment on the presence of biofilms in non-allergic patients with chronic rhinosinusitis with nasal polyposis. Eur Arch Otorhinolaryngol 271, 1057–1065 (2014). https://doi.org/10.1007/s00405-013-2666-y

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  • DOI: https://doi.org/10.1007/s00405-013-2666-y

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