Intralesional bleomycin A5 injection for the treatment of nasal polyps through inducing apoptosis

Abstract

Conclusion: An intralesional bleomycin A5 (BLE) injection might be used as an alternative therapy for eosinophilic-type nasal polyps (NPs). BLE-induced apoptosis might play an important role in shrinkage of NPs.

Objectives: The aim of this study is to determine the effect and explore the possible role of apoptosis in shrinkage of NPs.

Methods: Twenty-nine patients with eosinophilic-type NPs experienced repeated local injection of BLE. The recurrence rate of this group was obtained. The mechanism of BLE treatment was investigated through an in vitro experiment. Nasal polyp tissues were treated with BLE. The apoptotic activity was detected by the presence of DNA smear and test of terminal deoxynucleotidyl transferase dUTP nick end labeling. The caspase-8 and PARP were examined through immunohistochemistry and Western blotting.

Results: After several local injections of BLE, the nasal polyp tissues decreased and then disappeared. During follow-up of 3 years the recurrence rate of this group was significantly lower than another one treated with operation plus medicine treatment. Apoptosis in BLE-treated tissue was prominently detected in the infiltrating inflammatory cells. The expression of PARP and casp-8 were increased in BLE-treated nasal polyp tissue compared with PBS-treated tissue.

Chinese abstract

结论: 病灶内注射博来霉素A5（BLE）可作为嗜酸性鼻息肉（NPs）的另一种疗法。 BLE诱导的细胞凋亡可能对于NPs收缩起重要作用。

目的：本研究的目的是确定这种作用, 探讨凋亡对于NPs收缩的可能作用。

方法：29例嗜酸粒细胞型NP患者接受反复局部注射BLE。获得该组的复发率。通过体外实验研究BLE治疗的机制。用BLE处理鼻息肉组织。通过DNA涂片的存在和末端脱氧核苷酸转移酶dUTP缺口末端标记的测试来检测凋亡活性。通过免疫组织化学和Western印迹来检测蛋白酶-8和PARP。

结果：在若干次局部注射BLE后, 鼻息肉组织减少了, 然后消失。随访3年期间, 该组患者的复发率明显低于手术加药物治疗组。 经BLE治疗的组织中的细胞凋亡在浸润炎性细胞中明显检测到。与经PBS治疗的组织相比, BLE治疗的鼻息肉组织中PARP和蛋白酶-8的表达增加。

Keywords:

• Nasal polyp
• bleomycin A5
• apoptosis

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The study was supported in part by the National Natural Science Foundation of China under grant no. 81500773, and in part by the Natural Science Foundation of Guangdong Province of China under grant no. 2015A030310125, and the Natural Science Foundation of Guangdong Province of China under grant no. 2014A030313158.