| 1. |
- Barck, Charlotte, et al.
(författare)
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Does nitrogen dioxide affect inflammatory markers after nasal allergen challenge?
- 2005
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Ingår i: American Journal of Rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 19:6, s. 560-566
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exposure to high ambient levels of nitrogen dioxide (NO2) enhances the bronchial inflammatory reaction to allergen in humans. We tested whether this NO2 effect occurs also in the upper airways. METHODS: Sixteen allergic subjects with rhinitis and mild asthma were exposed at rest to either purified air or 500 microg/m3 NO2 for 30 minutes, followed 4 hours later by a nasal allergen challenge. Nasal lavage was performed before air/NO2 exposure, before allergen challenge, and 1, 4 and 18 hours after allergen challenge. Symptoms were recorded. RESULTS: The percentage of eosinophils and neutrophils, eosinophil cationic protein, and myeloperoxidase were similar after exposure to air + allergen and to NO2 + allergen. We noticed a tendency to increased sneezing the day after exposure to NO2 + allergen. CONCLUSION: The priming effect of an ambient brief NO2 exposure on subsequent allergic response was not noticeable in activation of inflammatory cells and mediators in the upper airways.
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| 2. |
- Berglof, A, et al.
(författare)
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Association of bronchopneumonia with sinusitis due to Bordetella bronchiseptica in an experimental rabbit model
- 2000
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 14:2, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- An animal model for rhinogenic sinusitis was developed in rabbits naturally colonized with Bordetella bronchiseptica. It was found that ostial occlusion predisposes the sinus to invasion with this opportunistic bacterium and subsequent sinusitis as a result of reduced local host defense. In addition to the inflammatory lesions in the sinus, bronchitis and pneumonia were found in 84% of the experimental rabbits, suggesting that ostial dysfunction can also contribute to infectious disease of the lower respiratory tract. In such a model it is possible to study the significance of asymptomatic carriage of potential pathogens after ostial occlusion.
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| 3. |
- Eccles, R, et al.
(författare)
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Efficacy and safety of topical combinations of ipratropium and xylometazoline for the treatment of symptoms of runny nose and nasal congestion associated with acute upper respiratory tract infection
- 2007
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 21:1, s. 40-45
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Tidskriftsartikel (refereegranskat)abstract
- Rhinorrhea and nasal congestion are simultaneous symptoms associated with the common cold. This study investigated the efficacy and safety of a combination nasal spray of ipratropium and xylometazoline for simultaneous treatment of these symptoms. Methods The trial was a multicenter double-blind, parallel-group, randomized design on patients with common cold symptoms. Patients scored symptoms of runny nose and nasal congestion and recorded adverse events in a diary for up to 7 days. Patients also recorded tissue use. The five test treatments consisted of ipratropium, 0.6 mg/mL, and xylometazoline, 1.0 mg/mL; ipratropium, 0.6 mg/mL, and xylometazoline, 0.5 mg/mL; ipratropium, 0.6 mg/mL; xylometazoline, 1.0 mg/mL; and placebo solution. Results Eight hundred sixty-four patients were screened and 786 patients received treatment. One day after treatment there was a clear separation between the scores for the placebo and ipratropium treatment groups for rhinorrhea and between the placebo and xylometazoline treatment groups for congestion. Both ipratropium/xylometazoline 1.0 and ipratropium/xylometazoline 0.5 treatments were superior to xylometazoline with respect to rhinorrhea (p < 0.0001) and superior to ipratropium with respect to nasal congestion scores (p < 0.001). Both the ipratropium combination treatments had significantly lower tissue use than the xylometazoline treatment group (p < 0.0001). Adverse events were distributed equally between the treatments, except mucus tinged with blood, epistaxis, nasal passage irritation, and nasal dryness, which had a higher incidence in the three groups that received medicines containing ipratropium. Conclusion The results indicate that a combination medicine of ipratropium and xylometazoline is safe and effective for treatment of rhinorrhea and nasal congestion associated with common cold.
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| 4. |
- Graf, PM, et al.
