Verapamil modulates interleukin-5 and interleukin-6 secretion in organotypic human sinonasal polyp explants

BackgroundVerapamil is an L-type calcium channel blocker (CCB) that has been shown to have immunomodulatory properties in a variety of tissues. The goal of this study was determine whether verapamil is capable of regulating cytokine secretion in sinonasal polyps and to compare this effect to dexamethasone, an established immunosuppressive corticosteroid. MethodsThis was an institutional review board (IRB)-approved study in sinonasal polyp explants derived from 8 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Polyps were incubated with dexamethasone or verapamil for 24 hours followed by an additional 24 hours with Staphylococcal enterotoxin B (SEB). Concentrations of secreted cytokines over each exposure period were determined by enzyme-linked immunosorbent assay (ELISA) and are expressed as a percent. Results were compared using a 2-tailed Student t test. ResultsThe percent of SEB-stimulated interleukin-5 (IL-5) secretion (mean standard deviation [SD], 339.94% +/- 315.48%) between the second and first treatment periods was significantly reduced following exposure to dexamethasone (74.08% +/- 26.77%, p < 0.05) and verapamil (119.99% +/- 69.32%, p < 0.05). The percent of SEB-stimulated IL-6 secretion (217.53% +/- 89.51%) was also significantly reduced following exposure to verapamil (148.82% +/- 79.15%, p < 0.05) but not dexamethasone (148.86% +/- 145.24%). Finally, the percent of SEB-stimulated thymic stromal lymphopoietin (TSLP) secretion (37.86% +/- 18.88%) demonstrated a nonsignificant trend toward reduction with both dexamethasone (31.15% +/- 35.28%) and verapamil (20.14% +/- 12.10%). ConclusionAlthough the mechanism has yet to be fully understood, L-type CCBs are capable of reducing inflammation in multiple tissues. Verapamil was specifically found to reduce airway goblet cell hyperplasia and eosinophilic infiltration in a murine asthma model. Our data support these findings suggesting that verapamil can modulate T-helper cell type 2 (Th2)-associated cytokine secretion in sinonasal polyp explants. This data points to a possible therapeutic role for CCBs in the management of CRSwNP. (C) 2014 ARS-AAOA, LLC.