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Sarkar S, Routhray S, Ramadass B, Parida PK. A Review on the Nasal Microbiome and Various Disease Conditions for Newer Approaches to Treatments. Indian J Otolaryngol Head Neck Surg 2023; 75:755-763. [PMID: 37206729 PMCID: PMC10188862 DOI: 10.1007/s12070-022-03205-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/23/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction: Commensal bacteria have always played a significant role in the maintenance of health and disease but are being unravelled only recently. Studies suggest that the nasal microbiome has a significant role in the development of various disease conditions. Search engines were used for searching articles having a nasal microbiome and disease correlation. In olfactory dysfunction, dysbiosis of the microbiome may have a significant role to play in the pathogenesis. The nasal microbiome influences the phenotype of CRS and is also capable of modulating the immune response and plays a role in polyp formation. Microbiome dysbiosis has a pivotal role in the development of Allergic Rhinitis; but, yet known how is this role played. The nasal microbiome has a close association with the severity and phenotype of asthma. They contribute significantly to the onset, severity, and development of asthma. The nasal microbiome has a significant impact on the immunity and protection of its host. The nasal microbiome has been a stimulus in the development of Otitis Media and its manifestations. Studies suggest that the resident nasal microbiome is responsible for the initiation of neurodegenerative diseases like Parkinson's Disease.Materials and Methods: Literature search from PubMed, Medline, and Google with the Mesh terms: nasal microbiome AND diseases. Conclusion: With increasing evidence on the role of the nasal microbiome on various diseases, it would be interesting to see how this microbiome can be modulated by pro/pre/post biotics to prevent a disease or the severity of illness.
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Affiliation(s)
- Saurav Sarkar
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Samapika Routhray
- Department of Dentistry, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Balamurugan Ramadass
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pradipta Kumar Parida
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
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2
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Numerical study on the distribution of nitric oxide concentration in the nasal cavity of healthy people during breathing. Nitric Oxide 2023; 130:12-21. [PMID: 36417988 DOI: 10.1016/j.niox.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND In the nasal cavity, nitric oxide (NO) is involved in many physiological functions, including antibacterial and antiviral activity, promotion of nasal mucociliary clearance, and regulation of blood vessel expansion in the nasal mucosa. We investigated the distribution of NO concentration in the nasal cavity of healthy individuals during breathing. METHODS A three-dimensional numerical model of the nasal airway, including the bilateral maxillary sinuses, was created to simulate NO distribution in the nasal cavity during normal breathing. The effect of different nasal airflow velocities and NO concentrations in the maxillary sinus on NO distribution in the nasal cavity was evaluated. The NO concentration in the nasal exhalation of 50 healthy people in Dalian was measured using an NO analyzer, and the growth rate of the NO concentration in the nasal cavity was measured under breath-holding conditions. RESULTS The distribution of NO concentration in the nasal cavity of healthy people during breathing was obtained from numerical simulation results. Lower the airflow rate, higher was the NO concentration and greater was the diffusion range in the nasal cavity. The NO concentration in the nasal cavity increased with an increase in its concentration in the maxillary sinus, indicating a linear relationship. The NO concentration in the nasal exhalation of healthy people in Dalian and the growth rate of the NO concentration in the nasal cavity under breath-holding conditions were obtained through experiments. The numerical results correspond with the experimental results. CONCLUSIONS The NO entered the nasal cavity mainly by diffusion and followed the convection flow of the respiratory air in the nasal cavity. NO concentration in the nasal cavity was related to the respiratory airflow velocity and NO concentration in the maxillary sinus. During inspiration, NO was present only in the nasal airway posterior to the maxillary sinus ostium, whereas during exhalation, the exhaled NO diffusely distributed throughout the nasal cavity.
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3
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Bulut F, Türksever Tetiker A, Çelikkol A, Şafak AS, Topçu B, Ballica B. Plasma Asymmetrıc Dımethylargınıne (ADMA) and Nıtrıc Oxıde (NO) Levels ın Patıents wıth Chronıc Pansınusıtıs. Indian J Otolaryngol Head Neck Surg 2022; 74:1591-1596. [PMID: 36452608 PMCID: PMC9702502 DOI: 10.1007/s12070-021-02720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/27/2021] [Indexed: 11/28/2022] Open
Abstract
Chronic pansinusitis is a mucosal inflammation of the nose and all paranasal sinuses with severe inflammation of the upper airways. Asymmetric dimethylarginine (ADMA) is associated with oxidative stress. In this study, we aimed to examine the plasma levels and importance of ADMA and nitric oxide (NO) in patients with chronic pansinusitis. The study was conducted with a total of 64 patients. The study group included a total of 40 patients with chronic pansinusitis. (18 females, 22 males) (mean age 32.27 ± 10.02). The control group consisted of 24 patients (11 females and 13 males). The mean age of the patients in the control group was 31.35 ± 6.05 years. Nasal endoscopic examinations were performed in patients with a history of chronic pansinusitis and symptoms of chronic pansinusitis. Later, the diagnosis of chronic pansinusitis was confirmed with coronal paranasal sinus Computed tomography scans. Plasma ADMA levels were measured by ELISA method and NO levels were measured by Griess method. Plasma ADMA and NO levels of the patients and healthy volunteers were measured and the mean plasma levels of the two groups were compared. ADMA levels were significantly higher in the group with chronic pansinusitis compared to the control group (1.23 ± 0.41 μM and 0.28 ± 0.06 μM, respectively) (p < 0.001), while NO levels were significantly lower in the patient group compared to the control group (7.06 ± 1.07 μM and 12.25 ± 0.95, μM, respectively) (p < 0.001). Our results show that the increase in ADMA levels and the decrease in NO levels are associated with chronic pansinusitis. According to these results, increased plasma levels of ADMA in chronic pansinusitis may be useful in clinical use as a sign of increased oxidative stress.
