Nasal expression of the vascular endothelial growth factor and its receptors is reduced by mepolizumab in chronic rhinosinusitis with nasal polyposis

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a phenotype of chronic rhinosinusitis characterized by the presence of nasal polyps. To date, medical therapy and surgery can manage the disease in most of the cases. However, despite improvements in surgical techniques, CRSwNP is characterized by relapses in severe cases, thus leading to the study of biological drugs such as Mepolizumab, antagonizing IL-5. Experimental and clinical evidence demonstrates that CRSwNP is driven by a type 2 immune response and displays eosinophil infiltration, mucosal inflammation, and hyperplasia of the epithelium. Besides, it has been described that vascular endothelial growth factor (VEGF) is strongly upregulated in the mucosa of CRSwNP patients, promoting edema and epithelial cell growth in nasal polyps when compared to normal mucosa. Notably, other reports demonstrated that IL-5 stimulates VEGF production, which may influence immune cells’ activity in inflammatory conditions.