Nasal Turbinate Mucosa Research Articles

Expression of serotonergic (5HT) receptors in patients with chronic rhinosinusitis with nasal polyposis and in normal nasal mucosa

Expression of serotonergic (5HT) receptors in patients with chronic rhinosinusitis with nasal polyposis and in normal nasal mucosa: a case-control study.Background Chronic rhinosinusitis with nasal polyposis is one of the challenging conditions regarding treatment and management. Many recent studies introduced new modalities for treatment like targeted immunomodulating drugs rather than antihistamines, local and systemic steroids, and endoscopic sinus surgery. Understanding the pathology behind the disease by studying its immunologic pathways and substances that take part in the inflammatory process can help in the introduction of new treatment options that can improve outcomes and decrease the costs of treatment.Objective The aim of our study is to demonstrate the presence of 5-HT receptors in nasal polyps and inferior turbinate mucosa in patients with chronic rhinosinusitis with nasal polyposis and then compare this expression of 5-HT receptors with inferior turbinate mucosa of the normal control group.Methods A case-control study was conducted on 80 patients. Specimens from nasal polypi and turbinate mucosa of patients with chronic rhinosinusitis (cases) and specimens from normal turbinate mucosa (controls) were stained with serotonin receptor Immunohistochemical staining by automated immunostainer in the pathology department laboratory in Ain Shams University Hospital with ratio 1:200–400 as recommended by the manufacturing company. Then, compared as regards stain distribution and intensity of mucosal lining, glands, and blood vessels.Results There was a significant difference between polyp cases and controls as regards lining epithelium and mucosal gland stain distribution and stain intensity. Also significant difference between the polyp cases and controls as regards blood vessel strain distribution. However, no significant difference was found as regards blood vessel stain intensity. There was a significant difference between turbinate cases and controls as regards lining epithelium stain distribution, and stain intensity. There was no significant difference between turbinate cases and controls as regards gland stain distribution. However, a significant difference was found between turbinate and controls as regards gland stain intensity. There was a significant difference between turbinate cases and controls as regards blood vessel stain distribution; however, no significant difference was present as regards stain intensity. There was no significant difference between polyp and turbinate cases as regards lining epithelium and blood vessel stain distribution and stain intensity. There was no significant difference between polyp and turbinate cases as regards gland stain distribution; however, a highly significant difference between polyp and turbinate cases as regards gland stain intensity.Conclusion Serotonin receptors are highly expressed in patients with chronic rhinosinusitis with nasal polyposis in both turbinate and polypoidal tissues which proves that serotonin has a strong role in the formation and growth of nasal polypi and allergic reactions. Hence serotonin modulating drugs can be studied as a new therapy for chronic rhinosinusitis with nasal polyposis.

INDICATORS OF MUC 5AC AND MUC 1 MUCOPOLYSACCHARIDE EXPRESSION IN THE NASAL MUCOSA OF PATIENTS WITH POSTNASAL DRIP SYNDROME AND NASAL SEPTUM DEVIATION

Introduction. Determining the cause of postnasal drip syndrome can be quite challenging. Nasal septum deformation has been recognized as one possible factor. Understanding the fundamental processes of postnasal drip syndrome is crucial for developing targeted therapeutic strategies for treating this pathology. In our study, we examined the clinical and histological features of postnasal drip syndrome in individuals with nasal septum deformation and investigated the expression of mucopolysaccharides, specifically the indicators of MUC 5AC and MUC 1.
 The aim. This study aims to investigate the clinical and histological aspects of postnasal drip syndrome (PNDS) in patients with nasal septum deformation. Specifically, the study aims to explore the expression levels of MUC5AC and MUC1 in biopsies of the nasal turbinate mucosa.
 Materials and methods. A total of 29 samples of nasal mucosa from the lower nasal turbinates were collected. These samples were divided into two groups: patients with nasal septum deviation with and without postnasal drip syndrome. Levels of MUC5AC and MUC1 were determined using Western blot analysis.
 Results. Upon analysis of histological sections, we identified a significant increase in tissue metaplasia and lymphoid infiltration in the nasal mucosa of patients with postnasal drip syndrome compared to the control group. The levels of mucopolysaccharides, MUC5AC and MUC1, were higher in the nasal mucosa of the research group compared to the control group.
 Conclusions. The obtained data suggest that anatomical changes in the nasal cavity may play a role in the development of postnasal drip syndrome through alterations in mucin secretion.