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Affiliation(s)
- Fuat Bulut
- Private Çorlu REYAP Hospital, Department of Otorhinolaryngology, Istanbul Rumeli University, Istanbul, Turkey
| | | | - Aliye Çelikkol
- Department of Medical Biochemistry, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Ayşe Sezim Şafak
- Private Kurtköy Ersoy Hospital, Department of Otorhinolaryngology, Istanbul Yeni Yüzyıl Üniversity, Istanbul, Turkey
| | - Birol Topçu
- Department of Biostatistics, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Basak Ballica
- Istanbul Bahcesehir University, Faculty of Medicine, Istanbul, Turkey
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4
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Parra-Ferro M, Justice JM, Lobo BC, Munger SD, Schlosser RJ, Mulligan JK. Utilization of Nasal Mucus to Investigate the Pathophysiology of Chronic Rhinosinusitis. Am J Rhinol Allergy 2022; 36:872-883. [PMID: 35848564 DOI: 10.1177/19458924221111830] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Nasal mucus is proving to be a useful means by which to study the pathogenesis of chronic rhinosinusitis (CRS). Given the increase in publications examining nasal mucus and the lack of a review on this topic, we will focus on this noninvasive approach to studying CRS. Particular attention will be drawn towards inflammatory cytokines and biomarkers and their influence on disease severity. METHODS A literature review of papers published in English pertaining to nasal mucus was performed using the PubMed database. The search utilized combinations of the following keywords: sinusitis, polyps, sample collection, nasal mucus, or nasal secretion. Studies solely on acute or bacterial sinusitis, allergic rhinitis, or cystic fibrosis were not included. RESULTS A wide variety of materials and methods have been used to collect nasal mucus. Numerous assay types have been performed with the most common being ELISA, cytometric bead array, and proteomics. Most studies have focused on examining the levels of Th1/Th2 cytokines along with chemokines associated with type 2 immunity. Other factors identified include growth factors, senescence-associated proteins, complement, and antimicrobial defenses have also been identified. Nasal mucus cytokines have proven useful in cluster analysis and predicting postoperative improvement in Sino-nasal Outcome Test (SNOT-22) scores. One limitation of the use of nasal mucus is that some studies have suggested that nasal mucus does not always reflect the tissue microenvironment. CONCLUSIONS Nasal mucus represents a critical tool by which to examine the sinonasal microenvironment in a noninvasive manner. Unlike studies of tissue, it can be utilized in both surgically and medically managed patients and avoids the trauma of biopsies. However, studies are still needed to determine the most effective method for nasal mucus collection. Studies should also take care to confirm that nasal mucus markers do, in fact, reflect the levels of the product studied in the tissue.
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Affiliation(s)
- Mauricio Parra-Ferro
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida
| | - Jeb M Justice
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida.,Center for Smell and Taste, 3463University of Florida, Gainesville, Florida
| | - Brian C Lobo
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida
| | - Steven D Munger
- Department of Otolaryngology-Head & Neck Surgery, 3463University of Florida, Gainesville, Florida.,Department of Pharmacology and Therapeutics, 440202University of Florida College of Medicine, Gainesville, Florida.,Center for Smell and Taste, 3463University of Florida, Gainesville, Florida.,Training Program in Chemosensory Science, 3463University of Florida, Gainesville, Florida.,Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, 3463University of Florida College of Medicine, Gainesville, Florida
| | - Rodney J Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer K Mulligan
- Center for Smell and Taste, 3463University of Florida, Gainesville, Florida.,Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, 3463University of Florida, Gainesville, Florida
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Bandara SMR, Samita S, Kiridana AM, Herath HMMTB. Elevated nitric oxide and carbon monoxide concentration in nasal-paranasal sinus air as a diagnostic tool of migraine: a case - control study. BMC Neurol 2021; 21:407. [PMID: 34702215 PMCID: PMC8547087 DOI: 10.1186/s12883-021-02434-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A recent study showed that 60-s paranasal air suction results in an immediate pain relief in acute migraine. This is the study to assess the Nitric Oxide (NO) and Carbon Monoxide (CO) concentration in nasal-paranasal sinus air of migraine patients and to compare it with healthy controls. METHODOLOGY The NO and CO levels of air sucked out from nasal-paranasal sinuses of 20 migraine adolescent and young adults among school students, aged 16 -19 years, and 22 healthy similar aged school students as controls were measured as key responses using a portable NO and a portable CO analyzer. RESULTS Patients had comparatively high values compared to the controls for paranasal NO (both left and right sides), paranasal CO (both left and right sides), Fraction Exhaled NO (FeNO) and Fraction Exhaled CO (FeCO). Patients had median paranasal NO contents of 132.5 ppb and 154 ppb on left and right sides respectively compared to 36 ppb and 34.5 ppb corresponding values in controls (P < 0.0001). Similar pattern was observed with paranasal CO (P < 0.0001). FeNO and FeCO content were also higher in patients (P < 0.0001). Receiver characteristic operating curves of all gas measurements showed that they all could classify patients and controls effectively and NO was the most effective followed by paranasal CO. After air suction, the mean pain scores of general headache and tenderness dropped by a very large margin in migraine patients (P < 0.0001). CONCLUSIONS Suctioned out high nasal-paranasal sinus NO and CO levels can be used to distinguish migraine patients from healthy subjects. In fact, suctioned out paranasal NO measurements of both sides with a cutoff point of 50 ppb provided a perfect classification of patients and controls. Increased sinus NO and CO during acute episode of migraine is an observation we had and we agree that further studies are needed to conclude that NO and CO can be a causative molecule for migraine headache. TRAIL REGISTRATION Clinical Trial Government Identification Number - 1548/2016. Ethical Clearance Granted Institute - Medical Research Institute, Colombo, Sri Lanka (No 38/2016). Sri Lanka Clinical Trial Registration number: SLCTR/ 2017/018 (29/06/2017). Approval Granting Organization to use the device in the clinical trial- National Medicines Regulatory Authority Sri Lanka (16/06/2018), The device won award at Geneva international inventers exhibition in 2016 and President award in 2018 in Sri Lanka. It is a patented device in Sri Lanka and patent number was SLKP/1/18295. All methods were carried out in accordance with CONSORT 2010 guidelines.
