糖皮质激素治疗增加鼻息肉中COX-2基因的表达
2009/05/18
关键词：环氧合酶-1；环氧合酶-2；糖皮质激素；鼻息肉
为了评价鼻息肉中COX-2的变化，Pujols等对65例鼻息肉患者进行研究。
作者将鼻息肉患者随机分为激素治疗组（n=51，其中33例患哮喘）和非激素治疗组（n=14）。激素治疗组患者接受泼尼松口服和布地奈德鼻吸治疗2周后继续鼻吸布地奈德10周。入组时、治疗2周以及研究结束后（治疗12周）进行鼻粘膜活检，测定COX-1和COX-2的mRNA水平，另外测定循环中COX-2的蛋白水平。
研究发现，入组时，哮喘组和非哮喘组患者的鼻息肉中COX-1和COX-2的表达没有差异。但激动治疗2周后COX-2的表达增加，12周后表达下降；但COX-1的mRNA水平没有变化。在12周时，非哮喘患者的COX-2仍保持较高水平，而哮喘患者的COX-2明显降低。循环中未检出COX-2蛋白。
综合研究结果，作者认为，激素治疗增加鼻息肉中COX-2的表达。
（韩伟 青岛市市立医院东院呼吸科 266071 摘译）
（Eur. Respir. J., Mar 2009; 33: 502 - 508.）
Eur Respir J. 2009 Mar;33(3):502-8. Epub 2008 Nov 14. Links
Glucocorticoid therapy increases COX-2 gene expression in nasal polyps in vivo.
Pujols L, Benitez P, Alobid I, Martinez-Antón A, Roca-Ferrer J, Mullol J, Picado C.
Keywords: Cyclooxygenase-1, cyclooxygenase-2, glucocorticoids, nasal polyps
The aim of the present study was to evaluate the in vivo regulation of cyclooxygenase-2 in nasal polyps. In total, 65 patients with nasal polyps were randomly (3:1) treated with (n = 51; 33 with asthma) or without (n = 14) oral prednisone and intranasal budesonide for 2 weeks plus intranasal budesonide for 10 additional weeks. Biopsies were obtained at baseline and after 2 and 12 weeks of treatment. All samples were analysed for cyclooxygenase-1 and cyclooxygenase-2 mRNA. Attempts were made to detect cyclooxygenase-2 protein. At baseline, cyclooxygenase-1 and cyclooxygenase-2 expression did not differ between polyps from nonasthmatic and asthmatic patients. Cyclooxygenase-1 mRNA was unchanged by glucocorticoid treatment, while cyclooxygenase-2 mRNA increased in glucocorticoid-treated patients at week 2 compared with baseline and then decreased at week 12. Within subgroups, increased cyclooxygenase-2 mRNA was found at week 2 in polyps from nonasthmatic and asthmatic patients compared with baseline. At week 12, cyclooxygenase-2 expression remained high in nonasthmatics while it decreased in asthmatics. Cyclooxygenase-2 protein was not detected under any circumstances. Glucocorticoid therapy enhances cyclooxygenase-2 expression in vivo in nasal polyps, a finding that does not follow the generally accepted assumption that cyclooxygenase-2 expression is suppressed by glucocorticoids.
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成人哮喘患者的体重指数、体重增加和其它可以决定肺功能下降的因素
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阻断肿瘤坏死因子α在重症持续哮喘中的随机、双盲、安慰剂对照研究
