Nasal Mucosa Research Articles

Volatile Oil of Magnolia biondii Pamp. for Transnasal Administration: Its Preparation, Characterization, and Mechanism of Action in the Treatment of Allergic Rhinitis.

Allergic Rhinitis (AR) is a common chronic nasal condition usually caused by allergens. The immune system overreacts when the body is exposed to allergens, releasing a lot of tissue chemicals that cause congestion, more secretions, and an inflammatory reaction in the nasal mucosa. In clinical practice, it remains a significant public health issue. Modern pharmacological studies have demonstrated that Magnolia Volatile Oil (MVO) has good anti-inflammatory, antibacterial, immunomodulatory, and other pharmacological effects. Previous research and literature reports have reported that MVO has good therapeutic effects on allergic rhinitis. However, due to the poor water solubility of Magnolia, its bioavailability is low. The purpose of this present work is to develop a new microemulsion formulation to improve the stability and bioavailability of MVO. The droplet size, PDI, and zeta potential of Magnolia volatile oil microemulsion (MVOME) were characterized along with its physical characteristics, and these values were found to be 14.270.03 nm, 0.09410.31, and -0.35850.12 mV, respectively, demonstrating the successful formation of microemulsion. In OVA-induced AR rats, MVO-ME dramatically reduced the serum levels of TNF-α, IL-1β, and IL-6 inflammatory factors. In addition, MVO-ME significantly inhibited the expression of protein levels of PPAR-γ and P65 in the nasal mucosa of AR rats. In this regard, we hypothesized that MVO-ME may play a therapeutic role in AR by activating the PPAR signaling pathway as well as inhibiting the activation of the NF/κB signaling pathway. MVO-ME has systematic advantages, such as high solubility, bioavailability, etc. It is expected to be an efficient nano-drug delivery system for the clinical treatment of allergic rhinitis.

Assessment of Vidian canal morphology in axial section and its associated structures using cone beam computed tomography: A descriptive study

The Vidian Nerve (VN), a branch of the trigeminal nerve, passes by the Vidian Canal (VC), located at the base of the skull. The VC branches into the greater petrosal nerve and the VN in the pterygopalatine fossa, where the greater petrosal nerve carries parasympathetic fibers to the lacrimal glands and nasal mucosa, and the VN carries sensory fibers from the nasopharynx, nasal cavity, and palate. In this study, 60 subjects of both sexes who underwent cone beam computed tomography (CBCT) were selected by a convenient sampling technique. The data were subjected to statistical analysis following the examination of the various parameters in the axial sections. Among the various morphological characteristics appraised in the axial section, there was no significant sexual dimorphism, except for the angle between the VC and the medial wall of the maxillary sinus, which shows statistical significance. The present study aims to investigate morphometric analysis and its associated structures, offering insightful information about the complex structure of the Vidian canal (VC), which provides adequate knowledge for surgeons to plan with more caution complex skull base procedures, and eventually to lower the therapeutical risks associated with it.

Orange Peel Lactiplantibacillus plantarum: Development of A Mucoadhesive Nasal Spray with Antimicrobial and Anti-Inflammatory Activity

Background/Objectives: Due to the high frequency and severity of upper respiratory bacterial infections, probiotics could offer a new medical approach. We explored the antibacterial and anti-inflammatory properties of the new strain Lactiplantibacillus plantarum BIA and formulated a nasal spray. Methods: L. plantarum BIA was isolated from orange peel and taxonomically identified through 16S rRNA gene sequencing. Its antibacterial activity was tested against Pseudomonas aeruginosa, Streptococcus pyogenes, Bacillus subtilis, Escherichia coli, and Staphylococcus aureus, while anti-inflammatory potential was evaluated by Griess assay. BIA genome was fully sequenced and analyzed to assess its safety. BIA was formulated in a freeze-dried matrix, containing prebiotics and cryoprotectants, to be reconstituted with a polymer solution. Solutions containing two types of hydroxypropyl methylcellulose (HPMC) and hyaluronic acid were evaluated as resuspending media and compared in terms of pH, viscosity, and mucoadhesion ability. The biological activity of BIA formulated as nasal spray was verified together with the stability of the selected formulations. Results: L. plantarum BIA inhibited human pathogens’ growth and showed anti-inflammatory activity and a safe profile. In the best-performing formulation, the probiotic is lyophilized in 10% fructooligosaccharides, 0.1% ascorbic acid, and 0.5% lactose and reconstituted with HPMC high viscosity 1% w/v. This composition ensured the probiotic’s viability for up to six months in its dried form and one week after reconstitution. It also allowed interaction with the nasal mucosa, preserving its antimicrobial and anti-inflammatory activities. Conclusion: The developed nasal spray could become a promising formulation in the field of nasal infectious and inflammatory diseases.