Differences in normal nasal computed tomography findings in different dog breeds

Background: Computed tomography (CT) is the gold standard for diagnosing canine nasal diseases. However, it cannot easily detect minor abnormalities in inflammatory diseases because they are not accompanied by obvious morphological changes. Aim: The present study aimed to compare the differences in normal CT findings of turbinate structure and mucosa between breeds in order to establish criteria for CT diagnosis of inflammatory diseases of the nasal cavity. Methods: CT data from 77 dogs of five breeds without nasal diseases were retrospectively studied. The nasal air percentage, which reflects the volume of the nasal turbinate structure and mucosa, was measured. The nasal turbinate mucosa was measured for contrast enhancement reflecting blood flow. Measurements were performed in the ventral and ethmoid turbinate regions. Comparisons were made between breeds and sections. Results: The air percentage in the ventral and ethmoid turbinate regions was significantly different between breeds. Contrast enhancement was significantly different between breeds only in the ethmoid turbinate. Moreover, different breeds had different correlations between body weight, age, nose length, and air percentage. Conclusion: In this study, reference values for normal CT findings of the nasal structure and mucosa were obtained, taking into account the breed, measurement section, and patient factors. The results showed that the volume of the turbinate structure and contrast enhancement of nasal mucosa differed depending on the breed. The measured values also differed depending on the cross-sections and patient factors.

Inferior nasal turbinate mucosa shrinkage prior to surgery under local anaesthesia

Introduction and ObjectivesChronic rhinitis-related complaints may result from isolated hypertrophy of the inferior nasal turbinates. If the symptoms persist despite conservative management, turbinoplasty is indicated. However, the nasal mucosa lining the inferior turbinates seems decongested immediately before the surgery performed under local anaesthesia, compared to the examination when the patients were entered for surgery. The study aimed to confirm this observation and to hypothesize as to the reasons for its occurrence. Patients and MethodsThe measurements of the longest distances between the medial rim of the inferior nasal turbinate mucosa and nasal septum and the shortest distances between the lower rim of the turbinate and floor of the nasal cavity in the inferior part of both common nasal meatus, were carried out on photos taken during endoscopic examinations: the one entering the patient for turbinoplasty, and the other immediately before the procedure. The results in this group were compared to those obtained from patients operated on under general anaesthesia. ResultsIn 130 patients aged 18-60 (mean=40.7) years, operated on under local anaesthesia, the sum of the mean distances between the nasal septum and the medial rim of the lower turbinate in both nasal cavities, was 3.4mm during the first examination, and 4.5mm (p=.0008) during the second one. In the group of 42 participants aged 26-47, mean=36.8 years operated on under general anaesthesia, the values were: 4.8mm and 3.6mm (p=.02), respectively. The differences were significantly smaller in the smokers (.3) compared to non-smokers (1.3; p=.04) mm. ConclusionsRecords of the entering examination must be considered before turbinoplasty under local anaesthesia.

Inferior nasal turbinate mucosa shrinkage prior to surgery under local anaesthesia

Introduction and ObjectivesChronic rhinitis-related complaints may result from isolated hypertrophy of the inferior nasal turbinates. If the symptoms persist despite conservative management, turbinoplasty is indicated. However, the nasal mucosa lining the inferior turbinates seems decongested immediately before the surgery performed under local anaesthesia, compared to the examination when the patients were entered for surgery. The study aimed to confirm this observation and to hypothesize as to the reasons for its occurrence. Patients and MethodsThe measurements of the longest distances between the medial rim of the inferior nasal turbinate mucosa and nasal septum and the shortest distances between the lower rim of the turbinate and floor of the nasal cavity in the inferior part of both common nasal meatus, were carried out on photos taken during endoscopic examinations: the one entering the patient for turbinoplasty, and the other immediately before the procedure. The results in this group were compared to those obtained from patients operated on under general anaesthesia. ResultsIn 130 patients aged 18-60 (mean=40.7) years, operated on under local anaesthesia, the sum of the mean distances between the nasal septum and the medial rim of the lower turbinate in both nasal cavities, was 3.4mm during the first examination, and 4.5mm (p=.0008) during the second one. In the group of 42 participants aged 26-47, mean=36.8 years operated on under general anaesthesia, the values were: 4.8mm and 3.6mm (p=.02), respectively. The differences were significantly smaller in the smokers (.3) compared to non-smokers (1.3; p=.04) mm. ConclusionsRecords of the entering examination must be considered before turbinoplasty under local anaesthesia.

