The Effects of Corticosteroid on Tissue Lactoferrin in Patients with Nasal Polyposis

Abstract

Although, lactoferrin (LF) is the second most important antimicrobial and anti-inflammatory peptide after lysozyme in upper respiratory tract, little is known about its role in chronic rhinosinusitis (CRS). Recent studies pronounced that LF levels were significantly reduced in CRS with nasal polyposis (NP) compared with other subgroups. However, effects of systemic corticosteroid (CS) treatment, which is currently the main NP treatment modality, and subsequent surgical intervention on LF levels are still not known. This study was designed to evaluate the effects of CS treatment and surgical intervention on LF levels in patients with NP. Patients with inflammatory NP who were scheduled to undergo CS treatment and a control group were included in this study. LF levels were determined from mucosal samples taken from both groups, before and after CS treatment, and also 1 month after surgical intervention. Twenty-seven patients with NP and 14 patients who underwent septoplasty were included in the study. Tissue LF levels were significantly lower in the NP group compared with the control group (p = 0.014). Tissue LF levels did not change significantly in NP patients after CS treatment. However, a significant reduction in tissue LF was detected 1 month after endoscopic sinus surgery. Tissue LF concentrations significantly decreased in patients with NP. CS treatment had no effect on tissue LF levels, whereas postendoscopic sinus surgery, tissue LF levels were getting lower because there was also a reduction in inflammatory load (whether from reduction in mucosa surface area or resolution of disease).