(författare)
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One year follow-up of patients with rhinitis medicamentosa after vasoconstrictor withdrawal
- 1997
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 11:1, s. 67-72
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to systematically follow-up 10 patients with rhinitis medicamentosa for at least 1 year after vasoconstrictor withdrawal. During withdrawal of the decongestants the patients used budesonide nasal spray, 400 μg/day, for 6 weeks. The thickness of the nasal mucosa, the decongestive effect of oxymetazoline, and the histamine sensitivity were measured with rhinostereometry during the period. The thickness of the nasal mucosa and the symptom scores of nasal stuffiness were reduced considerably 6 and 12 months after vasoconstrictor withdrawal. The histamine sensitivity reflecting nasal hyperreactivity was still increased after 6 months, but not after 1 year. The decongestive effect of oxymetazoline increased after 6 months, indicating reversible tolerance. We conclude that when given adequate treatment and information about nose-drop overuse, all patients were able to stop using the vasoconstrictors and no one relapsed into a daily long-term overuse of vasoconstrictors during the 1-year follow-up period.
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| 5. |
- Grudemo, H, et al.
(författare)
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Studies of spontaneous fluctuations in congestion and nasal mucosal microcirculation and the effects of oxymetazoline using rhinostereometry and micromanipulator guided laser Doppler flowmetry
- 1999
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 13:1, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- The mucosa of the inferior turbinate was studied using rhinostereometry and micromanipulator-guided laser Doppler flowmetry in 10 healthy volunteers. First, spontaneous fluctuations were studied measuring congestion and multiple microcirculatory parameters simultaneously every 2 minutes. The subjects were then challenged with oxymetazoline using the same measuring technique studying the effects of the challenge during 12 minutes. There were spontaneous variations in congestion of up to 2.1 mm and variations in perfusion from 38% to 175% of average. There was no correlation between congestion in itself, or change in congestion, to perfusion or any other microcirculatory parameter. After challenge with oxymetazoline there was a rapid decrease in perfusion at 3 minutes after which there were no significant changes. The congestion decreased gradually throughout the procedure. Because congestion reflects the filling of the venous sinusoids and the flowmetry the state of the superficial vessels, we conclude that there are spontaneous short-term fluctuations in the sympathetic tone with independent actions on the different vessels. After challenge with a sympathomimetic drug, there was a decrease in both swelling and flow, but not synchronized. The combination of rhinostereometry and micromanipulator-guided laser Doppler flowmetry is a useful tool to study the dynamics of intranasal challenge reactions.
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| 6. |
- Henriksson, G, et al.
(författare)
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Effects of topical budesonide treatment on glucocorticoid receptor mRNA down-regulation and cytokine patterns in nasal polyps
- 2001
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 15:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- The effects of a topically applied corticosteroid, budesonide, on the expression of glucocorticoid receptor (CR) mRNA and regulation of pro-inflammatory cytokine patterns in patients with nasal polyps were evaluated. All patients were eligible for surgical polypectomy, and a majority of them had been treated with nasal steroids. Patients were given 400 μg b.i.d. (group A, n = 11), 200 μg bid. (group B, n = 10), or no treatment (group C, n = 15) during two months before polypectomy. Morning serum cortisol was analyzed on the day of surgery. Surgically removed polyps were taken for analysis of GR mRNA expression by solution hybridization. Remaining tissue was cryostat-sectioned, whereafter quantification of the cytokines interleukin 1β, interleukin 2, interleukin 4, interleukin 5, interleukin 6, interleukin 10, tumor necrosis factor a, and interferon γ was made by immunohistochemistry and digitized image analysis. No significant differences among the three groups were found for any of the parameters investigated. Conclusion: nasal polyps do not respond with down-regulation of CR mRNA or cytokines following topical corticosteroid treatment. The proposed corticosteroid resistance may be inherent, or induced by a change of local tissue bioavailability.
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| 7. |
- Henriksson, G, et al.
(författare)
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Expression of P-glycoprotein 170 in nasal mucosa may be increased with topical steroids
- 1997
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 11:4, s. 317-321
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Tidskriftsartikel (refereegranskat)abstract
- The synthesis of P-glycoprotein 170 (P-gp), a “multidrug resistance” protein capable of extruding various drugs including 11-OH steroids from human cells, can be upregulated by certain glucocorticosteroids. This study demonstrates the presence of P-gp in the columnar surface epithelium and in glandular acini of healthy nasal mucosa with immunohistochemical technique. Furthermore, nasal polyps from 5 of 17 patients treated with clinical doses of a topical nasal steroid, budesonide, appear to show a stronger staining intensity for P-gp than polyps from 13 untreated patients. This suggests the possibility of local P-gp gene induction by topical glucocorticoid treatment. Upregulation of P-gp synthesis appears as a new possible cause of relative resistance to topical steroid medication in patients with nasal inflammatory disease.