Paliperidone-loaded nose to brain targeted NLCS: optimisation, evaluation, histopathology and pharmacokinetic estimation for schizophernia.

Study was to develop a nanostructured-lipid-careers (NLCs) of paliperidone (PLP) for nose-to-brain targeting. NLCs was prepared by sonication, high-shear homogenisation method, and characterised their mean diameter, PDI, zeta-potential, morphology (by SEM, TEM and AFM), entrapment efficiency, drug loading, in vitro release, interaction study (by FTIR), and stability. Further, ex vivo permeation and ciliotoxicity performed in sheep nasal mucosa, and in vivo biodistribution/pharmacokinetic was performed in rats for schizophernia. Developed NLCs showed spherical and clearly 3-dimentinal structure with 129 ± 2.7 nm mean diameter, 0.304 ± 0.003 PDI, -7.61 ± 0.56 mV zeta-potential, 58.16 ± 0.17% entrapment efficiency, 65.8 ± 2% drug loading and 74.32 ± 0.003% release in 12 h, followed by Higuchi model. Ex vivo study showed NLCs have three times higher permeation, compare to pure drug (around 71.50.32% in 6 h) and 3.98 g/cm2/h steady sate flux. The blood/brain ratio given by intranasally have higher compare to IV route, and 94.53 ± 21.45% drug targeting efficiency in brain. In conclusion, NLCs have easily crossed BBB, higher drug delivery and effective for schizophrenia in given by intranasal.

LRRC8A drives NADPH oxidase-mediated mitochondrial dysfunction and inflammation in allergic rhinitis.

Allergic rhinitis (AR) is a complex disorder with variable pathogenesis. Increasing evidence suggests that the LRRC8A is involved in maintaining cellular stability, regulating immune cell activation and function, and playing significant roles in inflammation. However, the involvement of LRRC8A in AR inflammation and its underlying mechanisms remain unclear. LRRC8A expression in AR patients, confirmed by qRT-PCR and Western blotting, was analyzed to investigate its relationship with the clinical characteristics of AR patients. In vitro, IL-13 stimulated HNEpCs to establish a Th2 inflammation model, with subsequent LRRC8A knockout or overexpression. NOX1/NOX4 inhibitor (GKT137831) and chloride channel inhibitor (DCPIB) were utilized to investigate AR development mechanisms during LRRC8A overexpression. An OVA-induced AR model with nasal mucosa LRRC8A knockdown confirmed LRRC8A's regulatory role in AR inflammation. LRRC8A mRNA and protein levels were significantly elevated in AR patients, positively correlating with NADPH oxidase subunits and Th2 inflammatory markers. In vitro, IL-13 stimulation of HNEpCs resulted in upregulation of LRRC8A and increased expression of NOX1, NOX4, and p22phox, along with mitochondrial dysfunction and NF-κB pathway activation. The knockout of LRRC8A reversed these effects. In nasal mucosal epithelial cells, DCPIB and GKT137831 completely blocked mitochondrial dysfunction caused by the overexpression of LRRC8A, which led to up-regulation of NOX1, NOX4, and p22phox. In vivo, knocking down LRRC8A reduced eosinophil infiltration, downregulated the expression of NOX1, NOX4, p22phox IL-4, IL-5, and IL-13, and decreased NF-κB pathway activation. LRRC8A drives the upregulation of NOX1, NOX4, and p22phox, leading to ROS overproduction and mitochondrial dysfunction. It also activates NF-κB, ultimately leading to nasal mucosal epithelial inflammation. LRRC8A may be a potential target for the treatment of AR.

