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[Cytological assessment of nasal mucosa in children with adenoidal hypertrophy. Part II].

In this investigation we would like to evaluate what changes in cytology of the nasal mucosa occur after surgical removal of adenoids. The investigation was performed on 25 children (10 girls and 15 boys) aged 3-13. Material for the cytological evaluation was obtained from the nasal concha. The children were tested twice: before and one month after the surgery. Cytograms of the nasal mucosa of children with adenoidal hypertrophy before the surgery showed increased number of neutrophils. Cytological normalisation of the nasal mucosa occurs in one month after the surgical removal. In two children percentage of eosinophils in cytograms increased and percentage of neutrophils remained significant after the surgery. Cytological assessment of the nasal mucosa performed before and after surgical removal of the hypertrophied adenoid is helpful in evaluation of the accomplished therapy and may indicate what are the reasons of its failure.

Adenoidectomy↗

[Microcirculation of the nasal mucosa during use of balloon tamponade].

BACKGROUND: Nasal packings are commonly accepted in the treatment of severe epistaxis. Cuffed catheters are known to cause damage to the nasal mucosa most likely by interfering with tissue perfusion. In this study the effect of different pressure levels on local perfusion of septal mucosa is investigated. METHOD: In 15 healthy subjects the blood flow in septal mucosa was measured by laser doppler flowmetry by positioning a cuffed epistaxis catheter into the nasal cavity with a laser probe attached to it. Increasing pressure was administered by injecting saline solution while continuously recording intraluminal pressure, perfusion, and filling volume. The local pressure affecting the septal mucosa at the moment of stalling perfusion was determined by subtracting the extranasal cuff pressure from the current intranasal cuff pressure at same inflation volumes. RESULTS: Microcirculation of the septal mucosa stopped when the local pressure exceeded a value of Pmean = 42 mmHg. Individual variations (n = 15) were small (s = 9 mmHg). The intraluminal cuff pressure was measured to be about ten times higher due to the retraction force of the cuff. Spontaneous oscillations of the blood flow were reduced with increasing pressure to the blood vessels. Filling volumes up to 3.2 ml were sufficient to stop perfusion. CONCLUSIONS: Cuffed nasal packings stop the blood flow in nasal mucosa even at low local pressures. Depending on the material characteristics of different cuffs the pressure to dilate the cuff may, however, be several times higher than the actual local pressure. This effect may cause problems in the proper use of cuffed catheters. Laser doppler flowmetry proved to be helpful in determining reproducible perfusion values.

Adolescent↗

Rhinostereometry and laser Doppler flowmetry in human nasal mucosa: changes in congestion and microcirculation during intranasal histamine challenge.

The nasal mucosa of 10 healthy volunteers was studied with the combination of rhinostereometry and laser Doppler flowmetry during a challenge with 0.14 ml histamine dihydrochloride in stepwise increasing concentrations of 0.5, 1.0, 2.0, 4.0, 8.0 and 16.0 mg/ml. Five and 10 min after each challenge the degree of congestion and the microcirculatory parameters perfusion, velocity of flow and concentration of moving blood cells were recorded. A complex reaction pattern was seen. It was possible to measure simultaneously the degree of congestion and the microcirculatory parameters. With this combination of methods, it seemed possible to identify the effects of histamine on the different components of the nasal mucosa. The combination of the two methods appears to make possible detailed studies of the relationship between changes in congestion and microcirculation during intranasal challenges in humans.

Administration, Intranasal↗

Metabolism of progesterone by the nasal mucosa in mice and rats.

The metabolism of 4-14C-progesterone by the nasal mucosa and lung from mice and rats was investigated in vitro. Using thin-layer radiochromatography at least 10 and 7, yet unidentified, metabolites were found at incubation with slices from the nasal mucosa and lung, respectively. The results further indicated that the rate of progesterone metabolism was higher in the nasal mucosa than in the lung. Autoradiography of lung slices incubated with 14C-progesterone showed that a selective localization of radioactivity occurred in the bronchial mucosa.