Correlation of acidic mammalian chitinase expression with disease severity in patients with moderate/severe persistent allergic rhinitis

Aim of the studyTo assess the level of acidic mammalian chitinase (AMCase) expression and IL-8 in nasal inferior turbinate mucosa in patients with mild and moderate to severe allergic rhinitis (AR).Material and methodsParticipants in this case-control study were divided into three groups, including patients with moderate and severe persistent allergic rhinitis, cases with mild forms of persistent AR, and control or healthy group. We obtained biopsies of nasal inferior turbinate mucosa from all participants. Expression of AMCase and IL-8 mRNAs were evaluated by real-time polymerase chain reaction (PCR). The serum levels of AMCase and IL-8 were determined by ELISA. The number of eosinophils per field, blood eosinophils, total serum IgE levels, and specific serum IgE levels were measured. Patients’ clinical manifestations were assessed by total nasal syndrome score (TNSS).ResultsExpression of AMCase and IL-8 in patients with moderate and severe perineal allergic rhinitis were significantly elevated compared to the control group and patients with mild persistent allergic rhinitis. Serum levels of AMCase and IL-8 were associated with specific IgE, nasal eosinophil count, and TNSS.ConclusionsAccording to the results of this study, there might be a relationship between the expression of AMCase and IL-8 in nasal turbinate mucosa and the severity of allergic rhinitis.

Therapeutic effect of topical administration of red onion extract in a murine model of allergic rhinitis

The aim of this study was to evaluate the effect of topical administration of onion (Allium cepa) extract on nasal cavity for treatment of allergic rhinitis (AR). BALB/c mice were sensitized by intraperitoneal injection of ovalbumin (OVA) and challenged with intranasal instillation of OVA with or without onion extracts for five times a week on 3 consecutive weeks. Allergic symptom score according to frequencies of sneezing, serum total and OVA specific immunoglobulin E (IgE) level, cytokine levels of nasal mucosa and eosinophilic infiltration were analyzed. Allergic symptom score, serum total and OVA specific IgE, cytokine levels of nasal mucosa (interleukin (IL)-4, IL-5, IL-10, IL-13, IFN-γ, TNF-α and COX-2) and eosinophilic infiltration were higher in allergic mouse group than negative control group. Topical application of onion extracts significantly reduced allergic symptoms and OVA specific IgE levels. Cytokine levels of IL-4, IL-5, IL-10, IL-13 and IFN-γ were significantly decreased in groups treated with onion extract. In addition, eosinophil infiltration of nasal turbinate mucosa was also significantly decreased after treatment with onion extract. Topical administration of onion extract significantly reduces allergic rhinitis symptom and allergic inflammatory reaction in a murine allergic model. It can be assumed that the topical application of onion extract regulates allergic symptoms by suppressing the type-1 helper (Th1) and type-2 helper (Th2) responses and reducing the allergic inflammatory reaction.

Differential Expression of Fas in Moderate/Severe and Mild Persistent Allergic Rhinitis and Its Correlation With Pathological Parameters

The roles of Fas in immune system are multifaceted, and the interaction between Fas receptor and Fas ligand is essential for maintaining the immune tolerance. We aimed to assess the level of the expression of Fas receptor on nasal inferior turbinate mucosa in patients with mild persistent allergic rhinitis (M PAR) and moderate to severe (M/S) PAR and determined the relationship between disease severity and production of Fas. A total of 70 patients with M/S PAR, 70 patients with M PAR, and 70 healthy individuals were enrolled in this study. We obtained biopsies of nasal inferior turbinate mucosa from the participants. The expression of Fas mRNA was evaluated by real-time polymerase chain reaction. The presence and location of Fas were determined by immunohistochemistry. The number of eosinophils per field, blood eosinophils, total serum IgE levels, and specific serum IgE levels were measured. Clinical manifestations of patients were assessed by Total Nasal Syndrome Score (TNSS). The expression of Fas in patients with M/S PAR was decreased significantly compared to the control group and patients with M PAR. Local mucosal expression of Fas was correlated with specific IgE, nasal eosinophil count, and TNSS. According to the results of this study, there might be a relationship between the expression of Fas receptor on nasal turbinate mucosa and the severity of persistent allergic rhinitis.