Chronic rhinosinusitis with nasal polyps: predictors of recurrence 5 years after surgery

Backgrounds Chronic rhinosinusitis with nasal polyps (CRSwNP) is a medical condition characterized by persistent inflammation of the nasal mucosa and sinuses, accompanied by the presence of nasal polyps. When medical treatments prove ineffective, endoscopic sinus surgery (ESS) is recommended, yielding variable outcomes and recurrence rates ranging from 5% to 60%. Aims/Objectives The primary objectives of this study were to evaluate the outcomes of ESS and to identify independent predictors of recurrence and revision surgery. Material and Methods Retrospective cross-sectional study, focusing on patients diagnosed with CRSwNP who underwent ESS with a minimum follow-up period of 60 months. Various variables were collected. Multivariate and regression analyses were employed to assess the predictors associated with both recurrence and revision surgery. Results The study analyzed 130 patients. The 5-year recurrence rate was 35.4%, and 17.7% of patients required revision surgery. These variables included asthma (p < 0.001), frontal sinus involvement (p < 0.001), Lund–Mackay score (p < 0.001), Endoscopic Nasal Polyps Score (p < 0.001), and eosinophilia in peripheral blood (p < 0.001). All the variables mentioned above were identified as predictors of recurrence and revision surgery. Conclusions and Significance Asthma, frontal sinus involvement, increased eosinophilia in peripheral blood, and a higher score on the LM system and NPS are poor prognostic factors in CRSwNP.

Hypoxia-reducedYAP phosphorylation enhances expression of Mucin5AC in nasal epithelial cells of chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is an upper respiratory disease characterized by persistent inflammation of the nasal mucosa. However, the mechanism of abnormal Mucin5AC expression by CRSwNP epithelial cells is not fully understood. We investigated the potential role of yes-associated protein (YAP) underlying the mechanism of excessive epithelial Mucin5AC expression in CRSwNP in a hypoxic model. Tissue biopsies of CRSwNP (n = 60), chronic rhinosinusitis without nasal polyps (CRSsNP) (n = 9) and healthy controls (n = 30) were investigated together with a well-established hypoxic model of primary human nasal epithelial cells (hNECs). The expression levels of hypoxia inducible factor (HIF)-1α and YAP, and the effect of the signaling axis on mucus secretion in hNECs were analyzed. We observed a significant elevated expression levels of YAP in patients with CRSwNP and CRSsNP compared to controls. In addition, HIF-1α expression of CRSwNP was higher than that of control group. Under hypoxic conditions, HIF-1α was found to regulate the upregulation of YAP in hNECs. Further investigations revealed that HIF-1α facilitated the activation and nuclear localization of active-YAP by reducing the phosphorylation of YAP. This mechanism appeared to be linked to HIF-1α-mediated inhibition of LATS 1 phosphorylation and subsequent YAP degradation. HIF-1α was shown to promote the expression of P63 and the levels of Mucin5AC in hNECs by enhancing YAP activation. Our findings indicated that hypoxia enhances YAP activation by decreasing p-LATS 1 and YAP phosphorylation. This has the potential to impact on the proliferation of basal cells and the differentiation of goblet cells in CRSwNP, ultimately leading to a pathological condition characterized by excessive Mucin5AC expression.

Euphorbium compositum SN improves the innate defenses of the airway mucosal barrier network during rhinovirus infection.