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Affiliation(s)
| | - S Samita
- University of Peradeniya, Peradeniya, Sri Lanka
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6
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Kawasumi T, Takeno S, Ishikawa C, Takahara D, Taruya T, Takemoto K, Hamamoto T, Ishino T, Ueda T. The Functional Diversity of Nitric Oxide Synthase Isoforms in Human Nose and Paranasal Sinuses: Contrasting Pathophysiological Aspects in Nasal Allergy and Chronic Rhinosinusitis. Int J Mol Sci 2021; 22:7561. [PMID: 34299181 PMCID: PMC8304068 DOI: 10.3390/ijms22147561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022] Open
Abstract
The human paranasal sinuses are the major source of intrinsic nitric oxide (NO) production in the human airway. NO plays several roles in the maintenance of physiological homeostasis and the regulation of airway inflammation through the expression of three NO synthase (NOS) isoforms. Measuring NO levels can contribute to the diagnosis and assessment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS). In symptomatic AR patients, pro-inflammatory cytokines upregulate the expression of inducible NOS (iNOS) in the inferior turbinate. Excessive amounts of NO cause oxidative damage to cellular components, leading to the deposition of cytotoxic substances. CRS phenotype and endotype classifications have provided insights into modern treatment strategies. Analyses of the production of sinus NO and its metabolites revealed pathobiological diversity that can be exploited for useful biomarkers. Measuring nasal NO based on different NOS activities is a potent tool for specific interventions targeting molecular pathways underlying CRS endotype-specific inflammation. We provide a comprehensive review of the functional diversity of NOS isoforms in the human sinonasal system in relation to these two major nasal disorders' pathologies. The regulatory mechanisms of NOS expression associated with the substrate bioavailability indicate the involvement of both type 1 and type 2 immune responses.
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Affiliation(s)
| | - Sachio Takeno
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan; (T.K.); (C.I.); (D.T.); (T.T.); (K.T.); (T.H.); (T.I.); (T.U.)
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7
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Abstract
BACKGROUND The question of the "true" function of the maxillary sinus and the paranasal sinuses (PS) has been a controversial issue in the literature for decades, leading to many discussions and speculations. OBJECTIVE This review briefly summarizes various theories on the possible physiology and functions of the maxillary sinus/PS that have been discussed over the centuries. MATERIALS AND METHODS A literature search was conducted in PubMed using a combination of the search terms "physiology," "function," "maxillary sinus," and "paranasal sinuses." RESULTS Current and scientifically evidenced theories are described. "Sinusology" is the science of the PS. The maxillary sinuses might simply serve to improve the respiratory function of the nose. A flow of inspiratory air does not occur. The maxillary sinuses are decisively involved in the production of nitrogen monoxide (NO) and thus in supporting the immune defense of the nasal cavity. The mucosa of the maxillary sinus continuously synthesizes NO and serves as a reservoir of NO. Other important functions are protection of the orbit and the brain in case of skull fractures, as well as weight reduction of the skull. CONCLUSION The various theories about the function of the PS still raise many questions and their true function is yet not fully understood. Possible functions of the maxillary sinuses are local immune defense through the production of NO. The PS serve as a crumple zone for vital cerebral structures in the context of craniocerebral traumas.
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8
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Lv H, Liu PQ, Xiang R, Zhang W, Chen SM, Kong YG, Xu Y. Predictive and Diagnostic Value of Nasal Nitric Oxide in Eosinophilic Chronic Rhinosinusitis with Nasal Polyps. Int Arch Allergy Immunol 2020; 181:853-861. [PMID: 32690852 DOI: 10.1159/000509211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A hallmark of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) is mucosal eosinophil-predominant inflammation. Nasal nitric oxide (nNO) is a known biomarker of eosinophilic inflammation in the upper airway. However, the utility of nNO measurement in the upper airway remains controversial. The present study aimed to compare the use of other clinical parameters with nNO to prediagnose patients with eCRSwNP from Central China. METHODS From June 2019 to December 2019, 70 patients with CRSwNP undergoing endoscopic sinus surgery and 30 healthy subjects were enrolled. nNO measurements were performed in all of these subjects. Computed tomography scans, full blood count with differential analysis, and determination of total immunoglobulin E (total IgE) and plasma cytokines were performed before surgery. Receiver operating characteristic curves and logistic regression analysis were used to assess the predictive potential of the clinical parameters. RESULTS We recruited 24 patients with eCRSwNP and 46 with noneosinophilic CRSwNP (non-eCRSwNP). In patients with eCRSwNP, nNO levels were significantly higher than those in patients with non-eCRSwNP (p < 0.0001). Blood eosinophil percentages and counts, total IgE, and CT-derived ethmoid sinus and maxillary sinus ratio (E/M ratio) were all significantly higher compared with those in patients with non-eCRSwNP (p < 0.05). To diagnose eCRSwNP, the highest area under the curve (0.803) was determined for nNO. At a cutoff of >329 parts per billion (ppb), the sensitivity was 83.30% and the specificity was 71.70%. However, the levels of plasma cytokines Th1/Th2 were not significantly different between the histological types of CRSwNP (p > 0.05). CONCLUSION Measurement of nNO is useful for the early diagnosis of eCRSwNP.
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Affiliation(s)
- Hao Lv
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Pei-Qiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rong Xiang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Zhang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shi-Ming Chen
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yong-Gang Kong
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China, .,Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China,
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9
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Kumpitsch C, Koskinen K, Schöpf V, Moissl-Eichinger C. The microbiome of the upper respiratory tract in health and disease. BMC Biol 2019; 17:87. [PMID: 31699101 PMCID: PMC6836414 DOI: 10.1186/s12915-019-0703-z] [Citation(s) in RCA: 217] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 02/08/2023] Open
Abstract
The human upper respiratory tract (URT) offers a variety of niches for microbial colonization. Local microbial communities are shaped by the different characteristics of the specific location within the URT, but also by the interaction with both external and intrinsic factors, such as ageing, diseases, immune responses, olfactory function, and lifestyle habits such as smoking. We summarize here the current knowledge about the URT microbiome in health and disease, discuss methodological issues, and consider the potential of the nasal microbiome to be used for medical diagnostics and as a target for therapy.
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Affiliation(s)
- Christina Kumpitsch
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Kaisa Koskinen
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Veronika Schöpf
- Institute of Psychology, University of Graz, Universitaetsplatz 2, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Austria
- Present address: Medical University Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Christine Moissl-Eichinger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Austria
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10
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Role of Taste Receptors as Sentinels of Innate Immunity in the Upper Airway. J Pathog 2018; 2018:9541987. [PMID: 30363975 PMCID: PMC6188595 DOI: 10.1155/2018/9541987] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/01/2018] [Accepted: 08/27/2018] [Indexed: 12/21/2022] Open
Abstract
Evidence is emerging that shows taste receptors serve functions outside of taste sensation of the tongue. Taste receptors have been found in tissue across the human body, including the gastrointestinal tract, bladder, brain, and airway. These extraoral taste receptors appear to be important in modulating the innate immune response through detection of pathogens. This review discusses taste receptor signaling, focusing on the G-protein-coupled receptors that detect bitter and sweet compounds in the upper airway epithelium. Emphasis is given to recent studies which link the physiology of sinonasal taste receptors to clinical manifestation of upper airway disease.
