Corticosteroid therapy increases membrane-tethered while decreases secreted mucin expression in nasal polyps

Allergy. 2008 Oct;63(10):1368-76. doi: 10.1111/j.1398-9995.2008.01678.x. Epub 2008 Jun 5.


Background: Mucus hypersecretion is a hallmark of nasal polyposis (NP). Corticosteroids (CS) are first-line treatment for NP, decreasing their size and inflammatory component. However, their effect on mucin production is not well-understood. The aim of this (pilot) study was to investigate CS effect on mucin expression in NP.

Methods: Patients were randomized in control (n = 9) and treatment (oral prednisone for 2 weeks and intranasal budesonide for 12 weeks; n = 23) groups. Nasal polyposis from nonasthmatic (NP; n = 13), aspirin-tolerant (NP-ATA; n = 11) and aspirin-intolerant (NP-AIA; n = 8) asthmatics were studied. Nasal polyposis biopsies were obtained before (w0) and after 2 (w2) and 12 (w12) weeks of CS treatment. Secreted (MUC5AC, MUC5B and MUC8) and membrane-tethered (MUC1, MUC4) mucins (immunohistochemistry) and goblet cells (Alcian blue-periodic acid Schiff) were quantified in both epithelium and glands. Rhinorrea and nasal obstruction were also assessed.

Results: At w2, steroids increased MUC1 (from 70 to 97.5) and MUC4 (from 80 to 100) in NP-ATA patients' epithelium compared with baseline (w0). At w12, steroids decreased MUC5AC (from 40 to 5) and MUC5B (from 45 to 2.5) in NP-ATA patients' epithelium and glands, respectively, compared with baseline. No mucin presented significant changes in NP-AIA patients. MUC5AC and MUC5B expression correlated with goblet and mucous cell numbers, respectively, and MUC5AC also with rhinorrea score.

Conclusions: These results suggest: (i) CS up-regulate membrane (MUC1, MUC4) while down-regulate secreted (MUC5AC, MUC5B) mucins; (ii) there exists a link between secreted mucin expression and goblet cell hyperplasia; and (iii) NP from AIA may develop resistance to CS treatment.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Budesonide / administration & dosage
  • Budesonide / therapeutic use*
  • Down-Regulation / drug effects*
  • Female
  • Gene Expression Profiling
  • Humans
  • Male
  • Middle Aged
  • Mucins / antagonists & inhibitors
  • Mucins / biosynthesis
  • Mucins / genetics*
  • Mucins / metabolism*
  • Nasal Mucosa / drug effects*
  • Nasal Mucosa / metabolism
  • Nasal Polyps / drug therapy*
  • Nasal Polyps / metabolism
  • Pilot Projects
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use*
  • Prospective Studies
  • Up-Regulation / drug effects*


  • Mucins
  • Budesonide
  • Prednisone