{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T05:06:22Z","timestamp":1779512782324,"version":"3.53.1"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial inflammatory disease characterized by heterogeneous phenotypes and endotypes, necessitating personalized therapeutic strategies. Precision medicine approaches integrating molecular biomarkers may improve treatment selection and disease stratification. In this prospective controlled study, we investigated the tissue-level immunohistochemical effects of oral corticosteroids (OCSs) and topical steroids on the expression of periostin, eotaxin, interleukin-4 (IL-4), transforming growth factor-\u03b2 (TGF-\u03b2), and tumor necrosis factor-\u03b1 (TNF-\u03b1) in nasal polyp tissue. Sixty-five patients eligible for endoscopic sinus surgery (ESS) were enrolled and divided into two groups: Group 1 (n = 42) received topical steroids combined with oral prednisone (40 mg\/day for 7 days preoperatively), whereas Group 2 (n = 23) received topical steroids alone. Immunohistochemical analysis demonstrated a significant reduction in periostin and eotaxin expression in both epithelial and stromal compartments following OCS therapy, accompanied by increased TGF-\u03b2 expression. No significant differences were observed in IL-4 or TNF-\u03b1 expression. These findings indicate that short-term OCSs selectively modulate molecular pathways associated with eosinophilic inflammation and tissue remodeling in CRSwNP, supporting biomarker-driven precision medicine strategies.<\/jats:p>","DOI":"10.3390\/ijms27104565","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:17:23Z","timestamp":1779203843000},"page":"4565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathway-Specific Effects of Oral Corticosteroids on Eosinophilic Inflammation and Tissue Remodeling in Chronic Rhinosinusitis with Nasal Polyps"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3653-893X","authenticated-orcid":false,"given":"Kamil","family":"Radajewski","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6653-4599","authenticated-orcid":false,"given":"Pawe\u0142","family":"Burduk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, 85-168 Bydgoszcz, Poland"},{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Wierzchowska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, 85-168 Bydgoszcz, Poland"},{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7099-8115","authenticated-orcid":false,"given":"Paulina","family":"Antosik","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathomorphology, Collegium Medicum, Nicolaus Copernicus University, 85-009 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2771-413X","authenticated-orcid":false,"given":"Jakub","family":"J\u00f3\u017awicki","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathomorphology, Collegium Medicum, Nicolaus Copernicus University, 85-009 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Burduk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0416-7583","authenticated-orcid":false,"given":"Dariusz","family":"Grzanka","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathomorphology, Collegium Medicum, Nicolaus Copernicus University, 85-009 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin20.401","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"58","author":"Fokkens","year":"2020","journal-title":"Rhinology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1016\/j.jaci.2019.01.038","article-title":"Eosinophil peroxidase, GATA3, and T-bet as tissue biomarkers in chronic rhinosinusitis","volume":"143","author":"Lal","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.jaci.2020.01.027","article-title":"Formation of nasal polyps: The roles of innate type 2 inflammation and deposition of fibrin","volume":"145","author":"Takabayashi","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_4","first-page":"3","article-title":"Role of corticosteroids in Functional Endoscopic Sinus Surgery--a systematic review and meta-analysis","volume":"54","author":"Pundir","year":"2016","journal-title":"Rhinology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.wjorl.2018.09.002","article-title":"Immunomodulators in chronic rhinosinusitis","volume":"4","author":"Lavigne","year":"2018","journal-title":"World J. Otorhinolaryngol. Head. Neck Surg."},{"key":"ref_6","unstructured":"Onerci, T.M., and Ferguson, B.J. Nasal Polypositas, Springer."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1111\/j.1398-9995.2006.01225.x","article-title":"Differentiation of chronic sinus diseases by measurement of inflammatory mediators","volume":"61","author":"Claeys","year":"2006","journal-title":"Allergy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1513\/AnnalsATS.201609-720OC","article-title":"Serum Periostin as a Biomarker for Comorbid Chronic Rhinosinusitis in Patients with Asthma","volume":"14","author":"Asano","year":"2017","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jaci.2006.02.046","article-title":"Periostin: A novel component of subepithelial fibrosis of bronchial asthma downstream of IL-4 and IL-13 signals","volume":"118","author":"Takayama","year":"2006","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"152","DOI":"10.4193\/Rhin16.314","article-title":"The effect of systemic treatments on periostin expression reflects their interference with the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps","volume":"55","author":"Derycke","year":"2017","journal-title":"Rhinology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.jaci.2013.04.050","article-title":"Increased periostin associates with greater airflow limitation in patients receiving inhaled corticosteroids","volume":"132","author":"Kanemitsu","year":"2013","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1089\/dna.2014.2712","article-title":"Expression of POSTN, IL-4, and IL-13 in Chronic Rhinosinusitis with Nasal Polyps","volume":"34","author":"Milonski","year":"2015","journal-title":"DNA Cell Biol."