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11
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The Role of Taste Receptors in Airway Innate Immune Defense. SINUSITIS 2018. [DOI: 10.3390/sinusitis3020006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Murray GM, O'Neill RG, Lee AM, McElroy MC, More SJ, Monagle A, Earley B, Cassidy JP. The bovine paranasal sinuses: Bacterial flora, epithelial expression of nitric oxide and potential role in the in-herd persistence of respiratory disease pathogens. PLoS One 2017; 12:e0173845. [PMID: 28282443 PMCID: PMC5345874 DOI: 10.1371/journal.pone.0173845] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/27/2017] [Indexed: 12/14/2022] Open
Abstract
The bovine paranasal sinuses are a group of complex cavernous air-filled spaces, lined by respiratory epithelium, the exact function of which is unclear. While lesions affecting these sinuses are occasionally reported in cattle, their microbial flora has not been defined. Furthermore, given that the various bacterial and viral pathogens causing bovine respiratory disease (BRD) persist within herds, we speculated that the paranasal sinuses may serve as a refuge for such infectious agents. The paranasal sinuses of clinically normal cattle (n = 99) and of cattle submitted for post-mortem examination (PME: n = 34) were examined by microbial culture, PCR and serology to include bacterial and viral pathogens typically associated with BRD: Mycoplasma bovis, Histophilus somni, Mannheimia haemolytica and Pasteurella multocida, bovine respiratory syncytial virus (BRSV) and bovine parainfluenza-3 virus (BPIV-3). Overall, the paranasal sinuses were either predominantly sterile or did not contain detectable microbes (83.5%: 94.9% of clinically normal and 50.0% of cattle submitted for PME). Bacteria, including BRD causing pathogens, were identified in relatively small numbers of cattle (<10%). While serology indicated widespread exposure of both clinically normal and cattle submitted for PME to BPIV-3 and BRSV (seroprevalences of 91.6% and 84.7%, respectively), PCR identified BPIV-3 in only one animal. To further explore these findings we investigated the potential role of the antimicrobial molecule nitric oxide (NO) within paranasal sinus epithelium using immunohistochemistry. Expression of the enzyme responsible for NO synthesis, inducible nitric oxide synthase (iNOS), was detected to varying degrees in 76.5% of a sub-sample of animals suggesting production of this compound plays a similar protective role in the bovine sinus as it does in humans.
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Affiliation(s)
- Gerard M Murray
- Sligo Regional Veterinary Laboratory, Department of Agriculture, Food and Marine, Doonally, Sligo, Ireland
| | - Rónan G O'Neill
- Central Veterinary Research Laboratory, Department of Agriculture, Food and Marine, Backweston, Celbridge, County Kildare, Ireland
| | - Alison M Lee
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Máire C McElroy
- Central Veterinary Research Laboratory, Department of Agriculture, Food and Marine, Backweston, Celbridge, County Kildare, Ireland
| | - Simon J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Aisling Monagle
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Bernadette Earley
- Animal and Bioscience Research Department, Animal & Grassland Research and Innovation Centre, Teagasc, Grange, Dunsany, County Meath, Ireland
| | - Joseph P Cassidy
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
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13
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Workman AD, Palmer JN, Adappa ND, Cohen NA. The Role of Bitter and Sweet Taste Receptors in Upper Airway Immunity. Curr Allergy Asthma Rep 2016; 15:72. [PMID: 26492878 DOI: 10.1007/s11882-015-0571-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Over the past several years, taste receptors have emerged as key players in the regulation of innate immune defenses in the mammalian respiratory tract. Several cell types in the airway, including ciliated epithelial cells, solitary chemosensory cells, and bronchial smooth muscle cells, all display chemoresponsive properties that utilize taste receptors. A variety of bitter products secreted by microbes are detected with resultant downstream inflammation, increased mucous clearance, antimicrobial peptide secretion, and direct bacterial killing. Genetic variation of bitter taste receptors also appears to play a role in the susceptibility to infection in respiratory disease states, including that of chronic rhinosinusitis. Ongoing taste receptor research may yield new therapeutics that harness innate immune defenses in the respiratory tract and may offer alternatives to antibiotic treatment. The present review discusses taste receptor-protective responses and analyzes the role these receptors play in mediating airway immune function.
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Affiliation(s)
- Alan D Workman
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Medical Center, 5th Floor Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - James N Palmer
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Medical Center, 5th Floor Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Nithin D Adappa
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Medical Center, 5th Floor Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Noam A Cohen
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Medical Center, 5th Floor Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA. .,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. .,Monell Smell and Taste Center, Philadelphia, PA, USA. .,Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
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14
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Magomedov MM, Andriyaskin DV. [The role of accessory ostia of the maxillary sinuses in pathogenesis of acute and chronic maxillary sinusitis]. Vestn Otorinolaringol 2015; 80:98-100. [PMID: 26640843 DOI: 10.17116/otorino201580598-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of the present study was to analyze the literature publications concerning the problem of accessory ostia of the maxillary sinuses and their influence on the development and clinical course of acute and chronic maxillary sinusitis. It is concluded that, despite the conflicting opinions of different authors, accessory ostia appear to be involved in pathogenesis of maxillary sinusitis as the factors that provoke chronization of the inflammatory processes.
