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Conclusions: No significant subepithelial healing differences were found between Gelfoam and polyurethane foam (PUF). However, levels of hyperplasia of the mucosal lining and inflammation were lower with PUF packing. PUF packing is not feasible as a middle ear packing material for abraded mucosa. Further studies are required before clinical application. Objective: To date, there have been few reports on the antiadhesive effect of PUF as a middle ear packing. The purpose of this study was to investigate the antiadhesive effect of PUF soaked with saline in an animal model of mucosal trauma. Methods: Bioresorbable PUF soaked with saline was placed over abraded mucosa in the experimental group ( n = 7), and compressed Gelfoam soaked with saline was placed in the control group ( n = 7). After measurement of auditory brainstem responses (ABRs), the animals were sacrificed 3 weeks after packing placement for histological observation. Results: The ABR results at postoperative week 3 showed no statistically significant difference between the preoperative and post-packing values. An adhesion pattern with subepithelial thickening was observed in the control group. Adhesion was not observed in the experimental group; however, subepithelial fibrous thickening was noted. [ABSTRACT FROM AUTHOR]

Conclusion Lipopolysaccharide (LPS) challenge of the human nose has the capacity to reduce the amount of natural anti-inflammatory proteins, such as uteroglobin. Objectives Nasal challenge with LPS, an activator of innate immunity, has been shown to increase the amount of pro-inflammatory mediators in nasal lavage fluid. Uteroglobin is a newly described anti-inflammatory mediator that is secreted in the nose. This study examined the effect of nasal LPS application on the level of uteroglobin in nasal lavage fluid as well as on the expression of uteroglobin in nasal mucosa. Materials and methods Thirty-eight volunteers were challenged nasally with either 50 µg LPS or vehicle; 6 h later, nasal lavage fluid was collected and a nasal biopsy was obtained. Levels of uteroglobin, albumin and the pro-inflammatory mediators interleukin (IL)-6 and IL-8 were analysed in the lavage fluids using enzyme-linked immunosorbent assays (ELISAs). Biopsies were used for either quantification of uteroglobin mRNA by real-time PCR or for localization of the corresponding protein with immunohistochemistry. Results The uteroglobin level decreased in nasal lavage fluid following LPS challenge, whereas the levels of IL-6 and albumin increased. Uteroglobin was mainly seen in the respiratory epithelium and its mRNA expression decreased as a consequence of the LPS challenge. [ABSTRACT FROM AUTHOR]

Conclusions. T cells in adenoid surface secretion (AdSS) possess the property of cytokine production and are mainly downregulatory or of Th1 type. These results strengthen the hypothesis of an active immunological defense in AdSS. Objectives. Recently, we demonstrated the presence of activated T cells in AdSS. The aims of this study were to elucidate the ability of these T cells to produce cytokines and to reveal their cytokine profile. Material and methods. Eight children subjected to adenoidectomy were enrolled. Samples of AdSS, adenoid tissue and peripheral blood were obtained, as well as a nasopharyngeal culture. T cells obtained from AdSS, adenoid tissue and peripheral blood were then cultured and stimulated with anti-CD3 and -CD28 for 5 days. The production of interferon (IFN)-?, tumor necrosis factor (TNF)-a and IL-2, -4, -5 and -10 was then analyzed using flow cytometry. Results. All children had T cells in AdSS capable of cytokine production. T cells in AdSS, adenoid tissue and peripheral blood samples from all children produced IFN-?. Of the cytokines analyzed, IFN-? was produced in the highest concentrations. In 6/8 children, T cells in AdSS also produced TNF-a and IL-10. [ABSTRACT FROM AUTHOR]

A large set of mucin genes is expressed in nasal polyps. The expression pattern is complex and may reflect the wide spectrum of variables involved in polyp formation and progression. Prospective studies including subgroups of nasal polyps and involving substantial numbers of cases in each subgroup will be required to elucidate these variables and to understand how they affect mucus secretion. At present, 15 of the 19 known mucin genes are expressed in the human airways. Nasal polyps might be expected to have a mucin expression pattern comparable to that of the airways. The aim of this study was to investigate mucin expression in nasal polyps. Nasal polyp samples were obtained from 20 patients during functional endoscopic sinus surgery. Normal (control) sphenoid sinus mucosa was obtained from patients undergoing trans-sphenoid hypophysectomy. The expression of eight mucin genes (MUC1–4, -5AC, -5B, -6 and -7) was studied by in situ hybridization utilizing digoxigenin-labelled oligonucleotide probes. MUC6 and -7 were not expressed in sphenoid sinus mucosa, while all the studied mucin genes were expressed in nasal polyps. Expression patterns varied widely between individual polyps. The predominant epithelial mucin genes were MUC4, -5AC and -3, while MUC5B and -7 were mainly of glandular origin. MUC1, -2 and -6 were weakly expressed. The major alteration in gene expression in nasal polyps was found in the submucosal glands. MUC4 and -5AC represent a major component of both submucosal glands and epithelial cells in nasal polyps. [ABSTRACT FROM AUTHOR]