Rhinoviruses (RV) are the major cause of common colds in healthy individuals and are associated with acute exacerbations in patients with chronic lung diseases. Yet, no vaccines or effective treatment against RV are available. This study investigated the effect of Euphorbium compositum SN (ECSN6), a multicomponent, multitarget medication made from natural ingredients, on the mucosal barrier network during RV infection. Mucociliary-differentiated airway epithelial cell cultures were infected with RV or sham, and treated with 20% ECSN6 or placebo twice daily. Barrier integrity was assessed by measuring transepithelial resistance (TER), permeability to inulin, and expression and localization of intercellular junctions proteins (IJ). Ciliary beat frequency (CBF), expression of pro-inflammatory cytokines, antiviral interferons and mucins, and viral load were also measured. C57BL/6 mice were infected intranasally with RV or sham and treated with 40% ECSN6 or placebo twice daily. Inflammation of sinunasal mucosa, localization of E-cadherin, viral load and mucin gene expression were determined. ECSN6-treated, uninfected cell cultures showed small, but significant increase in TER over placebo, which was associated with enhanced localization of E-cadherin and ZO-1 to IJ. In RV-infected cultures, treatment with ECSN6, but not placebo prevented RV-induced (1) reduction in TER, (2) dissociation of E-cadherin and ZO-1 from the IJ, (3) mucin expression, and (4) CBF attenuation. ECSN6 also decreased RV-stimulated expression of pro-inflammatory cytokines and permeability to inulin. Although ECSN6 significantly increased the expression of some antiviral type I and type III interferons, it did not alter viral load. In vivo, ECSN6 reduced RV-A1-induced moderate inflammation of nasal mucosa, beneficially affected RV-A1-induced cytokine responses and Muc5ac mRNA expression and prevented RV-caused dissociation of E-cadherin from the IJ of nasal mucosa without an effect on viral clearance. ECSN6 prevents RV-induced airway mucosal barrier dysfunction and improves the immunological and mucociliary barrier function. ECSN6 may maintain integrity of barrier function by promoting localization of tight and adherence junction proteins to the IJ. This in turn may lead to the observed decrease in RV-induced pro-inflammatory responses in vitro. By improving the innate defenses of the airway mucosal barrier network, ECSN6 may alleviate respiratory symptoms caused by RV infections.

Real-world predictors of dupilumab prescription in patients with chronic rhinosinusitis with nasal polyps.

Despite increasing dupilumab use for chronic rhinosinusitis with nasal polyps (CRSwNP), little is known about the factors influencing its use in real-world practice. We aimed to identify factors that may predict dupilumab prescription in CRSwNP patients who have undergone endoscopic sinus surgery (ESS). A single-institution, retrospective cohort study of patients who underwent ESS for CRSwNP between 2015 and 2023 was conducted. Demographics, comorbidities, 22-item sinonasal outcome test (SNOT-22) scores, and dupilumab prescription date were extracted from patient records. Intraoperative nasal mucus cytokine levels were measured using a multiplex bead assay. Univariate logistic regression analysis was performed to identify factors associated with dupilumab prescription, and multivariate logistic regression was used to adjust for surgery date. A total of 299 CRSwNP patients were included, including seventy (23.4%) who were prescribed dupilumab postoperatively. Patients were more likely to be prescribed dupilumab if they had asthma (odds ratio [OR] 2.304), aspirin-exacerbated respiratory disease (AERD, OR 3.375), elevated tissue eosinophils (OR 1.005), and higher 3-month postoperative SNOT-22 scores (OR 1.027). Patients prescribed dupilumab also had greater odds of having elevated mucus interleukin (IL)-5 (OR 1.128) and IL-13 (OR 1.213). When adjusting for surgery date, associated factors included: asthma (OR 2.444), AERD (OR 3.750), allergic rhinitis (OR 1.833), higher tissue eosinophils (OR 1.005), elevated 3-month SNOT-22 scores (OR 1.028), and higher IL-5 (OR 1.123) and IL-13 (OR 1.202) levels. Asthma, AERD, allergic rhinitis, and elevated tissue eosinophil, IL-5, and IL-13 levels are predictive of dupilumab prescription in CRSwNP patients. These may serve as clinical and inflammatory biomarkers and can aid in counseling patients about expected disease trajectory.