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Affiliation(s)
- M M Magomedov
- N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997
| | - D V Andriyaskin
- N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997
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15
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Hochhegger B, Alves GRT, Irion KL, Watte G, Scheeren B, Rottenfuser R, Marchiori E. Computed tomographic pulmonary changes in patients with chronic rhinosinusitis. Br J Radiol 2015; 88:20150273. [PMID: 26246280 DOI: 10.1259/bjr.20150273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate whether patients with a diagnosis of chronic rhinosinusitis (CRS) show characteristic pulmonary changes on chest CT compared with a control group without sinusopathy. METHODS This retrospective, observational study included patients with and without a diagnosis of CRS who underwent CT examination of the lungs between 2012 and 2014. Two radiologists, who were blinded for the presence of CRS, reviewed the scans for the presence of any abnormalities consensually. The χ(2) test was used for correlative analysis, with a significance level of 0.05. RESULTS A total of 123 CT series (51.2% from male patients, mean age 41 ± 16 years) were reviewed, including those from 59 (48%) patients with a diagnosis of CRS. Patients with CRS were more likely than the control group to exhibit atelectasis, bronchiolectasis, centrilobular nodules and ground-glass opacities (all p < 0.05), with a significant predilection for middle lobe and lingular involvement observed (p < 0.001). Other abnormalities, such as bronchial wall thickening and air trapping, did not differ between groups. CONCLUSION Atelectatic changes, ground-glass opacities, bronchiolectasis and centrilobular nodules are the most frequent abnormalities associated with CRS, with peculiar middle lobe and lingular involvement observed on chest CT examinations. ADVANCES IN KNOWLEDGE CRS is a frequent disorder that displays typical pulmonary changes at CT. The recognition of such findings can prevent patients with this condition from undergoing unnecessary investigations that might be based on the presence of the aforementioned radiological features.
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Affiliation(s)
- Bruno Hochhegger
- 1 Post-graduation Program in Medicine (Radiology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giordano R T Alves
- 1 Post-graduation Program in Medicine (Radiology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Klaus L Irion
- 2 Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Guilherme Watte
- 3 Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Betina Scheeren
- 3 Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Robson Rottenfuser
- 4 Division of Radiology, Hospital da Cidade de Passo Fundo, Passo Fundo, Brazil
| | - Edson Marchiori
- 1 Post-graduation Program in Medicine (Radiology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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16
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Zheng Z, Ren H, VonWald I, Meyerhoff ME. Highly sensitive amperometric Pt-Nafion gas phase nitric oxide sensor: Performance and application in characterizing nitric oxide-releasing biomaterials. Anal Chim Acta 2015; 887:186-191. [PMID: 26320801 PMCID: PMC4555983 DOI: 10.1016/j.aca.2015.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/29/2015] [Accepted: 06/04/2015] [Indexed: 11/17/2022]
Abstract
A highly sensitive amperometric gas-phase nitric oxide (NO) sensor based on a Pt working electrode chemically deposited on a Nafion film is described. The Pt electrode is chemically deposited on a Nafion 117 membrane by impregnating the film with Pt(NH3)4(2+) ions, which are then exposed to NaBH4 to precipitate conductive Pt metal. The sensor was characterized with a mass-flow controlled 1 ppm NO standard gas and has an electrochemical surface area of 34 ± 9 cm(2), low limits of detection (4.3 ± 1.1 ppb) and a fast response time (<5s) toward changes in gas phase NO levels. Good correlation was found for measurements with the new amperometric Pt-Nafion sensor vs. chemiluminescence results for detecting the rates of NO release from Carbosil2080A polymer films doped with S-nitroso-N-acetylpenicillamine (R = 0.999, m = 0.999, n = 6) and for electrochemical reduction of nitrite to NO (R = 0.999, m = 0.938, n = 3) mediated by a copper(II)-tri(2-pyridylmethyl)amine complex.
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Affiliation(s)
- Zheng Zheng
- Department of Chemistry, 930 N. University Avenue, University of Michigan, Ann Arbor, MI 48109, USA
| | - Hang Ren
- Department of Chemistry, 930 N. University Avenue, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ian VonWald
- Department of Chemistry, 930 N. University Avenue, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mark E Meyerhoff
- Department of Chemistry, 930 N. University Avenue, University of Michigan, Ann Arbor, MI 48109, USA.
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17
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Krasnozhen VN, Shcherbakov DA, Garskova YA. [The paranasal sinuses as the nitric oxide depot]. Vestn Otorinolaringol 2015. [PMID: 28635895 DOI: 10.17116/otorino20158049-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper was designed to report the currently available data on physiology of the nasal cavity and paranasal sinuses together with the results of national and international investigations on the computer modeling of the air flow in these structures. Also discussed are the gas composition in the paranasal sinuses and the potential factors responsible for the changes in the concentration of nitric oxide with the chemical formula of NO in the nasal cavity and paranasal sinuses.
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Affiliation(s)
- V N Krasnozhen
- Kazan State Medical Academy, Russian Ministry of Heath, Kazan, Russia, 420012
| | - D A Shcherbakov
- All-Russian Centre of Eye and Plastic Surgery, Russian Ministry of Health, Ufa, Russia, 450075
| | - Yu A Garskova
- Kazan State Medical Academy, Russian Ministry of Heath, Kazan, Russia, 420012
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18
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Manna A, Montella S, Maniscalco M, Maglione M, Santamaria F. Clinical application of nasal nitric oxide measurement in pediatric airway diseases. Pediatr Pulmonol 2015; 50:85-99. [PMID: 25156952 DOI: 10.1002/ppul.23094] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 05/04/2014] [Accepted: 06/06/2014] [Indexed: 12/12/2022]
Abstract
Nitric oxide plays an important role in several physiological and pathophysiological processes in the respiratory tract. Different ways to measure nasal nitric oxide levels in children are currently available. The possibility of obtaining nasal nitric oxide measurement from relatively young children, combined with the availability of portable devices that can be used even in the office setting, opens new perspectives for nasal nitric oxide analysis in the pediatric daily practice. This review presents a synopsis about the current clinical applications of nasal nitric oxide measurement in the pediatric clinical practice. A total of 3,775 articles on the topic were identified, of which 883 duplicates were removed, and 2,803 were excluded based on review of titles and abstracts. Eighty-nine full text articles were assessed for eligibility and 32 additional articles were obtained from the reference lists of the retrieved studies. Since very low nasal nitric oxide levels are found in the majority of patients with primary ciliary dyskinesia, most publications support a central role for nasal nitric oxide to screen the disease, and indicate that it is a very helpful first-line tool in the real-life work-up in all age groups. Decreased nasal nitric oxide concentration is also typical of cystic fibrosis, even though nasal nitric oxide is not as low as in primary ciliary dyskinesia. In other upper airway disorders such as allergic rhinitis, rhinosinusitis, nasal polyposis, and adenoidal hypertrophy, clinical utility of nasal nitric oxide is still critically questioned and remains to be established. Since nNO determination is flow dependent, a general consensus from the major investigators in this area is highly desirable so that future studies will be performed with the same flow rate. A shared nNO methodology will enable to overcome the challenges that lie ahead in incorporating nNO measurement into the mainstream clinical setting of pediatric airway diseases.
