Efficacy and tolerability of a new medical device in nasal polyposis treatment.

Nasal polyps represent a common endpoint in several disease processes. From the histological viewpoint a remodeling process of the respiratory epithelium accompanied by the infiltration of inflammatory cells and sub-epithelial edema can be observed. Recently the importance of the HMGB1 protein in the pathogenesis of severe inflammatory diseases, including nasal polyposis, has been demonstrated: this protein is released from necrotic or immune-activated cells and causes: the release of pro-inflammatory mediators and the survival of inflammatory cells. The inhibition of HMGB1 protein may be an efficacious and innovative therapeutic strategy for patients with nasal polyposis. Glycyrrhizin inhibits pro-inflammatory activities of HGMB1: the interaction between glycyrrhizin and HBMG1 is limited to a scavenger function of the inflammatory protein released by the necrotic cells. Materials and methods. Our clinical experience is related to a nasal ointment containing dipotassium glycirrhizinate and mannitol as active components: in an open controlled multi-centric study in patients affected by nasal polyposis the efficacy of this preparation was evaluated. 146 patients were enrolled: the ointment was used for 12 weeks. Polyps size, Active Anterior Rhinomanometry, MucoCiliary Transport Time were evaluated at the enrollment, after 4 and 12 weeks. Symptoms (nasal obstruction, rhinorrhea, taste and smell alterations) were also evaluated by a visual analogue scale. Results. This clinical study demonstrated positive effects of the ointment with polyp size reduction and improvement of rhinomanometric and MCT values, as well as symptom scores. Difficulties were reported on treatment administration and dosage.