Topical budesonide treatment reduces endothelial expression of intercellular adhesion molecules (vascular cell adhesion molecule-1 and P-selectin) and eosinophil infiltration in nasal polyps

Infiltration of eosinophil granulocytes and endothelial expression of vascu lar cell adhesion molecule-1 (VCAM-1) and P-selectin was investigated in bi opsies of polyps and inferior turbinates from 16 patients with nasal polyps , by the use of immunohistochemical staining and stereological quantificati on before, during and after topical treatment with budesonide (Rhinocort(R) Turbuhaler(R)). Before glucocorticoid treatment a higher density of eosino phil profiles (p < 0.005), making up a larger proportion of the total cellu lar infiltrate (p < 0.0005), was found in the polyps compared with the infe rior turbinates. Endothelial VCAM-1 expression was higher in polyps than in inferior turbinates (p < 0.005), in contrast with the expression of P-sele ctin, which was more frequently expressed in the inferior turbinates (p < 0 .05). Topical glucocorticoid treatment reduced the density of eosinophil pr ofiles (p < 0.05) and the endothelial expression of VCAM-1 (p < 0.007) and P-selectin (p < 0.02) in polyps. Eosinophil counts and VCAM-1 expression re turned to pre-treatment levels 8 weeks after discontinuation of budesonide treatment. The observed reduction in endothelial expression of cellular adh esion molecules may interfere with cellular recruitment in nasal polyps and thus contribute to the known anti-inflammatory effect of glucocorticoid in nasal polyposis.