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Affiliation(s)
- Angelo Manna
- Department of Translational Medical Sciences, "Federico II" University. Via Sergio Pansini, 5-80131, Naples, Italy
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19
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Lee RJ, Cohen NA. Taste receptors in innate immunity. Cell Mol Life Sci 2015; 72:217-36. [PMID: 25323130 PMCID: PMC4286424 DOI: 10.1007/s00018-014-1736-7] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/11/2014] [Accepted: 09/16/2014] [Indexed: 02/07/2023]
Abstract
Taste receptors were first identified on the tongue, where they initiate a signaling pathway that communicates information to the brain about the nutrient content or potential toxicity of ingested foods. However, recent research has shown that taste receptors are also expressed in a myriad of other tissues, from the airway and gastrointestinal epithelia to the pancreas and brain. The functions of many of these extraoral taste receptors remain unknown, but emerging evidence suggests that bitter and sweet taste receptors in the airway are important sentinels of innate immunity. This review discusses taste receptor signaling, focusing on the G-protein-coupled receptors that detect bitter, sweet, and savory tastes, followed by an overview of extraoral taste receptors and in-depth discussion of studies demonstrating the roles of taste receptors in airway innate immunity. Future research on extraoral taste receptors has significant potential for identification of novel immune mechanisms and insights into host-pathogen interactions.
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Affiliation(s)
- Robert J. Lee
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Ravdin Building, 5th floor, Philadelphia, PA 19104 USA
| | - Noam A. Cohen
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Ravdin Building, 5th floor, Philadelphia, PA 19104 USA
- Philadelphia Veterans Affairs Medical Center Surgical Services, 3900 Woodland Ave, Philadelphia, PA 19104 USA
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20
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The effect of a middle meatal antrostomy on nitric oxide ventilation in the maxillary sinus. Respir Physiol Neurobiol 2013; 192:7-16. [PMID: 24333403 DOI: 10.1016/j.resp.2013.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 11/30/2013] [Accepted: 12/02/2013] [Indexed: 10/25/2022]
Abstract
The effects of middle meatal antrostomy (MMA) on air and nitric oxide exchange in the human maxillary sinus were quantified using the computational fluid dynamics technique. One full period of respiration was considered in the anatomically correct numerical domain. The simulation results showed that MMA did not cause any noticeable change in the velocity or pressure fields at a global level but induced local velocity as high as 0.21m/s inside the maxillary. Therefore, enlargement of the ostium area by MMA allows inspiratory and expiratory nasal airflow to induce significant convective flows in the sinus, which in turn enhances gas exchange dramatically. At the end of the inspiration phase, NO concentration in the maxillary sinus decreased to about 54% of the initial value. NO concentration decreased only by about 30% during the expiration phase. This difference in reduction rate is thought to result from the difference in airflow velocity in the extended ostium during inspiration vs. expiration.
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21
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Takeno S, Taruya T, Ueda T, Noda N, Hirakawa K. Increased exhaled nitric oxide and its oxidation metabolism in eosinophilic chronic rhinosinusitis. Auris Nasus Larynx 2013; 40:458-64. [DOI: 10.1016/j.anl.2013.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 01/25/2013] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
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Lee RJ, Chen B, Redding KM, Margolskee RF, Cohen NA. Mouse nasal epithelial innate immune responses to Pseudomonas aeruginosa quorum-sensing molecules require taste signaling components. Innate Immun 2013; 20:606-17. [PMID: 24045336 DOI: 10.1177/1753425913503386] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 08/02/2013] [Indexed: 11/17/2022] Open
Abstract
We previously observed that the human bitter taste receptor T2R38 is an important component of upper respiratory innate defense because it detects acyl homoserine lactone (AHL) quorum-sensing molecules secreted by Gram-negative bacteria. T2R38 activation in human sinonasal epithelial cells stimulates calcium and NO signals that increase mucociliary clearance, the major physical respiratory defense against inhaled pathogens. While mice do not have a clear T2R38 ortholog, they do have bitter taste receptors capable of responding to T2R38 agonists, suggesting that T2R-mediated innate immune mechanisms may be conserved in mice. We examined whether AHLs activate calcium and NO signaling in mouse nasal epithelial cells, and utilized pharmacology, as well as cells from knockout mice lacking important components of canonical taste signal transduction pathways, to determine if AHL-stimulated responses require taste signaling molecules. We found that AHLs stimulate calcium-dependent NO production that increases mucociliary clearance and thus likely serves an innate immune role against Gram-negative bacteria. These responses require PLCβ2 and TRPM5 taste signaling components, but not α-gustducin. These data suggest the mouse may be a useful model for further studies of T2R-mediated innate immunity.
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Affiliation(s)
- Robert J Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Bei Chen
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin M Redding
- Monell Chemical Senses Center and Philadelphia VA Medical Center Surgical Services, Philadelphia, PA, USA
| | - Robert F Margolskee
- Monell Chemical Senses Center and Philadelphia VA Medical Center Surgical Services, Philadelphia, PA, USA
| | - Noam A Cohen
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA Surgical Services, Philadelphia Veterans Administration Medical Center, Philadelphia, PA, USA
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Impacts of fluid dynamics simulation in study of nasal airflow physiology and pathophysiology in realistic human three-dimensional nose models. Clin Exp Otorhinolaryngol 2012. [PMID: 23205221 PMCID: PMC3506767 DOI: 10.3342/ceo.2012.5.4.181] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
During the past decades, numerous computational fluid dynamics (CFD) studies, constructed from CT or MRI images, have simulated human nasal models. As compared to rhinomanometry and acoustic rhinometry, which provide quantitative information only of nasal airflow, resistance, and cross sectional areas, CFD enables additional measurements of airflow passing through the nasal cavity that help visualize the physiologic impact of alterations in intranasal structures. Therefore, it becomes possible to quantitatively measure, and visually appreciate, the airflow pattern (laminar or turbulent), velocity, pressure, wall shear stress, particle deposition, and temperature changes at different flow rates, in different parts of the nasal cavity. The effects of both existing anatomical factors, as well as post-operative changes, can be assessed. With recent improvements in CFD technology and computing power, there is a promising future for CFD to become a useful tool in planning, predicting, and evaluating outcomes of nasal surgery. This review discusses the possibilities and potential impacts, as well as technical limitations, of using CFD simulation to better understand nasal airflow physiology.
