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Nguyen TN, Koga Y, Wakasugi T, Kitamura T, Suzuki H. Nasal polyps show decreased mucociliary transport despite vigorous ciliary beating. Braz J Otorhinolaryngol 2024; 90:101377. [PMID: 38232516 PMCID: PMC10827508 DOI: 10.1016/j.bjorl.2023.101377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE Mucociliary transport function in the airway mucosa is essential for maintaining a clean mucosal surface. This function is impaired in upper and lower airway diseases. Nasal polyps are a noticeable pathological feature that develop in some of the patients with chronic rhinosinusitis. Like ordinary nasal mucosae, nasal polyps have a ciliated pseudostratified epithelium with vigorous ciliary beating. We measured ex vivo Mucociliary Transport Velocity (MCTV) and Ciliary Beat Frequency (CBF) and explored the expressions of Planar Cell Polarity (PCP) proteins in nasal polyps in comparison with turbinate mucosae. METHODS Inferior turbinates and nasal polyps were surgically collected from patients with chronic rhinosinusitis. Ex vivo MCTV and CBF were measured using a high-speed digital imaging system. Expressions of PCP proteins were explored by fluorescence immunohistochemistry and quantitative RT-PCR. RESULTS The MCTV of nasal polyps was significantly lower than that of the turbinates (7.43 ± 2.01 vs. 14.56 ± 2.09 μm/s; p = 0.0361), whereas CBF did not differ between the two tissues. The MCTV vector was pointed to the posteroinferior direction in all turbinates with an average inclination angle of 41.0 degrees. Immunohistochemical expressions of Dishevelled-1, Dishevelled-3, Frizzled3, Frizzled6, Prickle2 and Vangl2 were lower in the nasal polyps than in the turbinates. Confocal laser scanning microscopy showed that Frizzled3 was localized along the cell junction on the apical surface. The expression levels of mRNAs for Dishevelled-1, Dishevelled-3 and Frizzled3 in the nasal polyps were also decreased in comparison with the turbinates. CONCLUSION These results indicate that muco ciliary transport in nasal polyps is impaired although vigorous ciliary beating is maintained, and that the impairment may be caused by a decrease in Dishevelled/Frizzled proteins and resultant PCP disarrangement. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Thi Nga Nguyen
- University of Occupational and Environmental Health, School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kitakyushu, Japan; Vinh Medical University, Faculty of Public Health, Vinh City, Vietnam
| | - Yuma Koga
- University of Occupational and Environmental Health, School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kitakyushu, Japan
| | - Tetsuro Wakasugi
- University of Occupational and Environmental Health, School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kitakyushu, Japan
| | - Takuro Kitamura
- University of Occupational and Environmental Health, School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kitakyushu, Japan
| | - Hideaki Suzuki
- University of Occupational and Environmental Health, School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kitakyushu, Japan.
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Pourova J, Dias P, Pour M, Bittner Fialová S, Czigle S, Nagy M, Tóth J, Balázs VL, Horváth A, Csikós E, Farkas Á, Horváth G, Mladěnka P. Proposed mechanisms of action of herbal drugs and their biologically active constituents in the treatment of coughs: an overview. PeerJ 2023; 11:e16096. [PMID: 37901462 PMCID: PMC10607228 DOI: 10.7717/peerj.16096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/24/2023] [Indexed: 10/31/2023] Open
Abstract
Various medicinal plants find their use in cough treatment, based on traditions and long-term experience. Pharmacological principles of their action, however, are much less known. Herbal drugs usually contain a mixture of potentially active compounds, which can manifest diverse effects. Expectorant or antitussive effects, which can be accompanied by others, such as anti-inflammatory or antibacterial, are probably the most important in the treatment of coughs. The aim of this review is to summarize the current state of knowledge of the effects of medicinal plants or their constituents on cough, based on reliable pharmacological studies. First, a comprehensive description of each effect is provided in order to explain the possible mechanism of action in detail. Next, the results related to individual plants and substances are summarized and critically discussed based on pharmacological in vivo and in vitro investigation.
