| Project/Area Number |
22591901
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Nippon Medical School (2011-2012)
Kagoshima University (2010) |
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Principal Investigator |
MATSUNE Shoji 日本医科大学, 医学部, 教授 (00253899)
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| Co-Investigator(Kenkyū-buntansha) |
KURONO Yuichi 鹿児島大学, 医歯(薬)学総合研究科, 教授 (80153427)
SUNADUKA Toshiaki 北里大学, その他の研究科, 教授 (30226592)
OHKUBO Kimihiro 日本医科大学, 医学(系)研究科 (研究院), 教授 (10213654)
ADUMA Arata 日本医科大学, 医学部, 教授 (10184194)
FUJIKURA Terumichi 日本医科大学, 医学部, 准教授 (00238552)
GOTO Yuduru 日本医科大学, 医学部, 准教授 (80281426)
吉福 孝介 鹿児島大学, 医学部・歯学部附属病院, 講師 (70381168)
大堀 純一郎 鹿児島大学, 医歯学総合研究科, 助教 (90507162)
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| Project Period (FY) |
2010 – 2012
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| Project Status |
Completed (Fiscal Year 2012)
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| Budget Amount *help |
¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Fiscal Year 2012: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2011: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2010: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 難治性副鼻腔炎 / マクロライド / ステロイド / プライミング効果 / 増強効果 / エオタキシン / 好酸球性副鼻腔炎 / 培養線維芽細胞 |
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| Research Abstract |
In Japan long term low dose macrolide therapy is now a fundamental and standard pharmacotherapy for chronic rhiosinusitis (CRS), especially in neutrophil rather than eosinophil dominant type. Erythromycin, 14-memmbered macrolide, was originally and prevalently used as an appropriate macrolide therapy for CRS. Later, clarithromycin (CAM) and roxithromycin (RXM), new 14-membered macrolide, became practically in use in1990s. As to the mechanism of macrolide effects on CRS, anti-inflammation is regarded to be much more important than antibiotic effects; macrolide suppresses IL-8 production at the site of inflammatory mucosa and inhibits recruit and activation of neutrophils. Recently, quite refractory cases with pronounced eosinophil infiltration in nasal polyps or sinus mucosa are seen in 30~40% among CRS with nasal polyps (CRSwNP). Postoperative oral steroid is now only effective and practical therapy for “remission induction” of this type of CRS. However, long term or high dose oral steroids induce harmful side effects such as stomach ulcer, moon face, osteoporosis and susceptibility to infection. This study was designed in order to elucidate the priming effect of macrolide on steroids experimentally and clinically. In this experimental and clinical trials, CAM was chosen as a representative 14-membered macrolides. For steroids in the trials, Dexamethasone (DEX) was used in experiments and steroid nasal spray, Mometasone or Betamethasone, was prescribed clinically. Experimentally and clinically, priming effect of CAM was depending on the case. Further study is necessary to delineate in details what kind ofcases among refractory CRS cases are eligible for priming effect of macrolide on steroidtherapy.
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