Animals↗

Association between atmospheric ozone levels and damage to human nasal mucosa in Florence, Italy.

We evaluated the effects of urban air pollutants on human nasal mucosa over an 8-month period on 102 subjects living in Florence, Tuscany, Italy. A group of subjects living in a city with a lower level of pollution (Sassari, Sardinia, Italy) was also analyzed. Nasal mucosa cells were harvested by brushing, a noninvasive procedure. Half of the cells were used for genotoxicity studies using the alkaline comet assay, and half for morphological studies. The levels of DNA damage in the nasal mucosa were considerably higher (+73%) in the subjects living in Florence than in Sassari. High levels of atmospheric ozone in Florence air correlated with DNA damage, and to the prevalence of inflammatory pathologies of the upper respiratory tract, although the ozone concentrations were below the Italian recommended attention level. Furthermore, higher levels of DNA damage were correlated with a dysfunction in the ability to maintain a normal epithelial cell structure. These data suggest an association between ozone air levels and damage in the upper respiratory tract. It remains unclear whether ozone itself or other associated pollutants are responsible for the observed alterations.

Air Pollutants↗

Effect of diesel exhaust on guinea pig nasal mucosa.

In this study using guinea pigs, we investigated the effects of diesel exhaust (DE) containing diesel exhaust particulate (DEP) on 1) vascular permeability induced by histamine, 2) nasal mucosal permeability to horseradish peroxidase (HRP), and 3) eosinophilic epithelial infiltration. The vascular permeability induced by histamine was enhanced significantly and dose-dependently in DE-exposed guinea pigs. The HRP reaction products in epithelial cells and intercellular spaces were significantly and dose-dependently increased in those guinea pigs. Eosinophil infiltration into the epithelial layer was significantly increased in guinea pigs exposed to DE containing 3.2 mg/m3 DEP, and the reactivity of the nasal mucosa to histamine solution applied on the nasal mucosa was significantly enhanced in those guinea pigs. These findings suggest that DE may play an important role not only in promoting nasal hyperreactivity induced by the enhancement of absorption of antigen through the nasal epithelium, but also in inducing eosinophil infiltration in nasal mucosa and enhancing nasal mucosal reactivity.

Animals↗

Alpha 2-adrenoceptors in homogenates of rat nasal mucosa.

The specific binding of [3H]rauwolscine to rat nasal mucosa membranes was saturable, stereoselective and of high affinity. The Scatchard plot pointed to a homogeneous population of binding sites (Kd = 3.6 +/- 0.6 nM; Bmax = 5.1 +/- 0.7 pmol/g). The non-specific binding appeared to be non-linear, probably due to filter binding. Inhibition of [3H]rauwolscine binding with the subtype-selective antagonist, prazosin, suggested the presence of alpha 2-adrenoceptor subclasses in rat nasal mucosa. The (-)-epinephrine inhibition curves demonstrated high- and low-affinity agonist binding sites. A monophasic (-)-epinephrine inhibition curve was obtained in the presence of guanine nucleotides.

Animals↗

[Expression of substance P receptor mRNA in nasal mucosa of rat in allergic rhinitis model].

OBJECTIVE: To study the expression of substance P receptor messenger RNA (SP-R mRNA) in nasal mucosa in allergic rhinitis (AR) rat model. METHODS: Twenty Wistar rats free of disease were randomly divided into two groups. AR model rats were established through repeated intraperitoneal shot of ovalbumin (OV) and consequently confirmed by local challenge with OV. SP-R mRNA in nasal mucosa, obtained from two groups, were used to do reverse transcriptive polymerase chain reaction (RT-PCR) and Southern blot. beta-actin was used as a standard control through out the whole process. RESULTS: The results showed definitely that there were positive expression of SP-R mRNA in normal nasal mucosa. This expressions increased significantly (P < 0.05) during nasal allergy. CONCLUSION: Increased expression SP-R mRNA in nasal mucosa in AR model might play roles in the development of AR.

Animals↗

[Autologous early transplantation of nasal mucosa after the most severe eye chemical burns].

