TIMP4 and chronic rhinosinusitis with nasal polyps: Inflammatory cytokines and MMPs are known to be elevated in the tissue of CRSwNP. Sixty patients were divided into two groups to receive budesonide or placebo for 14 days. The drug treatment reduced the polyp size compared with placebo and improved symptoms. The drug reduced the expression of the pro-inflammatory cytokines IL5 and eotaxin, and increased TGFβ1 and IL10 expressions in the polyp samples. Budesonide also decreased indices of remodeling in these samples including albumin, MMP2, MMP7, MMP8, and MMP9, but increased collagen and TIMP1, TIMP2, and TIMP4 levels.