CDK5 Regulates PD-L1 Expression and Cell Maturation in Dendritic Cells of CRSwNP.

The maturation of dendritic cells is critical for chronic rhinosinusitis with nasal polyps (CRSwNPs), especially eosinophilic chronic rhinosinusitis with nasal polyps (EosCRSwNPs), but the regulation mechanism of dendritic cells (DCs) maturation is still unclear. We identified nasal mucosa of 20 patients with EosCRSwNP, 16 non-EosCRSwNP patients, and inferior turbinate of 14 patients with nasal septum deviation after surgery. The expression of cyclin-dependent kinase 5 (CDK5) and programmed cell death 1 ligand 1 (PD-L1) were detected by immunofluorescent, real-time quantitative PCR, and Western blot in EosCRSwNP. The level of dendritic cell maturation was detected by flow cytometry and immunofluorescence staining after CDK5 expression interference with small interfering RNA (siRNA). The expression of CDK5 and PD-L1 in EosCRSwNP nasal mucosal tissue was significantly higher than that of non-EosCRSwNP and inferior turbinate nasal mucosa tissue, and there was a positive correlation between them. Immunofluorescence staining showed that CDK5 and PD-L1 were co-localized in dendritic cells. Synergistic stimulation of dendritic cells with LPS and TNF-α promotes the maturation of dendritic cells and increases the expression of CDK5 and PD-L1. However, blocking the expression of CDK5 in dendritic cells with siRNAs leads to a blockage of cell maturation. CDK5 can regulate the expression of PD-L1, and its presence is critical for the maturation of dendritic cells. CDK5 may play an important role in the pathogenesis of CRSwNP disease.

Differential expression of CCL18 in moderate/severe and mild persistent allergic rhinitis and its correlation with disease parameters

ABSTRACTBackground and Aims: This study aimed to assess the level of the expression of CCL-18 on nasal inferior turbinate mucosa in patients with mild (M) and moderate-to-severe (M/S) persistent allergic rhinitis (PAR).Methods: The participants in this case-controlled study were divided into three groups: patients with M/S PAR, patients with M PAR, and the healthy control group. Biopsies of nasal inferior turbinate mucosa were obtained from the participants. Expression of CCL-18 mRNA was evaluated by real-time PCR. The serum levels of CCL-18 were determined by ELISA. Total serum IgE levels and specific serum IgE levels were measured. The clinical manifestations were assessed using the total nasal syndrome score (TNSS).Results: Gene expression and the serum level of CCL-18 in patients with M/S PAR increased significantly compared to the control group and patients with M PAR. The serum level of CCL-18 was found to correlate with TNSS in patients with M/S PAR. There was a statistical correlation between the serum level of CCL-18 and the total serum IgE in the treatment groups.Conclusion: The results of the study indicate that there could be a relationship between the expression of CCL-18 in nasal turbinate mucosa and the severity of allergic rhinitis.

Solitary chemosensory cells producing interleukin-25 and group-2 innate lymphoid cells are enriched in chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is commonly characterized by type-2 inflammation. It is established that group-2 innate lymphoid cells (ILC2s) are a subset of immune cells important in orchestrating mucosal type-2 response. IL-25 is an epithelial-derived cytokine that is a critical activator of ILC2s. Recent evidence demonstrates that specialized taster epithelial cells, such as solitary chemosensory cells (SCCs), may be producers of IL-25. To elucidate the relationship between SCCs and ILC2s in CRSwNP, we sought to quantify ILC2s and SCCs to determine if these cell types are enriched in nasal polyps compared to healthy sinonasal mucosa. We quantified SCCs and ILC2s using multicolor flow cytometry in nasal polyps and non-inflamed turbinate mucosa from seven patients and investigated the role of IL-13 and dexamethasone on SCC frequency using tissue explants of nasal polyps and turbinate mucosa. SCCs were found to be the primary source of IL-25. Nasal polyps demonstrated higher populations of SCCs (33.0% vs 5.6%, p < 0.001) and ILC2s (2.40% vs 0.19%, p = 0.008) compared to patient-matched nonpolypoid turbinates. In cultured polyp explants, exogenous IL-13 increased the proportion of epithelial SCCs (40.2% IL-13 condition vs 28.9% untreated, p = 0.012), and this effect was reversed by addition of dexamethasone (40.2% vs 8.9%, p < 0.0005). These data support SCC and ILC2 expansion as well as increased IL-25 production in nasal polyps and may represent early events in the pathogenesis of CRSwNP. IL-13 stimulates proliferation of SCC in a feed-forward loop, a process that is steroid-sensitive.