Influence of breastfeeding on the ontogenesis of mucosal immunity in children

The role of breastfeeding in the development of the cellular immune system, antimicrobial strategies of neutrophils, and local cytokine levels was evaluated in a single-center, prospective, open-label, uncontrolled study of healthy infants who were either naturally or artificially breastfed. The main group included practically healthy children who were exclusively breastfed for the first year of life. Thirty-six children were examined during the first stage and 25 from this group during the second stage. The comparison group included children who received an adapted cow’s milk formula during the first half-year of their lives and a different formula during the second half-year. Thirty-one children were examined during stage one and 27 from this group were examined during stage two. A comprehensive study of mucosal immunity was conducted, assessing the cytokine profile and cellular components using the method of smear prints from the nasal mucosa. The results showed that the nature of feeding during the first year of life influences the formation of mucosal immunity and programming the postnatal development of the child’s immunological reactivity. In the absence of the immunomodulatory effects of breast milk, there is an imbalance in the cytokine profile, with a physiological deviation of the immune response linked to the predominance of Th2 profiles. In contrast, breastfeeding promotes the optimal cellular composition of the upper respiratory mucosa and a cytomorphological neutrophil profile with minimal destructive changes. Breastfeeding programs the optimal functional profile of neutrophils, including the level of receptor activity, intracellular biocidal activity, cytotoxicity, ability to complete phagocytosis. This natural infant feeding method has a long-term protective effect, preventing neutrophil destruction under the influence of environmental factors and respiratory viral agents, and ensuring optimal mucosal immunity development in the respiratory tract.

The Impact of NO2 on Epithelial Barrier Integrity of a Primary Cell-Based Air-Liquid Interface Model of the Nasal Respiratory Epithelium.

Nitrogen dioxide (NO2) is a pervasive gaseous air pollutant with well-documented hazardous effects on health, necessitating precise toxicological characterization. While prior research has primarily focused on lower airway structures, the upper airways, serving as the first line of defense against airborne substances, remain understudied. This study aimed to investigate the functional effects of NO2 exposure alone or in combination with hypoxia as a secondary stimulus on nasal epithelium and elucidate its molecular mechanisms because hypoxia is considered a pathophysiological factor in the onset and persistence of chronic rhinosinusitis, a disease of the upper airways. Air-liquid interface cell cultures derived from primary nasal mucosa cells were utilized as an invitro model, offering a high invitro-in vivo correlation. Our findings demonstrate that NO2 exposure induces malfunction of the epithelial barrier, as evidenced by decreased transepithelial electrical resistance and increased fluorescein isothiocyanate (FITC)-dextran permeability. mRNA expression analysis revealed a significant increase in IL-6 and IL-8 expressions following NO2. Reduced mRNA expression of the tight junction component occludin was identified as a structural correlate of the damaged epithelial barrier. Notably, hypoxic conditions alone did not alter epithelial barrier integrity. These findings provide information on the harmful effects of NO2 exposure on the human nasal epithelium, including compromised barrier integrity and induction of inflammatory responses. Overall, this study contributes to our understanding of pathophysiological mechanisms underlying also upper airway respiratory diseases associated with air pollution exposure and emphasizes the importance of mitigating NO2 emissions to safeguard respiratory health.

Odorant Binding Proteins Facilitate the Gas-Phase Uptake of Odorants Through the Nasal Mucus.

Mammalian odorant binding proteins (OBPs) have long been suggested to transport hydrophobic odorant molecules through the aqueous environment of the nasal mucus. While the function of OBPs as odorant transporters is supported by their hydrophobic beta-barrel structure, no rationale has been provided on why and how these proteins facilitate the uptake of odorants from the gas phase. Here, a multi-scale computational approach validated through available high-resolution spectroscopy experiments reveals that the conformational space explored by carvone inside the binding cavity of porcine OBP (pOBP) is much closer to the gas than the aqueous phase, and that pOBP effectively manages to transport odorants by lowering the free energy barrier of odorant uptake. Understanding such perireceptor events is crucial to fully unravel the molecular processes underlying the olfactory senseand move towards the development of protein-based biomimetic sensor units that can serve as artificial noses.

