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Effect of prednisone on nasal symptoms and peripheral blood T‐cell function in chronic rhinosinusitis
Author(s) -
Watanabe So,
Pinto Jayant M.,
Bashir Mohamed Elfatih H.,
De Tineo Marcella,
Suzaki Harumi,
Baroody Fuad M.,
Naclerio Robert M.,
Sharma Shilpy
Publication year - 2014
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21336
Subject(s) - medicine , foxp3 , peripheral blood mononuclear cell , nasal administration , immunology , il 2 receptor , flow cytometry , prednisone , interleukin , proinflammatory cytokine , regulatory t cell , real time polymerase chain reaction , inflammation , endocrinology , gastroenterology , t cell , immune system , cytokine , biochemistry , chemistry , in vitro , gene
Background Systemic corticosteroids are the most effective anti‐inflammatory drugs used for controlling chronic rhinosinusitis (CRS) symptoms. The potential mechanisms for their beneficial effects include increasing the number and function of T regulatory cells (Tregs), as reported in the local tissue post–intranasal steroid treatment. We investigated the effect of systemic corticosteroids on peripheral blood (PB) Tregs in subjects with CRS. Methods Twenty CRS subjects and 19 controls were recruited. PB mononuclear cells (PBMCs) were isolated from CRS subjects before and after systemic corticosteroid administration in the course of clinical treatment. Control subjects received no treatment and were studied at one visit. Nasal symptoms were recorded. CD4 + CD25 + Foxp3 + cells (Tregs) were analyzed by flow cytometry. Messenger RNA (mRNA) levels for interferon γ (IFN‐γ), interleukin 4 (IL‐4), IL‐10, IL‐13, IL‐17A, transforming growth factor β1 (TGF‐β1), forkhead box P3 (FoxP3), and GATA‐binding factor 3 (GATA‐3) were measured in PBMCs using real‐time polymerase chain reaction (PCR). Results CRS subjects reported improved nasal symptoms ( p = 0.005) and significantly reduced PB Tregs after treatment with corticosteroids ( p = 0.042). The transcript levels of IL‐4 and GATA‐3 were significantly higher in the CRS subjects at their first visit when compared to controls ( p = 0.019 and p = 0.05, respectively). Corticosteroid treatment lowered the transcript levels of immunoregulatory transcription factors [FoxP3 ( p = 0.048) and GATA‐3 ( p = 0.012)] and IFN‐γ ( p = 0.036) in PB. Conclusion In contrast to prior work in local nasal tissue, our study reports reduced PB Tregs and decreased T helper 1 (T H 1) and T H 2 function after treatment with systemic corticosteroids. These data indicate that corticosteroid effects on Tregs in CRS are complex involving local signals in the tissue that are distinct from those in circulating cells.