RESUMEN
OBJECTIVE: To correlate clinical prognosis to the expression of p65, c-Fos, GRalpha and GRbeta in patients with nasal polyps. METHODS: A biopsy was obtained at the first evaluation for patients with nasal polyps (20), and at rhinoplasty for control mucosa (8). Patients with nasal polyps were treated with glucocorticoids and followed for at least 30 months. The expression of each gene (p65, c-Fos, GRalpha and GRbeta) was determined by Real Time-PCR and correlated to clinical outcome. The indication for surgery was considered the end-point of resistance to glucocorticoid therapy. RESULTS: Patients with nasal polyps presented a higher expression of p65 (P<0.05), and a lower expression of GRalpha (P<0.0001), and of GRalpha/GRbeta relation (P<0.0001) than controls. The nasal polyps patients with higher expression of p65 correlated with a poorer response to glucocorticoids (P<0.05), with a four-fold higher risk for surgery to control symptoms. CONCLUSION: Patients with nasal polyps presented higher gene expression of p65, and a reduced expression of GRalpha and of GRalpha/GRbeta relation than controls. Higher p65 (NFkappaB) expression at diagnosis was also associated to a worst response to medical treatment, suggesting this could be considered as one mechanism of cell resistance to glucocorticoid treatment in patients with nasal polyps.