Anatomical study of pterygoid implants: artery and nerve passage through bone dehiscence of the greater palatine canal

PurposePterygoid implants are an alternative approach to avoid sinus-lifting or other grafting procedures. During pterygoid implant placement, dental surgeons risk damaging the greater palatine canal (GPC). However, they do not have sufficient reasons to avoid GPC injury. This study performed a detailed morphological analysis of the GPC to determine susceptibility to damage during pterygoid implant surgery.MethodsTo understand the detailed morphology of the GPC, gross anatomical analysis, histological analysis, and bone morphometry via micro-computed tomography were performed.ResultsWe found that the medial wall of the GPC communicated with the nasal cavity through the bone dehiscence. The dehiscence appeared near the inferior nasal concha in 72.4% of the cadavers. The nerve and artery passed from the GPC to the nasal mucous membrane through the dehiscence. Given that the greater palatine nerve passed medial to the descending palatine artery in the GPC, the descending palatine artery is damaged first rather than the greater palatine nerve during pterygoid implant surgery.ConclusionsDental surgeons who penetrate the GPC using an implant body may extend the bleeding to the nasal mucosa, which seems to spread the inflammation to the nasal cavity.

Modified PEG-Lipids Enhance the Nasal Mucosal Immune Capacity of Lipid Nanoparticle mRNA Vaccines

Background/Objectives: Omicron, the predominant variant of SARS-CoV-2, exhibits strong immune-evasive properties, leading to the reduced efficacy of existing vaccines. Consequently, the development of versatile vaccines is imperative. Intranasal mRNA vaccines offer convenient administration and have the potential to enhance mucosal immunity. However, delivering vaccines via the nasal mucosa requires overcoming complex physiological barriers. The aim of this study is to modify PEGylated lipids to enhance the mucosal immune efficacy of the vaccine. Methods: The PEGylated lipid component of lipid nanoparticle (LNP) delivery vectors was modified with chitosan or mannose to generate novel LNPs that enhance vaccine adhesion or targeting on mucosal surfaces. The impact of the mRNA encoding the receptor-binding domain of Omicron BA.4/BA.5 on the immune response was examined. Results: Compared to the unmodified LNP group, the IgG and IgA titers in the chitosan or mannose-modified LNP groups showed an increasing trend. The chitosan-modified group showed better effects. Notably, the PEGylated lipid with 1.5 mol% of chitosan modification produced high levels of IgG1 and IgG2a antibodies, promoting Th1/Th2 responses while also generating high levels of IgA, which can induce stronger cellular immunity, humoral immunity, and mucosal immunity. Conclusions: The 1.5 mol% of chitosan-modified LNPs (mRNA-LNP-1.5CS) can serve as a safe and effective carrier for intranasal mRNA vaccines, offering a promising strategy for combating the Omicron variant.

Fabrication and application of a dual drug-loaded nanoniosomes encapsulating rutin and berberine: optimization, in vitro and ex vivo evaluation

Rutin and berberine are naturally occurring polyphenols but their usefulness is restricted by their low bioavailability and poor solubility. Thus, by delivering rutin–berberine in the form of niosomes simultaneously and hoped to enhance the permeability through nasal route for the treatment of depression. Thin-film hydration approach was used to generate dual drug-loaded niosomes (rutin–berberine) encapsulating rutin and berberine. Various analytical techniques were used to characterize the morphology, size, compatibility, and leakage of the particles. These techniques included transmission electron microscopy, dynamic light scattering, UV spectrophotometry, and differential scanning calorimetry. The optimized formulation (rutin–berberine optimized niosomal formulation) was subjected to additional characterization for drug release, ex-vivo penetration investigation, confocal laser scanning microscopy, and 2,2-diphenyl-1-picrylhydrazyl assay. The rutin–berberine optimized niosomal formulation analysis showed that the drug release was 76.66 ± 1.24% at 24 hours, the entrapment efficiency was 74.8 ± 2.13% (rutin), and 79.0 ± 3.47% (berberine) and the vesicle size was 72.6 nm with a polydispersion index of 0.208. The antioxidant activity showed 73.67 ± 2.5% which is close to regular ascorbic acid. Studies on permeation ex-vivo revealed that rutin–berberine optimized niosomal formulation had considerably higher permeation (84.89 ± 3.15%) compared to rutin–berberine suspension (37.28 ± 2.33%). Furthermore, rhodamine B-loaded rutin–berberine optimized niosomal formulation appeared to have higher penetration than the control (rhodamine B-solution) according to the confocal laser scanning microscope results of the nasal mucosa. Based on all the experimental data, rutin–berberine optimized niosomal formulations were determined to be a viable and successful intranasal delivery formulation.