UNLABELLED: The treatment of severe eye burns is still complicated. Since 1984 we have performed autologous nasal mucosa transplantation for the severe mucus deficiency syndromes often occurring during follow-up. Now we report on our initial experience using nasal mucosa transplantation shortly after severe burns. PATIENTS: Prospectively, nine patients (eight male, one female) were examined after autologous nasal mucosa grafting within 14 days after eye burns. In all patients there was an almost complete defect of limbal vascularization, large areas of necrotic conjunctiva and prolonged epithelialization problems. The patients were followed for an average of 38 months. RESULTS: In all patients the subjective complaints lessened and sufficient ocular wetting led to rapid reepithelialization. During the follow-up period two patients showed light symblephara. In five patients visual acuity improved to > or = 20/200. CONCLUSION: Early nasal mucosa transplantation is an additional tool in the treatment of severe ocular burns.

Adolescent↗

The kinetics of allergen-induced eotaxin level in nasal lavage fluid: its key role in eosinophil recruitment in nasal mucosa.

Eotaxin (CCL11) is a potent eosinophil chemoattractant belonging to the C-C chemokine. To evaluate the role of eotaxin in eosinophilic inflammation in nasal mucosa, we investigated the levels of eosinophil chemoattractants in nasal lavage fluids obtained after antigen challenge, compared with eosinophil counts and eosinophil protein X (EPX) levels. In subjects with allergic rhinitis, allergen challenge led to parallel increases in eosinophil counts, levels of EPX, and eotaxin concentrations in nasal lavage fluid. The levels of eotaxin in lavage samples showed strong correlation with lavage levels of eosinophil counts and EPX. Normal subjects had few, if any, eosinophils and EPX as well as the measured parameters in their nasal lavage fluids before and after antigen challenge. In our experiments of eosinophil endothelial transmigration (TEM) assay using the nasal microvascular endothelial cells, eotaxin showed the most potent effect among various eosinophil chemoattractants. In addition, treatment of eosinophils with anti-CCR-3 mAb significantly blocked eosinophil TEM induced by homogenate of nasal mucosa. These results indicate that eotaxin has an important role in eosinophil-dependent inflammation in nasal mucosa and suggest that blocking eotaxin or CCR-3 might be useful for new therapeutic tools of allergic rhinitis.

Allergens↗

Histamine and acetylcholine regulation of sympathetic nerve activity in guinea-pig nasal mucosa.

The regulating effects of histamine and acetylcholine (Ach) in norepinephrine (NE) transmission in nasal mucosa were investigated by analyzing 3H-NE release from isolated guinea-pig tissues. In addition, localization of the histamine H1 receptor and the muscarinic acetylcholine receptor on the sympathetic nerve in the guinea-pig nasal mucosa were examined by quantitatively evaluating these receptors after the unilateral removal of the superior cervical ganglion. Ach inhibited electrically-stimulated 3H-NE release in a concentration-dependent manner, and this effect was blocked by atropine. Histamine inhibited electrically-induced 3H-NE release at a concentration of 10(-5) M but enhanced it in concentration of 10(-3) M. Histamine increased the spontaneous release of 3H-NE in a dose-dependent manner, which was inhibited by pyrilamine (H1 antagonist) and excess Ach, but was not altered by cimetidine (H2 antagonist). These results suggest the following: 1) Local regulation of NE transmission in nasal mucosa involved excitatory H1 receptors, inhibitory H2 receptors and inhibitory muscarine receptors which can be facilitated by sensory stimulation with histamine. 2) Histamine regulation may vary with a balance between the excitatory and inhibitory effects. 3) Histamine in the high concentrations seen in cases of nasal allergy, may shift this balance causing increased NE release; at low concentrations, NE release is inhibited. In the second series of this study, we were unable to demonstrate a decreased number of either H1 or muscarine receptors on the side affected by unilateral cervical ganglia sympathectomy.

Acetylcholine↗

Nasal mucosa reaction. A model for mucosal reaction during challenge.

