Influence Of Mometasone Furoate Nasal Spray On The Nasal/Paranasal Mucosa Of Sinusitis

Sinusitis is a symptomatic inflammation of the mucosa of paranasal sinuses. Because of it usually appears with nasal symptems, it is now widely suggested that the denomination of"rhinosinusitis"may be more rational. The most common symptoms, including nasal obstruction, smell loss, rhinorrhea, and facial pressure, have been well characterized. As the complexity of its etiology, clinical combined therapy is essential.Mometasone furoate (MF) is a corticosteroid, which originally developed as a topical anti-inflammatory agent to treat dermatologic disorders, asthma, and more recently as a nasal spray for allergic rhinitis (Nasonex). It has been shown to be efficacious and well tolerated by patients with persistent asthma; improving lung function while reducing the magnitude of allergen-induced early and late asthmatic responses, allergen-induced airway hyperresponsive- ness, and allergen-induced increases in sputum eosinophilia. New researches show that MF which is applied as a local corticosteroid(mometasone furoate nasal spray, MFNS) could improve the function of mucocililary system, as well as effect the local/systemic immunity and promote the recovery of the airway mucosa before/after endoscope surgery.Besides the efficacy of a corticosteroid, safety issues have to be taken into consideration. For topically applied glucocorticoids, the high local anti- inflammatory activity should be paralleled by a low systemic exposure. Therefore, it is favorable for a prolonged redistribution from local tissue into systemic circulation and a rapid and complete hepatic metabolism of the compounds to inactive derivatives. It has been reported that MF has a very low systemic bioavailability and very high affinity to the human glucocor- ticoid receptor has been reported. Meanwhile, the undesirable systemic side effects, such as the suppression of the hypothalamic-pituitary-adrenal(HPA) axis, have also been raised.Anyway, all of the investigate has not reached the final conclusion. Further studies are essential. This overview article has gathered many standpoints of various aspects, intending to benefit the clinical work.