Safety and Immunogenicity of Intranasal Razi Cov Pars as a COVID-19 Booster Vaccine in Adults: Promising Results from a Groundbreaking Clinical Trial

Protective antibodies in the upper respiratory tract prevent the spread of COVID-19 in the community. Intranasal vaccines could raise the specific secretory IgA and IgG levels. This is a single-center, randomized, double-blind, placebo-controlled clinical trial to evaluate the safety and immunogenicity of Razi Cov Pars (RCP) intranasal recombinant protein subunit COVID-19 vaccine as a booster in adults. We compared specific IgG and IgA levels in the intranasal RCP group (n = 97) versus placebo (n = 96) in serum, saliva, and nasal mucosal secretions on days 0 and 14 and reported their Geometric Mean Ratios (GMR) and 95% confidence intervals (CI). We showed significant increases in IgA and IgG anti-RBD in the nasal mucosa in the RCP group, but their increase was not detectable in the serum and saliva. Anti-spike IgA in the nasal mucosa also increased in the RCP group compared to the placebo. This increase against the COVID-19 variant Omicron was also similar to that of the Wuhan. We detected no serious adverse reactions or anaphylaxis and all adverse events resolved completely during the follow-up period and were similar in both groups. Intranasal RCP is safe, stimulates the respiratory mucosal immunity, and could be a booster on various COVID-19 vaccines and be effective against new virus variants.

Clinical, Histological, and HPV-Related Factors Associated to Diffuse Presentation of Exophytic Nasal Papillomas

Background: Sinonasal exophytic papillomas (SNEP) are benign tumours arising from nasal mucosa. Human papillomavirus (HPV) infection seems to be related to the aetiology of a fraction of SNEP cases. SNEP presentation can be focal (FSNEP) or diffuse (DSNEP), but factors related to focal or diffuse presentation have not yet been well ascertained. This study aimed to analyse clinical, histological, and HPV-related differences between FSNEP and DSNEP. Methods: A retrospective cohort of 18 patients with SNEP from our centre were evaluated. Demographic, clinical and follow-up data were collected. All samples were subject to histopathological evaluation, DNA quality control, HPV-DNA detection, and viral load assessment. Univariate analyses were performed to evaluate differences between FSNEP and DSNEP. Results: Twelve SNEP patients were included in the final analysis. Seven patients had a diffuse nasal presentation, being younger than patients affected with FSNEP (42.7 years vs. 65.2 years, p = 0.019). The nasal septum was significantly more affected in DSNEP than in FSNEP (85.7% vs. 20%, p = 0.029). HPV-DNA was detected more frequently (100%) in DSNEP (HPV11 in six cases, HPV6 in one case) than in FSNEP (40%, p = 0.045, HPV6 in two cases). The median viral load among HPV6-positive samples was 626.8 virus/cell for FSNEP and 80.2 for DSNEP, and among HPV11-positive samples was 1673.7 for DSNEP. Recurrences were more frequent in the diffuse than in the focal group (85.7% vs. 20%, p = 0.029). Conclusions: The diffuse presentation of SNEP seems to be related to younger patients, nasal septum involvement, HPV infection, mostly HPV11, and a higher risk of recurrence.