Rhinological symptoms in aspects of hyperreactivity and allergy are increasing problems. Previous reports on this subject are based on studies of airway obstruction (rhinomanometry), secreted substances during challenge, and symptom scores. To be able to define and evaluate the pathological reactions in nasal hyperreactivity and allergy, it is necessary to find principles to describe and standardize the reactions of the healthy nasal mucosa. The aim of this study was to examine congestion of the nasal mucosa in healthy volunteers. Existing measuring methods, in this aspect, are either indirect or not accurate enough for this purpose. With the development of rhinostereometry, an optical measuring method, it is possible to record nasal mucosa congestion with high accuracy. A nasal challenge test was made in healthy volunteers with gradually raised concentrations of a histamine solution, which was applied to the inferior concha on the right side. Recordings of the mucosal congestion were made with rhinostereometry. We found that it is possible, with statistical significance, to standardize the reactions of the healthy nasal mucosa: There is no congestion more than 0.4 mm with a histamine concentration of less than 4 mg/ml (p less than 0.05); congestion of more than 0.4 mm is present at histamine concentrations of 16 mg/ml (p less than 0.05).

Adult↗

Examination of the distribution of mast cells in the nasal mucosa of patients with seasonal allergic rhinitis.

OBJECTIVE: It is known that mast cells play an important role in pathogenesis of allergic rhinitis. In this study, we investigated the distribution of mast cells in the nasal mucosa of patients with seasonal allergic rhinitis during the pollen-season. METHODS: This study was carried out at the Faculty of Medicine, Dicle University, Turkey, during the grass-pollen season between, March and July in 2002. Twenty patients with seasonal allergic rhinitis (12 females and 8 males) and 20 healthy (10 females and 10 males) non-allergic controls were examined for the distribution and abundance of mast cells in nasal biopsies. Biopsies were performed in all patients and controls, once during natural provocation in the spring and were taken from the lower edge of the inferior turbinate using a forceps. The samples of nasal mucosa were fixed in 10% neutral buffered formaline, stained with 0.5% aqueous toluidine blue and hematoxylin and eosin were examined under a light microscope. RESULTS: Mast cells were observed in the nasal mucosa obtained from 12 patients (60%) and 5 patients (25%) controls cases (p=0.025). It was found out that intrapitelial mast cells are present in nasal mucosa samples of patients with SAR (seasonal allergic rhinitis) but not in the epithelium of non-allergic controls. CONCLUSION: The number of submucosal mast cells has considerably increased in the nasal mucosa samples of patients with SAR. Besides this, these cells are determined in great amounts in non-allergic individuals.

Adult↗

Electron spin resonance spin trapping assay and immunohistochemical localization of superoxide dismutases in the rat nasal mucosa.

The immunohistochemical method and electron spin resonance (ESR) spin trapping assay were employed to detect the localization and biochemical activity of superoxide dismutases (SODs) in the rat nasal mucosa. Manganese SOD and copper-zinc SOD were immunohistochemically illustrated to be richly expressed in the epithelial cells and the subepithelial glands of nasal mucosa. The olfactory vesicles also showed positive immunostaining for manganese SOD and copper-zinc SOD. ESR spin trapping assay revealed that SOD activity in the mucosa of olfactory areas was significantly higher than in the mucosa of respiratory areas; however, the ratio of SOD activity in the mitochondrial fraction to SOD activity in the cytosolic fraction was similar, approximating 17:83 in the mucosa of both the olfactory and respiratory areas. The predominant localization of SODs in epithelial cells of nasal mucosa suggests the importance of mucosal epithelium in protecting nasal mucosa against cytotoxic superoxide (O2-) radicals. Epithelial goblet cells and the connective tissue of lamina propria, which showed no positive immunostaining for SODs, are considered to be vulnerable to oxidative insults implicated in the generation of O2- radicals. The higher SODs activity in the mucosa of olfactory areas implies that there is a different requirement of SOD in mucosa of the respiratory and olfactory areas on scavenging microenvironmental O2- radicals.

Animals↗

Acetone-dependent regulation of cytochromes P4502E1 and P4502B1 in rat nasal mucosa.