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Affiliation(s)
- Jana Pourova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
| | - Patricia Dias
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
| | - Milan Pour
- Department of Organic and Bioorganic Chemistry, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
| | - Silvia Bittner Fialová
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | - Szilvia Czigle
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | - Milan Nagy
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | - Jaroslav Tóth
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovak Republic
| | | | - Adrienn Horváth
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Eszter Csikós
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Ágnes Farkas
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Györgyi Horváth
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University Prague, Hradec Králové, Czech Republic
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Pagliuca G, Clemenzi V, Martellucci S, Gazia F, Santarsiero S, Farina L, Stolfa A, Gallo A. Glycyrrhizin and Mannitol Nasal Therapy: Cytological and Clinical Outcomes in Chronic Rhinitis. Int Arch Otorhinolaryngol 2023; 27:e586-e592. [PMID: 37876682 PMCID: PMC10593527 DOI: 10.1055/s-0042-1758219] [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: 05/18/2022] [Accepted: 07/19/2022] [Indexed: 03/06/2023] Open
Abstract
Introduction Chronic rhinitis (CR) represents a widespread inflammation with a high incidence in the general population. Although it is generally considered a benign condition, CR has a relevant impact on quality of life and requires a specific treatment approach. Objective The aim of the present study was to investigate the efficacy of glycyrrhizin and mannitol intranasal treatment on chronic rhinitis using cytological analysis and subjective evaluation of symptoms. Methods A total of 55 patients suffering from chronic rhinitis were enrolled in the present study, 34 with allergic rhinitis (AR) and 21 with nonallergic rhinitis (NAR). The severity of four different nasal symptoms was determined by using a visual analogue scale (VAS). Specimens obtained by nasal scraping were collected for cytological analysis. Data were acquired before and after a 30-day treatment with glycyrrhizin and mannitol nasal spray. Statistical analyses were performed. Results The VAS scores for all four nasal symptoms considered in the present study, as well as for neutrophil cells, reduced significantly after therapy in both allergic and nonallergic patients. The number of eosinophils was not significantly lower in nonallergic patients. Conclusion A 30-day topical treatment with glycyrrhizin and mannitol may improve nasal symptoms and reduce inflammatory cells in the nasal mucosa in patients with chronic rhinitis without significant contraindications. Further studies could support our results and would better clarify all the aspects of this treatment.
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Affiliation(s)
- Giulio Pagliuca
- Otolaryngology University Unit, “S.M. Goretti Hospital”, Latina, Italy
| | - Veronica Clemenzi
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, Rome, Italy
| | | | - Francesco Gazia
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Otorhinolaryngology Unit, Messina, Italy
| | - Sara Santarsiero
- Otorhinolaryngology Unit, Pediatric Hospital “Bambino Gesù”, Roma, Italy
| | - Luigi Farina
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Stolfa
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Gallo
- Department of Sensorial Organs, ENT Section, “Sapienza” University of Rome, Rome, Italy
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Dos Santos M, Penteado JO, Baisch PRM, Soares BM, Muccillo-Baisch AL, da Silva Júnior FMR. Selenium dietary intake, urinary excretion, and toxicity symptoms among children from a coal mining area in Brazil. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:65-75. [PMID: 32710235 DOI: 10.1007/s10653-020-00672-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Selenium (Se) is necessary for several physiological functions in the human body; however, high concentrations of this element in coal mining areas raise the possibility of Se-related health risks. Children are much more vulnerable and at risk to environmental hazards than adults. The largest coal mining area of Brazil is located in the city of Candiota, where previous studies point to significant urinary Se concentrations among children. Food intake is the main Se source. The study aimed to evaluate dietary Se intake, as well as urinary Se excretion and classic symptoms of Se intoxication among children from Candiota and a control city in the same region. A cross-sectional study was carried out, with participation from 242 children between 6 and 12 years old in two cities in Rio Grande do Sul state, Brazil. Socioeconomic variables, dietary intake, and Se toxicity symptoms were evaluated through a structured questionnaire, and urinary Se levels were measured. Children from both cities had normal levels of Se intake and urinary excretion; however, children from Candiota had significantly higher levels of Se in both parameters in relation to the control city, especially for Se urinary excretion. There was low prevalence of Se toxicity symptoms. We conclude that coal mining activities may increase Se intake in children and consequently its urinary excretion.