The acute effects of the PAP treatment on nasal mucosa in patients with OSAS

Abstract BACKGROUND. Obstructive sleep apnea syndrome (OSAS) is a common disease in developed countries. PAP (Positive Airway Pressure) therapy is the most commonly used treatment modality, particularly in moderate to severe OSAS patients. However, several side effects make PAP treatment challenging to tolerate. This study examined the acute effects of PAP treatment on nasal functions. MATERIAL AND METHODS. This study included 32 patients who were diagnosed with severe OSAS following a PSG test and started PAP treatment. Symptom analysis was carried out with the SNOT-20 questionnaire; nasal physiological analysis was carried out with rhinomanometry and acoustic rhinometry tests performed before and after PAP treatment for one night and for one month. A saccharin test was carried out to assess the nasal mucociliary clearance before and after the treatment. RESULTS. A statistically significant difference between nasal symptom scores (p=0.003) and sleep quality (p=0.006) was observed in SNOT-20 questionnaire results. Total nasal resistance was significantly increased after one night’s sleep with PAP and after a one-month treatment with PAP. It was found that there was a statistically significant relation between the total nasal resistance value and PAP pressure. CONCLUSION. This study shows that PAP treatment increases nasal congestion after one night of treatment and after one month of treatment with a cumulative effect. PAP therapy positively affects sleeping quality and life quality, while negatively affecting nasal functions in the acute period.

Prostaglandin E Receptor 2 (EP2) Dysregulation in Allergic Fungal Rhinosinusitis Nasal Polyp Epithelium.

Allergic fungal rhinosinusitis (AFRS) is an eosinophilic subtype of chronic rhinosinusitis with nasal polyposis (CRSwNP). This study aimed to investigate the transcriptome of AFRS nasal polyp epithelium. Sinonasal epithelial cells were harvested from healthy nasal mucosa and polyp tissue collected from participants undergoing elective sinonasal surgery. Primary epithelial cells were subsequently grown in air/liquid interface and subjected to RNA-seq analysis, RT-qPCR, immunoblotting, and immunostaining. A total of 19 genes were differentially expressed between healthy and AFRS sample epithelium. The second top candidate gene, ranked by adjusted p-value, was prostaglandin E receptor 2 (PTGER2). The upregulation of PTGER2 was confirmed by RT-qPCR and immunoblot. The presence of the EP2 receptor, encoded by the PTGER2 gene, was confirmed by immunocytochemistry. PTGER2 is a potential novel therapeutic target for AFRS. EP2 dysregulation is associated with aspirin-exacerbated respiratory disease, potentially giving insight into common mechanisms of disease in severe CRSwNP. NA Laryngoscope, 2024.

Application of Polymarker Assistant External Alar Wedge Excision Combined With Internal Vestibular Floor Excision in Nasal Alar Reduction

Background: There are numerous techniques available to modify nasal alar. The combined alar base excision technique can narrow the nasal base and correct excessive alar flare at the same time. Despite its effectiveness, this procedure involves the removal of the skin of the nasal alar and the nasal mucosa, making the operation more challenging and raising the risk of postoperative asymmetry complications. Objectives: The purpose of this study is to develop a method of polymarker to assist the operation design to improve the precision of the operation and to avoid the complications discussed above. Methods: The authors conducted a retrospective review of patients undergoing nasal alar reduction using polymarker assistant external alar wedge excision combined with internal vestibular floor excision by a senior surgeon from January 2021 to April 2023. The postoperative appearance was evaluated in stratification by the patients during revisits using a VAS questionnaire. Results: The nasal alar was reduced with polymarker assistant external alar wedge excision combined with internal vestibular floor excision on 30 female patients ranging from 20 to 45 years of age, 10 of which were performed simultaneously with rib cartilage–related rhinoplasty. In all cases, the nasal alar was reduced without distortion. During the postoperative period, all the effects of the surgery were seen to persist for a lengthy period of time, and the patients were generally satisfied with the results.