It is believed that macrophage migration inhibitory factor mediates inflammation by stimulating the release of other pro-inflammatory cytokines. The use of systemic steroids in control of nasal polyposis is an established treatment. In this study the authors have aimed at establishing a link between use of steroids and reduction of macrophage migration inhibition factor. The study comprised 24 patients with nasal polyps, matched with a control group of 25 patients. In both groups, individuals possibly having other conditions where a role of macrophage migration inhibition factor could be relevant, such as asthma, malignancy, diabetes, dermatitis and likewise, were excluded. Methylprednisolone 1mg/kg was given orally and tapered off.

The pre-steroid therapy levels of macrophage migration inhibition factor were 3889pg/ml in the patient group and 2334.52pg/ml in the control group. The post-steroid therapy level in the patient group fell down to 2451.25pg/ml in the patient group, this being statistically significant.

Previous studies from literature have been quoted, but unlike this study, these measured the macrophage migration inhibition levels in the tissues and not the serum. One of these studies shows the effect is dose related. The study shows some justification in the use of steroids for nasal polyposis which can sometimes prove intractable.

The effects of systemic steroid therapy on macrophage migration inhibition factor concentrations in patients with nasal polyps.
Ekinci A.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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