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Affiliation(s)
- Marina Dos Santos
- Programa de Pós-graduação em Ciências Da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Júlia Oliveira Penteado
- Programa de Pós-graduação em Ciências Da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Paulo Roberto Martins Baisch
- Laboratório de Oceanografia Geológica, Instituto de Oceanografia, Universidade Federal do Rio Grande do Sul, Rio Grande, Brazil
| | - Bruno Meira Soares
- Escola de Química de Alimentos, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Ana Luíza Muccillo-Baisch
- Programa de Pós-graduação em Ciências Da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Flavio Manoel Rodrigues da Silva Júnior
- Programa de Pós-graduação em Ciências Da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, Brazil.
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Ciprandi G, Bellussi LM, Passali GC, Damiani V, Passali D. HMGB1 in nasal inflammatory diseases: a reappraisal 30 years after its discovery. Expert Rev Clin Immunol 2020; 16:457-463. [PMID: 32252560 DOI: 10.1080/1744666x.2020.1752668] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | | | | | - Valerio Damiani
- Medical Department, Drugs Minerals and Generics, Pomezia, Italy
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Ciprandi G, Tosca MA, Gallo F, Passali GC, Ameli F. Turbinate hypertrophy in children with allergic rhinitis: clinical relevance. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:43-47. [PMID: 32073560 PMCID: PMC7947744 DOI: 10.23750/abm.v91i1-s.9254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/01/2020] [Indexed: 11/23/2022]
Abstract
Allergic rhinitis (AR) is the most common immune-mediated disorder in childhood as it may affect up to 40% of children. Turbinate hypertrophy (TH) is an important sign as reliably predicts AR both in children and adults. Consistently, nasal obstruction is a very common symptom in AR patients and is closely linked with turbinate hypertrophy. This study investigated 544 (304 males) children with AR to define factors associated with TH. TH was diagnosed in 438 (80.81%) AR children. The multivariate analysis demonstrated a significant association between age, male gender, and recurrent acute otitis media (RAOM), and TH (p-values: 0.0219, <0.0001, and 0.0003, respectively; OR 0.87, 3.97, and 0.22 respectively). In conclusion, this real-life study showed that TH was very frequent in children with AR and age, male gender, and RAOM were significantly associated with TH.
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Affiliation(s)
| | | | - Fabio Gallo
- Health Sciences Department, Genoa University, Genoa, Italy.
| | | | - Franco Ameli
- Otorhinolaryngology Unit, Casa di Cura Villa Montallegro Health, Genoa, Italy.
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Passali D, Bellussi LM, Damiani V, Tosca MA, Motta G, Ciprandi G. Chronic rhinosinusitis with nasal polyposis: the role of personalized and integrated medicine. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:11-18. [PMID: 32073556 PMCID: PMC7947745 DOI: 10.23750/abm.v91i1-s.9243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Indexed: 02/06/2023]
Abstract
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a frequent disorder. From a clinical and an immunopathological point of view, different phenotypes and endotypes have been identified. The frequent comorbidity with asthma allowed to pave the way to the use of biological agents for the treatment of CRSwNP. Biological agents are targeted to antagonize IgE, interleukin (IL) 4, IL-5, and IL-13 at present. However, a correct and appropriate workup is mandatory, mainly concerning the exact definition of the specific pheno-endotype. The preliminary outcomes are promising, even though there is a need for well-established indications, criteria of responsiveness, duration, and safety. On the other hand, this personalized medicine could be fruitfully integrated with gold-standard medications, such as intranasal corticosteroids. As CRSwNP is a chronic disorder, treatment should be long-lasting, so complementary anti-inflammatory treatments could be opportunely integrated and/or alternated to steroids. (www.actabiomedica.it)
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Affiliation(s)
| | | | | | | | - Gaetano Motta
- ENT Department, University Luigi Vanvitelli, Naples, Italy.