Surgical treatment of vasomotor rhinitis with regard to the anatomic features of the nasal turbinate mucosa

The correct diagnosis and the choice of approach of surgical treatment of vasomotor rhinitis seem to be a simple task. However, the choice of surgical methods should be based on low invasiveness principle, providing early rehabilitation of the patient, as well as on reasonability principle, providing the efficacy of the treatment. We examined 106 patients with the deviated nasal septum and vasomotor rhinitis after surgical treatment. During the operation we revealed anatomical features of inferior turbinate structure. Based on these data, we have developed an original method of turbinoplasty with regard to intraoperative characteristics of inferior turbinate structure. 28 patients have been operated on according to this method. The efficacy of the suggested original surgical treatment method has been proven by the clinical data and the results of objective research methods.

Molecular Evidence for the Aerial Route of Infection of Mycobacterium leprae and the Role of Asymptomatic Carriers in the Persistence of Leprosy.

Leprosy persists as a public health problem. The chain of transmission and mechanism of infection are not completely understood. In the current study, we investigated the route of infection and of disease onset, from airway exposure, colonization, and bloodstream dissemination. Mycobacterium leprae DNA was detected through quantitative polymerase chain reaction in nasal vestibule, nasal turbinate mucosa, and peripheral blood samples, along with anti-phenolic glycolipid I serology and skin tests from the same individual, from 113 leprosy patients and 104 household contacts of patients (HHCs). Bivariate statistics and multiple correspondence analysis were employed. The rates of DNA positivity among patients were 66.4% (75 of 113) for nasal swab samples, 71.7% (81 of 113) for nasal turbinate biopsy samples, 19.5% (22 of 113) for blood samples, with seropositivity of 62.8% (71 of 113 samples) and with increasing incidences toward the multibacillary pole of the clinical spectrum. Positivity among HHCs were as follows: 49% (51 of 104) for nasal swab samples, 53.8% (56 of 104) for nasal biopsy samples, 6.7% (7 of 104) for blood samples, and 18.3% (19 of 104 samples) for anti-phenolic glycolipid I serology. During the follow-up of 5-7 years, out of 104 HHCs, 7 developed leprosy (6.7%). Risk for the disease outcome was estimated by comparing results in HHCs who develop leprosy with those not affected. Neither nasal passage nor mucosa positivity was determinant of later disease onset; however, blood presence increased the risk for disease development (relative risk/positive likelihood ratio, 5.54; 95% confidence interval, 1.30-23.62), as did seropositivity (positive likelihood ratio, 3.69 [1.67-8.16]; relative risk, 5.97 [1.45-24.5]). Our findings strongly suggest that the aerosol route of infection and transmission is predominant and that HHCs contribute to the infection risk to themselves and probably to others.

Measuring local immunoglobulin E in the inferior turbinate nasal mucosa in patients with allergic rhinitis

BackgroundStudies show that immunoglobulin E (IgE) is produced in the local nasal mucosa in allergic rhinitis patients. However, no study involved the measurement of IgE levels in the local nasal mucosal tissue in allergic rhinitis patients. This study aimed to measure the local IgE levels in the nasal mucosal tissue and to compare the levels of total IgE and specific IgEs in the serum and the inferior turbinate nasal mucosa in allergic rhinitis patients using the AlaSTAT 3gAllergy assay (Siemens Healthcare Diagnostics AG, Erlangen, Germany). MethodsTotal IgE antibodies and allergen-specific IgE antibodies in each sample of nasal mucosal tissue from 11 allergic rhinitis patients were measured with the AlaSTAT 3gAllergy assay. We compared the levels of total IgE and IgEs specific for house dust (HD), mites, and cedar pollen in the serum and the inferior turbinate. ResultsThe total IgE levels and the cedar pollen-specific IgE levels in the inferior turbinate mucosal tissue correlated significantly with their respective levels in serum. The HD- and mite-specific IgE levels in the inferior turbinate mucosal tissue did not correlate significantly with their respective levels in the serum. ConclusionsOur results evaluating the correlations between nasal mucosal and serum levels of antigen-specific IgE indicate that IgE produced in the nasal mucosa affects the IgE levels in the serum, especially the cedar pollen-specific IgE.

