Rhinosinusitis, also called sinusitis, is an inflammation of the sinuses, the tissues that surround the nasal passage. Allergies or an infection may result in the disease. Common symptoms include runny nose, post nasal drip, congestion, facial pain or discomfort, toothaches and so on. According to patient history and physical examination, rhinosinusitis can be divided into four subtypes: acute, recurrent acute, subacute and chronic. Sinus inflammation that does not respond to treatment and lasts 12 weeks or longer is considered chronic rhinosinusitis (CRS). New research of Harvard Medical School now has revealed that CRS may be treated with a drug used to treat other diseases. The drug, called Verapamil, is a prescription medication used to treat chest pain, an irregular heartbeat, and high blood pressure. The study appears in Journal of Allergy and Clinical Immunology. Verapamil was approved by the FDA in 1981. This drug is sold under various trade names, such as Calan, Covera HS, Isoptin SR, and Verelan. Verapamil is on the WHO's "List of Essential Medicines." Verapamil is usually used to treat high blood pressure and control chest pain. It works by relaxing blood vessels so the heart doesn't have to work as hard, increasing the supply of blood and oxygen to the heart, and slowing electrical activity in the heart to control heart rate. The new study demonstrates the therapeutic effect of Verapamil on chronic rhinosinusitis with nasal polyps (CRSwNP). The presence of nasal polyps reflexes that the condition is severe. CRSwNP is characterized by polypoid mucosa and predominantly TH2 inflammation. Previous studies have shown that a membrane efflux pump in the nasal lining -- epithelial P-glycoprotein (P-gp) -- is overexpressed in CRSwNP and it regulates the secretion of inflammatory cytokines. "Some of the inflammation in CRS with nasal polyps is generated by the nasal lining itself," said lead investigator Benjamin Bleier. Therefore, the researchers conducted a clinical trial to investigate whether blocking P-gp could inhibit inflammation in CRSwNP. Verapamil is a first-generation inhibitor of P-gp; it is cardioactive but low doses are tolerated. The researchers used the drug to treat patients with CRSwNP, and found that those receiving the drug showed improved outcomes compared to those receiving a placebo. But the effect of the treatment was not so good in patients with higher body mass index. Other researchers of the study include Marcel M. Miyake, Angela Nocera, Patricia Levesque, Rong Guo, Christine A. Finn, Pharm-D, Jeremy Goldfarb, Stacey Gray, Eric Holbrook, and Nicolas Busaba from Harvard Medical School, and Jose Eduardo L. Dolci from Santa Casa de Sao Paulo School of Medical Sciences. Cusabio offers various proteins such as Recombinant TLR2.
