The efficiency of TNF-α inhibitors at nasal polyp disease

Aim: Nasal polyposis is a benign disease which has a cronic inflammatory pathway. Eosinhopilic and Th2 related inflammatory is the most commen type.Genetic studies determined that genetic polimorphism at TNF-α gene localization may cause this inflammatory. We aimed to determine the effect of TNF-α inhibitors at nasal polyp fibroblasts which we produced at cell culture. Secondly we purposed to compare the effects of TNF-α inhibitors with steroids. Method:6 patient's nasal polyp specimens collected during endoscopic surgery. Nasal polyp fibroblasts were cultured and stimulated with IL-1ß. Cells were submitted to Dexamethasone, Etanercept and combination of them. Inflammatory response was detected with VCAM-1, RANTES and Eotaksin protein levels(ELISA) and expression (PCR). Results: Dexamethasone inhibited VCAM-1 and Eotaksin protein levels significantly. Etanercept effected Eotaksin protein levels but compered with Dexamethasone , Dexamethasone was more intense than Etanercept. Combination of Etanercept and Dexamethasone therapy had same protein levels as Dexamethasone therapy. Discussion: TNF-α inhibitors may be efficient in NP theapy. This study determined anti inflammatory effects of Etanercept at nasal polyp fibroblasts but it wasn't powerful as Dexamethasone. We couldn't detect synergistic effets of Dexamethasone and Etanercept. This study provides the moleculer bases for NP with a TNF-α inhibitor. Future primer culture studies are needed to determine ideal concentrations and time intervals of Etanercept for NP.