Herpes viruses and human papilloma virus in nasal polyposis and controls

IntroductionChronic rhinosinusitis with nasal polyps is a multifactorial disease entity with an unclear pathogenesis. Contradictory data exist in the literature on the potential implication of viral elements in adult patients with chronic rhinosinusitis. ObjectiveTo compare the prevalence of human herpes viruses (1–6) and Human Papilloma Virus in adult patients with chronic rhinosinusitis with nasal polyps and healthy controls. MethodsViral DNA presence was evaluated by real-time polymerase chain reaction application to nasal polyps specimens from 91 chronic rhinosinusitis with nasal polyps patients and nasal turbinate mucosa from 38 healthy controls. ResultsEpstein–Barr virus positivity was higher in nasal polyps (24/91; 26.4%) versus controls (4/38; 10.5%), but the difference did not reach significance (p=0.06). Human herpes virus-6 positivity was lower in nasal polyps (13/91; 14.29%) versus controls (10/38; 26.32%, p=0.13). In chronic rhinosinusitis with nasal polyps group, 1 sample was herpes simplex virus-1-positive (1/91; 1.1%), and another was cytomegalovirus-positive (1/91; 1.1%), versus none in controls. No sample was positive for herpes simplex virus-2, varicella-zoster virus, high-risk-human papilloma viruses (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) and low-risk-human papilloma viruses (6, 11). ConclusionDifferences in Epstein–Barr virus and human herpes virus-6 positivity among patients with chronic rhinosinusitis with nasal polyps and healthy controls are not statistically significant, weakening the likelihood of their implication in chronic rhinosinusitis with nasal polyps pathogenesis.

The Effectiveness of Epinastine Hydrochloride for Pediatric Sleep- Disordered Breathing Related Symptoms Caused By Hyperesthetic Non- Infectious Rhinitis

Objectives: The aims of this study were to prospectively evaluate the effectiveness of oral epinastine hydrochloride in pediatric outpatients with Sleep-Disordered Breathing- (SDB) related symptoms caused by hyperesthetic non-infectious rhinitis, and to assess their Quality of Life (QOL) prior to and following treatment. Study design: Prospective Methods: Pediatric outpatients (9 boys and 10 girls; average age, 5.6 years [SD=1.4]), with SDB related symptoms influenced by hyperesthetic non-infectious rhinitis were recruited. The children were all treated with oral epinastine hydrochloride dry syrup for 4 weeks. Before and after the 4-week treatment period, the following data were collected from each participant: otolaryngological findings, obstructive sleep apnea-18 (OSA-18) scores, and evaluation of QOL. Results: Epinastine hydrochloride significantly improved the swelling of the inferior nasal turbinate mucosa and decreased the quantity of nasal discharge. The initial total mean OSA-18 score was 58.5, whereas the total score reduced to 22.8 after oral epinastine hydrochloride treatment. Significant (p < 0.01) differences were found between pre- and post-treatment total OSA-18 scores as well as pre- and post-treatment measurements of domains of sleep disturbance, physical symptoms, and caregiver concerns. Conclusions: Epinastine hydrochloride therapy may improve nasal findings and QOL in pediatric outpatients with SDB related symptoms caused by hyperesthetic non-infectious rhinitis.

Expression of the cysteinyl leukotriene 1 receptor and glucocorticoid receptor-β in nasal polyps

The objective of this study was to analyze the expression of cysteinyl leukotriene 1 (CysLT1) receptor and glucocorticoid receptors (GRs) in nasal polyps, and to evaluate the relationship between the expression of CysLT1 receptors and that of GRs. Nasal polyps were taken from 32 patients of chronic rhinosinusitis with nasal polyposis. Samples of middle turbinate from seven healthy subjects were used as controls. Specimens were immunohistochemically stained for CysLT1 receptor, GR-α and GR-β receptor, and were quantified in the unit area of the tissues. Numbers of CysLT1 receptor-positive cells were much increased in nasal polyps than in middle turbinate (281 ± 67 vs. 157 ± 85 cells/mm(2), P = .01). There was no significant difference in the numbers of GR-α positive cells between nasal polyps and normal turbinate mucosa. GR-β positive cells were increased in nasal polyps as compared to normal turbinate mucosa (36 ± 8 vs. 19 ± 7 cells/mm(2), P = .03). A significant relationship was found between the expression of CysLT1 receptor and GR-β in nasal polyps (R = .525, P = .04), whereas there was no significant relationship between the expression of CysLT1 receptor and GR-α in nasal polyps. Our study shows that CysLT1 receptor expression predominates on GR-β over-expressed polyps. This may suggest the additional effect of CysLT1 receptor antagonist for the treatment of nasal polyposis resistant to steroid alone.