},{"key":"ref_13","first-page":"11","article-title":"Chronic rhinosinusitis with nasal polyposis: The role of personalized and integrated medicine","volume":"91","author":"Passali","year":"2020","journal-title":"Acta Biomed."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7428955","DOI":"10.1155\/2021\/7428955","article-title":"Sinonasal Tissue Remodelling during Chronic Rhinosinusitis","volume":"2021","author":"Amirapu","year":"2021","journal-title":"Int. J. Otolaryngol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Carsuzaa, F., B\u00e9quignon, \u00c9., Dufour, X., de Bonnecaze, G., Lecron, J.-C., and Favot, L. (2022). Cytokine Signature and Involvement in Chronic Rhinosinusitis with Nasal Polyps. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23010417"},{"key":"ref_16","first-page":"235","article-title":"IL-4 and TNF-alpha increased the secretion of eotaxin from cultured fibroblasts of nasal polyps with eosinophil infiltration","volume":"45","author":"Yoshifuku","year":"2007","journal-title":"Rhinology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.anl.2006.05.008","article-title":"TNF-\u03b1 upregulates VCAM-1 and NF-\u03baB in fibroblasts from nasal polyps","volume":"34","author":"Ohori","year":"2007","journal-title":"Auris Nasus Larynx"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s11882-015-0531-3","article-title":"Remodeling and repair in rhinosinusitis","volume":"15","author":"Watelet","year":"2015","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.jaci.2009.04.013","article-title":"TGF-beta signaling and collagen deposition in chronic rhinosinusitis","volume":"124","author":"Derycke","year":"2009","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11882-019-0850-x","article-title":"Precision Medicine in Rhinosinusitis","volume":"19","author":"Vlastos","year":"2019","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"102795","DOI":"10.1016\/j.amjoto.2020.102795","article-title":"Structured histopathology for endotyping and planning rational treatment in chronic rhinosinusitis","volume":"42","author":"Brescia","year":"2021","journal-title":"Am. J. Otolaryngol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Strehl, C., Ehlers, L., Gaber, T., and Buttgereit, F. (2019). Glucocorticoids-All-Rounders Tackling the Versatile Players of the Immune System. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01744"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13601-019-0303-6","article-title":"Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: An EAACI position paper","volume":"10","author":"Hox","year":"2020","journal-title":"Clin. Transl. Allergy"},{"key":"ref_24","first-page":"85","article-title":"The EUFOREA pocket guide for chronic rhinosinusitis","volume":"61","author":"Hellings","year":"2023","journal-title":"Rhinology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/alr.21336","article-title":"Effect of prednisone on nasal symptoms and peripheral blood T-cell function in chronic rhinosinusitis","volume":"4","author":"Watanabe","year":"2014","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1159\/000368652","article-title":"Corticosteroid regulates epithelial occludin expression in nasal polyps through a MKP-1-dependent pathway","volume":"76","author":"Chen","year":"2014","journal-title":"ORL"},{"key":"ref_27","first-page":"1086","article-title":"Inflammatory cytokine expression in recurrent nasal polyps by antibody chips","volume":"34","author":"Chen","year":"2009","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban"},{"key":"ref_28","first-page":"145","article-title":"Eosinophilic nasal polyps are a rich source of Eotaxin, Eotaxin-2 and Eotaxin-3","volume":"44","author":"Olze","year":"2006","journal-title":"Rhinology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1002\/lary.20191","article-title":"Eotaxin-1, -2, and -3 immunoreactivity and protein concentration in the nasal polyps of eosinophilic chronic rhinosinusitis patients","volume":"119","author":"Yao","year":"2009","journal-title":"Laryngoscope"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1177\/0194599814565606","article-title":"Early versus delayed endoscopic sinus surgery in patients with chronic rhinosinusitis","volume":"152","author":"Benninger","year":"2015","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Radajewski, K., Kali\u0144czak-G\u00f3rna, P., Zdrenka, M., Antosik, P., Wierzchowska, M., Grzanka, D., and Burduk, P. (2021). Short Term Pre-Operative Oral Corticosteroids\u2014Tissue Remodeling in Chronic Rhinosinusitis with Nasal Polyps. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153346"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/10\/4565\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T04:16:00Z","timestamp":1779509760000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/10\/4565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["ijms27104565"],"URL":"https:\/\/doi.org\/10.3390\/ijms27104565","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]}}}