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Hayer SD, Rabago DP, Amaza IP, Kille T, Coe CL, Zgierska A, Zakletskaia L, Mundt MP, Krahn D, Obasi CN, Molander RC. Effectiveness of nasal irrigation for chronic rhinosinusitis and fatigue in patients with Gulf War illness: protocol for a randomized controlled trial. Contemp Clin Trials 2015; 41:219-26. [PMID: 25625809 PMCID: PMC4387129 DOI: 10.1016/j.cct.2015.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/15/2015] [Accepted: 01/17/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Gulf War Illness (GWI) affects 1 in 7 returned Persian Gulf War veterans. Quality-of-life impact is large; there is no cure. Chronic sinus symptoms and fatigue are common. Nasal irrigation with saline (NI-S) or xylitol (NI-X) improve sinus symptoms and fatigue in the general population. This trial will assess the effect of NI-S and NI-X on sinus and fatigue symptoms, economic outcomes and pro-inflammatory milieu among participants with GWI. METHODS 75 participants (age 35 to 65 years, 25 in each of three arms) with GWI will be recruited from the Veteran's Administration and the community. They will use routine care for sinus symptoms and fatigue and be randomized to continued usual care alone or additional therapy with NI-S or NI-X. Participants will be able to adjust specific elements of the NI procedure. The primary outcome (Sinonasal Outcome Test, SNOT-20) and other self-reported assessments will occur at baseline, 8 and 26 weeks; lab assessment of pro-inflammatory cellular and cytokine profiles will occur at baseline and 26 weeks. Other outcomes will include fatigue-specific and overall health-related quality of life, pro-inflammatory cellular and cytokine profiles, cost-effectiveness and participant satisfaction. RESULTS Baseline demographic and clinical data from the first 10 participants show effective participant recruitment, enrollment, randomization, retention and data collection. CONCLUSION Early study conduct suggests that our participant-oriented approach will yield high rates of participant adherence and data capture, facilitating robust analysis. Results of this study will clarify the value of NI for chronic sinus symptoms and fatigue among patients with GWI. CLINICAL TRIAL REGISTRATION clinicaltrials.gov identifier NCT01700725.
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Affiliation(s)
- Supriya D Hayer
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - David P Rabago
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States.
| | - Iliya P Amaza
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Tony Kille
- 600 Highland Avenue, Madison, WI 53792, Department of Surgery, Division of Otolaryngology, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Aleksandra Zgierska
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Larissa Zakletskaia
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Marlon P Mundt
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Dean Krahn
- Department of Psychiatry, Veterans Administration Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States; Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Chidi N Obasi
- 1100 Delaplaine Court, Madison, WI 53715, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, United States
| | - Rachel C Molander
- Department of Psychiatry, Veterans Administration Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States; Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, United States
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Jetté ME, Hayer SD, Thibeault SL. Characterization of human vocal fold fibroblasts derived from chronic scar. Laryngoscope 2013; 123:738-45. [PMID: 23444190 DOI: 10.1002/lary.23681] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 07/10/2012] [Accepted: 07/25/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS In vitro modeling of cell-matrix interactions that occur during human vocal fold scarring is uncommon, as primary human vocal fold scar fibroblast cell lines are difficult to acquire. The purpose of this study was to characterize morphologic features, growth kinetics, contractile properties, α-smooth muscle actin (α-SMA) protein expression and gene expression profile of human vocal fold fibroblasts derived from scar (sVFF) relative to normal vocal fold fibroblasts (nVFF). STUDY DESIGN In vitro. METHODS We successfully cultured human vocal fold fibroblasts from tissue explants of scarred vocal folds from a 56-year-old female and compared these to normal fibroblasts from a 59-year-old female. Growth and proliferation were assessed by daily cell counts, and morphology was compared at 60% confluence for 5 days. Gel contraction assays were evaluated after seeding cells within a collagen matrix. α-SMA was measured using western blotting and immunocytochemistry (ICC). Quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) was used to assess differential extracellular matrix gene expression between the two cell types. RESULTS sVFF were morphologically indistinguishable from nVFF. sVFF maintained significantly lower proliferation rates relative to nVFF on days 3 to 6 (day 3: P = .0138; days 4, 5, and 6: P < .0001). There were no significant differences in contractile properties between the two cell types at any time point (0 hours: P = .70, 24 hours: P = .79, 48 hours: P = .58). ICC and western blot analyses revealed increased expression of α-SMA in sVFF as compared with nVFF at passages 4 and 5, but not at passage 6 (passage 4: P = .006, passage 5: P = .0015, passage 6: P = .8860). Analysis of 84 extracellular matrix genes using qRT-PCR revealed differential expression of 15 genes (P < .01). CONCLUSIONS nVFF and sVFF displayed differences in proliferation rates, α-SMA expression, and gene expression, whereas no differences were observed in contractile properties or morphology. Further investigation with a larger sample size is necessary to confirm these findings.
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Affiliation(s)
- Marie E Jetté
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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