Technique for Autologous Nasal Mucosa Transplantation in Severe Ocular Surface Disease

To describe the detailed surgical technique used for harvesting and transplantation of autologous nasal mucosa grafts for ocular surface reconstruction, to evaluate the clinical results and utility of autologous nasal mucosa grafts in ocular surface diseases. Autologous nasal mucosa was harvested from either the middle or inferior turbinate. It was transplanted on 11 eyes with severe ocular surface diseases including 4 eyes with chemical burns, 2 eyes with thermal burns, 1 eye with Stevens-Johnson syndrome, 1 eye with erythema multiforme major, and 3 eyes with extensively recurred pterygiums. Clinical outcomes were assessed based on ocular manifestation, epithelization, and visual acuity. The mean follow-up period was 19.9 months (range 13-32 months). Nasal mucosal tissues were safely excised, and their mucosal harvest sites were completely healed in 2 weeks without postoperative complications. All nasal mucosa autograft survived successfully with rapid epithelization, well-developed horizontal vascularization, and abundant mucin secretion. Clinical success, intact ocular surface epithelium without epithelial erosion more than 4 weeks, was achieved in all eyes. There was no recurrence of significant ulceration, conjunctivalization, fibrovascularization, symblepharon, or pterygium. Goblet cell transplantation using autologous turbinate nasal mucosa presents a promising treatment method in patients with severe ocular surface disorders.

Epinastine Hydrochloride for Pediatric Allergic Rhinitis

Objective: 1) Prospectively evaluate the effectiveness of epinastine hydrochloride (EH) for pediatric outpatients with sleep-disordered breathing (SDB) symptoms caused by allergic rhinitis (AR); 2) Assess the quality of life (QOL) of those children prior to and following treatment with oral EH. Method: Pediatric AR outpatients (19; boys, 9; girls, 10; average age, 5.6 years [SD = 1. 4]) with SDB symptoms were recruited. They were all treated with oral EH for 4 weeks. Before and after the 4-week treatment period, the otolaryngological findings and OSA-18 scores were collected for each participant. Results: Epinastine hydrochloride significantly improved the swelling of the inferior nasal turbinate mucosa and decreased the quantity of nasal discharge. The initial total mean OSA-18 score was 58.5, whereas the total score reduced to 22.8 after oral epinastine hydrochloride treatment. Conclusion: Epinastine hydrochloride therapy demonstrated positive clinical effects on both nasal findings and the QOL of pediatric outpatients with symptoms of SDB caused by allergic rhinitis. Epinastine hydrochloride therapy may improve nasal findings and QOL in pediatric outpatients with SDB symptoms.

Histological analysis of the distribution pattern of glandular tissue in normal inferior nasal turbinates

Nasal turbinates play an important role in nasal physiology. These functions include the important function of particle filtration by the mucocilliary system. Many nasal mucosal diseases, such as rhinitis and rhinosinusitis, are directly related with structural alterations of the mucosal lining of the turbinates. AIM: To study the distribution pattern of the glandular epithelium of the lamina propria in the normal lower nasal turbinate mucosa of the anterior, medium and posterior portions. MATERIAL AND METHOD: A prospective study in which small linear fragment of the lower nasal turbinate was removed from ten patients undergoing aesthetic nose surgery. The slides were hematoxilin-eosin stained, examined histologically and photographed. Glandular epithelium was delimited individually, the total area of the lamina propria on the anterior, medium and posterior portions of nasal turbinates was calculated (µm2). RESULTS: There was no statistically significant difference in the distribution pattern of the glandular epithelium of the lamina propria. CONCLUSION: This study showed no predominance of glandular epithelium distribution in anterior and posterior portions of lower nasal turbinates in normal subjects.