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Noda N, Takeno S, Fukuiri T, Hirakawa K. Monitoring of Oral and Nasal Exhaled Nitric Oxide in Eosinophilic Chronic Rhinosinusitis: A Prospective Study. Am J Rhinol Allergy 2012; 26:255-9. [DOI: 10.2500/ajra.2012.26.3772] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background We aimed to examine the effect of different therapeutic modalities on levels of fractional concentrations of exhaled nitric oxide (FeNO) in patients with eosinophilic chronic rhinosinusitis (ECRS). Methods Thirty-six ECRS patients with nasal polyps were treated either medically or surgically. Oral and nasal FeNO levels were measured using an electrochemical NO analyzer initially and at 1 and 6 months. The mRNA expression and localization of nitric oxide synthase (NOS) isoforms in sinus mucosa and nasal polyps were analyzed by real-time polymerase chain reaction (PCR) and immunohistochemistry. Results The mean oral FeNO levels in the surgical group had decreased significantly from 50.9 to 36.8 ppb 6 months after endoscopic sinus surgery. All patients in this group showed significantly higher nasal FeNO levels after treatment. The mean nasal FeNO levels were 62.3 ppb at 1 month and 93.6 ppb at 6 months. Mean oral and nasal FeNO levels in the medical group after treatment remained unchanged when compared with the baseline levels. Positive immunoreactivity of inducible NOS (iNOS) was observed in both epithelial cells and submucosal inflammatory cells. Real-time PCR analysis showed significant up-regulation of iNOS and IL-5 mRNA expression. Conclusion A combination of oral and nasal FeNO measurements is useful to monitor the extent of inflammation in CRS patients. The increase in nasal FeNO in the surgical group indicates prompt recovery of NO release from healed sinus mucosa through the opened sinus ostia. Reduction of oral FeNO levels may reflect a cessation of the underlying lower airway inflammation that is characteristic of ECRS.
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Affiliation(s)
- Noriaki Noda
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Sachio Takeno
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Takashi Fukuiri
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Katsuhiro Hirakawa
- Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Chen XB, Lee HP, Chong VFH, Wang DY. Aerodynamic characteristics inside the rhino-sinonasal cavity after functional endoscopic sinus surgery. Am J Rhinol Allergy 2012; 25:388-92. [PMID: 22185741 DOI: 10.2500/ajra.2011.25.3669] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate effects of functional endoscopic sinus surgery (FESS) on transient nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. METHODS A three-dimensional model of the nasal cavity was constructed from CT scans of a patient with FESS interventions on the right side of the nasal cavity. CFD simulations were then performed for unsteady aerodynamic flow modeling inside the nasal cavity as well as the sinuses. RESULTS Comparisons of the local velocity magnitude and streamline distributions inside the left and right nasal cavity and maxillary sinus regions were presented. Because of the FESS procedures in the right nasal cavity, existences and distributions of local circulations (vortexes) were found to be significantly different for the same nasal airflow rate but at different acceleration, deceleration, or quiet phases in the maxillary sinus region on the FESS side. Because of inertia effects, local internal airflow with circulation existences was continuous throughout the whole respiration cycle. With a larger peak inspiration flow rate, the airflow intensity inside the enlarged maxillary sinus increased significantly. Possible outcomes on functional performances of the nose were also examined and discussed. CONCLUSION Surgical enlargements of natural ostium of the maxillary sinus will change the aerodynamic patterns inside the main nasal cavity and maxillary sinus regions, which may affect normal nasal physiological functions. Local inertia effects play more important roles for the internal nasal airflow pattern changes and thus such conventional FESS procedures should be carefully planned.
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Affiliation(s)
- Xiao Bing Chen
- Department of Mechanical Engineering, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Na Y, Kim K, Kim SK, Chung SK. The quantitative effect of an accessory ostium on ventilation of the maxillary sinus. Respir Physiol Neurobiol 2012; 181:62-73. [PMID: 22326723 DOI: 10.1016/j.resp.2012.01.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 01/11/2012] [Accepted: 01/25/2012] [Indexed: 11/18/2022]
Abstract
The airflow and gas exchange behaviors of the human maxillary sinus were quantified to better understand the effect of an accessory ostium (AO). An anatomically correct numerical domain was constructed using CT data from a male patient with mild nasal obstruction. For the purpose of comparison, a numerical model without an AO was also generated by artificially removing the AO from the original model using CAD software. A steady-flow field through the nasal cavity was simulated using ANSYS-FLUENT v13.0 with a target flow rate of 250 ml/s. The Volume of Fluid (VOF) method was used to investigate the concentration field of nitric oxide (NO) initially filled in the maxillary sinus. The simulation results showed that a transit flow through the maxillary sinus developed in the presence of an AO. As the flow entered the sinus through either a natural or accessory ostium from the middle meatus, the velocity was significantly reduced to a local maximum of approximately 0.034 m/s inside the sinus. This by-pass flow rate through the sinus of 2.186×10(-1) to 3.591×10(-1) ml/s was a small fraction of the total flow rate inhaled from the nostril, but it effectively changed the local flow topology and led to a larger reduction in NO concentration in the maxillary sinus. This more rapid reduction in NO concentration was due to enhanced ventilation activity afforded by convective transport of the transit stream through the flow path connecting the natural ostium and the AO. The inspiration and expiration phases were qualitatively similar in flow pattern except for the flow direction in the maxillary sinus, suggesting that the AO plays a similar physiological role during both inspiration and expiration in terms of ventilation.