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Gariuc L, Sandul A, Rusu D, Passali D, Bellussi LM, Damiani V, Ciprandi G. A comparison between mometasone furoate nasal spray and intranasal glycyrrhetic acid in patients with allergic rhinitis: a preliminary study in clinical practice. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:65-72. [PMID: 32073564 PMCID: PMC7947735 DOI: 10.23750/abm.v91i1-s.9229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Indexed: 11/23/2022]
Abstract
Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction consequent to the exposure to the causal allergen. Glycyrrhetic acid (GlyAc) is a natural compound extracted from the liquorice that exerts anti-inflammatory activity. This real-life study compared intranasal GlyAc, present in a medical device containing also glycerol and mannitol, with mometasone furoate nasal spray (MFNS) in 50 adult outpatients with AR. Both treatments lasted 2 months. Endoscopic signs, perception of symptom severity, assessed by VAS, and nasal function measured by rhinomanometry were evaluated at baseline (T0), after one (T1) and two (T2) months. The intergroup analysis showed that at T1 there was no significant difference between groups about the use of decongestants and antihistamines, turbinate hypertrophy and pale mucosa, perception of olfaction and snoring. At T2 there was no significant difference between groups about use of relievers, all endoscopic signs, and perception of nasal discomfort, nasal obstruction, olfaction, and snoring. The intragroup analysis showed that in MFNS group there was a significant change during the entire period of treatment for all parameters except watery rhinorrhea (sign) and ocular discomfort; in GlyAc group there was a significant change during the entire period of treatment for all parameters. In conclusion, this preliminary study, conducted in clinical practice, evidenced that intranasal CysAC plus mannitol was able to significantly improve nasal endoscopic signs, perception of symptoms, and nasal function in patients with AR. Therefore, GlyAc could be a reasonable therapeutic option to control allergic inflammation. (www.actabiomedica.it)
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Affiliation(s)
- Lucia Gariuc
- Clinical Republican Hospital, Chisinau, Republic of Moldova.
| | | | - Daniela Rusu
- Clinical Republican Hospital, Chisinau, Republic of Moldova.
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Varricchio A, La Mantia I, Brunese FP, Ciprandi G. Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies. Ital J Pediatr 2020; 46:18. [PMID: 32039733 PMCID: PMC7008537 DOI: 10.1186/s13052-020-0782-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/29/2020] [Indexed: 12/24/2022] Open
Abstract
The upper airways (UA) should be considered as a functional unit. Current functional anatomy divides URT in three, mutually dependent, "junction boxes": i) the ostio-meatal complex (OMC), ii) the spheno-ethmoidal recess (SER), and iii) the rhinopharynx (RP). Correct ventilation and effective mucociliary clearance of these sites significantly affect the healthy physiology of the entire respiratory system. The OMC, SER, and RP obstruction is the first pathogenic step in the inflammatory/infectious cascade of UA disorders. The inflammation of the respiratory mucosa is the main pathogenic factor for airway obstruction. Moreover, bacterial biofilm (a strategy modality of bacterial survival) is an important local cause of systemic antibiotic ineffectiveness, recurrent infections, and antibiotic resistance. Health microbiota guarantees UA wellness; on the contrary, dysbiosis promotes and worsens UA infections. Allergy, namely type 2 inflammation, is a common cause of UA obstruction such as promoting in turn infections. Fiberoptic endoscopy is a mandatory diagnostic tool in clinical practice. Nasal cytology, mainly concerning flow cytometry, allows defining rhinitis phenotypes so allowing a precision medicine approach. Several conventional therapeutic approaches are available, but efficacy and safety should be ever properly considered before the prescription. Also, complementary medicine plays a fruitful role in the management of UA diseases. National and real-world studies are reported and discussed as they may be useful in daily clinical practice.
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Affiliation(s)
- Attilio Varricchio
- UOSD Video-Endoscopia delle VAS, P.O. San Gennaro - ASL Napoli 1-centro, Naples, Italy
| | | | | | - Giorgio Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Via Boselli 5, 16146, Genoa, Italy.
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