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| 8. |
- Norlander, T, et al.
(författare)
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The relationship of nasal polyps, infection, and inflammation
- 1999
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 13:5, s. 349-355
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Tidskriftsartikel (refereegranskat)abstract
- The role of infection as cause or effect in nasal polyps is debated. In experimentally induced sinusitis in rabbits, polyps are frequent. The initial polyp formation sequence involves multiple epithelial disruptions with proliferating granulation tissue. Regenerating epithelial branches spread into the underlying connective tissue, where intraepithelial microcavities give rise to a polyp body from the adjacent mucosa. Clinical as well as experimental studies indicate that nasal polyp formation and growth are activated and perpetuated by an integrated process of mucosal epithelium, matrix, and inflammatory cells, which in turn may be initiated by both infectious and noninfectious inflammation. The complexity of the pathophysiologic events in nasal polyposis is reinforced by the finding that epithelial desquamation, combined with infection or inflammation, will initiate polyp formation. Systemic glucocorticosteroids inhibit polyp formation as well as growth of pathogenic bacteria in the sinuses of rabbits with experimental infection. Therapeutic use of corticosteroids in polyp disease, combined with antibiotics or surgery, should be modified in relation to long-term progression, intensity variations, and predisposing conditions.
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| 9. |
- Ohm, M, et al.
(författare)
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Nasal histamine provocation of tenants in a sick-building residential area
- 1997
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 11:2, s. 167-175
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Tidskriftsartikel (refereegranskat)abstract
- Health problems associated with the indoor climate have aroused an increasing scientific interest, and the term “sick-building syndrome” (SBS), which describes the most frequent symptoms in this context, has been coined. However, it has been difficult to demonstrate objectively any pathophysiological changes in the subjects affected. Thirty-three healthy and nonatopic persons were randomly selected on the basis of answers in a postal questionnaire dealing with discomfort or health symptoms experienced in their home environment. Twenty-three lived in a residential area with indoor climate problems (SBS area) and 10 lived in an area without climate problems (non-SBS area). Twelve persons from the SBS area reported nasal symptoms, which they ascribed to their home environment. The remaining 11 persons from the same area, as well as the 10 subjects from the non-SBS area, had no nasal distress. They were examined with rhinostereometry during histamine provocation. Hyperreactivity, defined as mucosal swelling exceeding 0.4 mm at 5 and 10 minutes after provocation with 0.14 ml of 2 mg/ml histamine chloride, was frequent in the symptomatic SBS group as well as in the asymptomatic SBS group. The analysis of the increment of mucosal swelling for the whole range of histamine chloride concentrations (0.1 mg/ml to 16 mg/ml) showed significantly different growth curves for the three groups in the residential areas and an external reference group, (p < 0.0001). Subjects living in the SBS area were prone to nasal hyperreactivity, whether they reported symptoms from the upper airways or not. The results support the hypothesis that living in an SBS area increases the risk of developing nonspecific nasal hyperreactivity.
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| 10. |
- Rudblad, S, et al.
(författare)
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Nasal hyperreactivity among teachers in a school with a long history of moisture problems
- 2001
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Ingår i: American journal of rhinology. - : SAGE Publications. - 1050-6586 .- 1539-6290. ; 15:2, s. 135-141
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Tidskriftsartikel (refereegranskat)abstract
- Upper airway symptoms have frequently been reported in people working or residing in damp buildings. However, little information has been available on objective pathophysiologic findings in relation to these environments. Twenty-eight teachers, who had worked for at least five years in a recently renovated school that had had severe moisture problems for years, were randomly selected for this study. Eighteen teachers, who had worked in another school that had no moisture problems, were randomly selected to serve as the control group. Although remedial measures had been taken, an increase in the prevalence of mucous membrane irritations was still reported by the teachers in the target school. We used a nasal challenge test with three concentrations of histamine (1, 2 and 4 mg/mL). Recordings of swelling of the nasal mucosa were made with rhinostereometry, a very accurate optical non-invasive method. The growth curves of mucosal swelling induced by the three concentrations of histamine differed significantly between the two groups (p < 0.01). The frequencies of atopy, evaluated with the skin-prick test, were almost identical in both groups. The study indicates that long-term exposure to indoor environments with moisture problems may contribute to mucosal hyperreactivity of the upper airways. Such hyperreactivity also seems to persist for at least one year after remedial measures have been taken.
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