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Affiliation(s)
- Yang Na
- Department of Mechanical Engineering, Konkuk University, Seoul 143-701, Republic of Korea
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Sahin G, Klimek L, Mullol J, Hörmann K, Walther L, Pfaar O. Nitric Oxide: A Promising Methodological Approach in Airway Diseases. Int Arch Allergy Immunol 2011; 156:352-61. [DOI: 10.1159/000324678] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Furuya A, Asano K, Shoji N, Hirano K, Hamasaki T, Suzaki H. Suppression of nitric oxide production from nasal fibroblasts by metabolized clarithromycin in vitro. JOURNAL OF INFLAMMATION-LONDON 2010; 7:56. [PMID: 21092318 PMCID: PMC3003651 DOI: 10.1186/1476-9255-7-56] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 11/23/2010] [Indexed: 11/29/2022]
Abstract
Background Low-dose and long-term administration of 14-membered macrolide antibiotics, so called macrolide therapy, has been reported to favorably modify the clinical conditions of chronic airway diseases. Since there is growing evidence that macrolide antibiotic-resistant bacteria's spreaders in the populations received macrolide therapy, it is strongly desired to develop macrolide antibiotics, which showed only anti-inflammatory action. The present study was designed to examine the influence of clarithromycin (CAM) and its metabolized materials, M-1, M-4 and M-5, on free radical generation from nasal polyp fibroblasts (NPFs) through the choice of nitric oxide (NO), which is one of important effector molecule in the development of airway inflammatory disease in vitro. Methods NPFs (5 × 105 cells/ml) were stimulated with 1.0 μg/ml lipopolysaccharide (LPS) in the presence of agents for 24 hours. NO levels in culture supernatants were examined by the Griess method. We also examined the influence of agents on the phosphorylation of MAPKs, NF-κB activation, iNOS mRNA expression and iNOS production in NPFs cultured for 2, 4, 8, and 12 hours, respectively. Results The addition of CAM (> 0.4 μg/ml) and M-4 (> 0.04 μg/ml) could suppress NO production from NPFs after LPS stimulation through the suppression of iNOS mRNA expression and NF-κB activation. CAM and M-4 also suppressed phosphorylation of MAPKs, ERK and p38 MAPK, but not JNK, which are increased LPS stimulation. On the other hand, M-1 and M-5 could not inhibit the NO generation, even when 0.1 μg/ml of the agent was added to cell cultures. Conclusion The present results may suggest that M-4 will be a good candidate for the agent in the treatment of chronic airway inflammatory diseases, since M-4 did not have antimicribiological effects on gram positive and negative bacteria.
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Affiliation(s)
- Ayako Furuya
- Division of Physiology, School of Nursing and Rehabilitation Sciences, Showa University, Yokohama, Japan.
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Deroee AF, Nezami BG, Mehr SE, Hosseini R, Salmasi AH, Talab SS, Jahanzad I, Dehpour AR. Cholestasis induced nephrotoxicity: The role of endogenous opioids. Life Sci 2010; 86:488-92. [DOI: 10.1016/j.lfs.2010.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 02/02/2010] [Accepted: 02/02/2010] [Indexed: 01/24/2023]
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30
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Chronic Upregulation of the Endogenous Opioid System Impairs the Skin Flap Survival in Rats. Ann Plast Surg 2009; 63:558-63. [DOI: 10.1097/sap.0b013e31818d458e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Deroee AF, Naraghi M, Sontou AF, Ebrahimkhani MR, Dehpour AR. Nitric oxide metabolites as biomarkers for follow-up after chronic rhinosinusitis surgery. Am J Rhinol Allergy 2009; 23:159-61. [PMID: 19401041 DOI: 10.2500/ajra.2009.23.3289] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nitric oxide (NO) has a variety of effects on the pathophysiology of the nasal cavity and seems to play an important role in inflammation. It is increased in the common cold but decreased in acute and chronic rhinosinusitis (CRS). Exhaled NO increases after endoscopic sinus surgery in CRS. In our previous study we showed that NO metabolite (nitrate and nitrite) levels are increased in the sinus cavity of CRS patients. We hypothesized that NO metabolite levels are increased to normal in the nasal lavage of CRS patients after endoscopic sinus surgery and NO metabolites in the nasal lavage can be used as indicators of the disease status after surgery. METHODS This study was performed on 52 patients with CRS who did not respond to medical therapy and who underwent surgery. NO metabolite levels were measured in nasal lavages of the patients before surgery and 2 months after surgery. RESULTS NO metabolite levels (mean +/- SEM) were 18.11 +/- 3.08 micromol/L and 35.97 +/- 4.64 micromol/L in nasal lavages of patients before and after surgery, respectively. The levels of NO metabolites were increased significantly (p < 0.01) after surgery in nasal lavages and patients reported significant improvement based on the visual analog scoring after the operation. CONCLUSION NO metabolite levels were decreased in nasal lavages of CRS patients and were increased to normal levels after surgery along with improvement of the disease. NO metabolite levels may be used as an indicator for the follow-up of patients after endoscopic sinus surgery.
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:66-73. [PMID: 19225308 DOI: 10.1097/moo.0b013e32832406ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mirbagheri SA, Nezami BG, Assa S, Hajimahmoodi M. Rectal administration of d-alpha tocopherol for active ulcerative colitis: A preliminary report. World J Gastroenterol 2008; 14:5990-5. [PMID: 18932276 PMCID: PMC2760182 DOI: 10.3748/wjg.14.5990] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the anti-oxidant and anti-neutrophil recruitment effects of rectal d-alpha (d-α) tocopherol administration on mild and moderately active ulcerative colitis (UC).
METHODS: Fifteen patients with mild and moderately active ulcerative colitis were enrolled in an open-label study of d-α tocopherol enema (8000 U/d) for 12 wk. All patients were receiving concomitant therapy with 5-aminosalicylic acid derivatives (5-ASA) and/or immunomodulator medications. Endoscopic evaluation was performed at baseline and after 4th and 12th weeks. Disease activity was measured with the Mayo disease activity index (DAI) and remission was defined as DAI of ≤ 2 with no blood in stool. Clinical response was defined as a DAI reduction of ≥ 2.
RESULTS: At the end of 12th week, the average DAI score significantly decreased compared to the beginning of the study (2.3 ± 0.37 vs 8 ± 0.48, P < 0.0001). One patient was withdrawn after 3 wk for being unavailable to follow-up. On the 4th week of therapy, 12 patients showed clinical response, 3 of whom (21.4%) achieving remission. After 12 wk, all 14 patients responded clinically to the therapy and remission was induced in 9 of them (64%). No patient reported adverse events or was hospitalized due to worsened disease activity.
CONCLUSION: This preliminary report suggests that rectal d-α tocopherol may represent a novel therapy for mild and moderately active UC. The observed results might be due to the anti-inflammatory and anti-oxidative properties of vitamin E.
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Current World Literature. Curr Opin Otolaryngol Head Neck Surg 2008; 16:292-5. [DOI: 10.1097/moo.0b013e3283041256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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