The inducibility and molecular regulation of cytochrome P4502E1 (CYP2E1) has been examined in nasal mucosa of rats after acetone treatment and compared to that of cytochrome P4502B1 (CYP2B1). Twenty-four hours following treatment with acetone (5 mL/kg) for 2 days, the amount of CYP2E1 as well as the rate of microsomal 4-nitrophenol hydroxylase activity had increased by a factor of 2-3, in microsomes isolated from nasal mucosa. The increase in CYP2E1 was accompanied by a corresponding increase of CYP2E1 mRNA, as determined by northern and slot blot analyses. In contrast, hepatic and renal CYP2E1 mRNA, studied in the same rats, did not increase, despite the fact that the amount of CYP2E1 was increased 3- and 5-fold, respectively. The amount of CYP2B1, an isozyme known as acetone-inducible in other tissues, decreased significantly by acetone, as detected by immunoblot analysis. After 48 hr, the amount of CYP2E1 enzyme, the level of CYP2E1 mRNA and the rate of 4-nitrophenol hydroxylase activity had returned to normal levels, whereas in liver and kidneys the immunoreactive protein remained 3-4-fold higher than control. The results indicate that acetone does not regulate CYP2E1 in nasal mucosa by post-translational mechanisms, in contrast to the situation observed in liver and kidneys. This indicates a tissue-specific expression of post-translational regulatory systems responsible for P450 stabilization. Furthermore, nasal CYP2B1 also seems to be regulated in a tissue-specific manner by acetone.

Acetone↗

Substance P- and calcitonin gene-related peptide-containing nerve fibers in the nasal mucosa of chronically hypoxic rats.

The distribution of substance P-immunoreactive and calcitonin gene-related peptide-immunoreactive nerve fibers in the nasal mucosa was compared between normoxic and chronically hypoxic rats (10% O2 and 3.0-4.0% CO2 for 3 months). In the normoxic nasal mucosa, substance P- and calcitonin gene-related peptide-immunoreactive nerve fibers were found within and under the epithelium and around the glands and blood vessels in the lamina propria. These immunoreactive fibers have many varicosities. In the chronically hypoxic nasal mucosa, the relative density of intra- and subepithelial substance P-immunoreactive and calcitonin gene-related peptide-immunoreactive fibers and those in the lamina propria was higher than in normoxic mucosa. The length of substance P-positive fibers within the chronically hypoxic olfactory and respiratory epithelium was 1.66 and 2.45 times higher than within the normoxic epithelium, respectively. The length of calcitonin gene-related peptide-immunostained fibers within the chronically hypoxic olfactory and respiratory epithelium was 1.56 and 1.84 times higher, respectively. Because substance P and calcitonin gene-related peptide are the predominant signal peptides of primary sensory neurons, the increased number of these fibers may represent enhanced sensory mechanisms in the hypoxic nasal mucosa. In addition, considered together with the findings in chronically hypoxic tracheal mucosa, the increased density of intraepithelial fibers containing substance P and calcitonin gene-related peptide suggests that this is a predominant feature of hypoxic adaptation throughout the upper and lower respiratory tracts.

Animals↗

An immunocytochemical study on the distribution of calcitonin gene-related peptidergic nerve fibers in rat nasal mucosa.

The distribution of calcitonin gene-related peptidergic (CGRP) nerve endings in rat nasal mucosa was investigated with immunocytochemical technique (ABC method). The results showed that CGRP endings had a robust localization along the walls of arterioles, venules and around the acini of glands, with the endings near the wall of arterioles being most strongly stained. The typical morphology of CGRP endings could be recognized as multistage-branched terminals with rosary varicosities. CGRP immunoreactive neurons were also found in the trigeminal ganglion (TG). Supported by morphological evidence, we suggest that CGRP endings in rat nasal mucosa are the peripheral fibers originating from the ganglion cells in TG. These fibers may be involved in the perception of mucosal stimuli and the propagation of nerve impulse to the central terminals and will thus release CGRP in the brain stem. There is also possibility that CGRP may be peripherally released following local stimulation in the nasal mucosa and exert influences on the mucosal functions.

Animals↗