Conclusion This study demonstrates that, in the nasal respiratory mucosa of patients with vasomotor rhinitis, oxidative stress following peroxynitrite formation is confined to the respiratory epithelium. This suggests that the role of peroxynitrite in vasomotor rhinitis differs from its role in other diseases of the respiratory tract. The results of this study also support the concept that different pathogenetic mechanisms are probably involved in vasomotor rhinitis. Objective Previous studies indicated that nitric oxide (NO) is involved in the pathogenesis of vasomotor rhinitis, strong expression of NO synthase being detected in the smooth muscle cells of the cavernous sinuses and in the respiratory epithelium. However, most adverse effects of high levels of NO originate from the reaction of NO with superoxide anions to form peroxynitrite. Therefore, in this study we evaluated the involvement of peroxynitrite in the pathogenesis of vasomotor rhinitis. Material and methods Sites of peroxynitrite formation were identified by immunolabelling for 3-nitrotyrosine (3NT), its footprint in tissues. Samples of nasal mucosa were obtained from vasomotor rhinitis patients and from control subjects who had undergone corrective surgery of the nasal septum. All samples were obtained by reduction of the inferior turbinate. Results Examination of specimens from vasomotor rhinitis patients revealed that 3NT is absent in epithelium with a normal appearance, cells of the subepithelial connective tissue, the glands and the blood vessels, including the cavernous sinuses. In contrast, intense 3NT immunolabelling was found in the disrupted respiratory epithelium. 3NT was not present in any of the specimens from control subjects. [ABSTRACT FROM AUTHOR]

Objectives --Several pieces of evidence have suggested that nitric oxide (NO) fulfills important functions in the respiratory mucosa, under both normal and pathological conditions. This study was performed to investigate the role of NO in the nasal respiratory epithelium of patients affected by vasomotor rhinitis. The structure and ultrastructure of the epithelium were also examined. Material and Methods --The localization of NO synthase activity was determined by means of reduced nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase ultracytochemistry. Nasal mucosa was obtained from patients who had undergone surgical therapy for reduction of the inferior turbinate. Results --Examination of hematoxylin-eosin-stained sections revealed that most of the nasal mucosa covering the surgical samples was characterized by severe epithelial damage. The ultrastructural study confirmed the light microscopic observations. Ciliary loss, absence of the intercellular junctions and distension of the intercellular spaces were found in the damaged epithelium. The basement membrane was frequently interrupted. Some epithelial cells were identified as basal cells. Other cells of the damaged epithelium were probably involuted ciliated and goblet cells. The ultracytochemical study showed that the basal cells were NADPH-diaphorase-negative in healthy subjects and strongly NADPH-diaphorase-positive in subjects with vasomotor rhinitis. Conclusions --It is suggested that NO has cytotoxic effects and causes inhibition of mitotic activity in the basal cells, leading to epithelial disruption and breakdown of the protective functions of the epithelium. [ABSTRACT FROM AUTHOR]

The paranasal sinuses are connected to the nasal cavity via small osties. Ostial occlusion, caused by mucosal swelling, will result in a slowly increasing negative pressure inside the sinus cavity. In parallel, the oxygen content in the sinus will decrease, resulting in the development of relative hypoxia. Hypoxia is a powerful inducer of nitric oxide (NO) synthase, and inducible NO synthase has been shown to be present in considerable amounts in the upper airways, including the sinuses. The present study was designed to investigate whether a reduction in sinus pressure would affect upper airway NO production. Thirteen healthy volunteers were investigated. A pressure chamber was used to lower the ambient pressure to-4.9 kPa. NO was sampled from one nostril or via a drainage tube inserted into the maxillary sinus before, during and after the hypobaric exposure. When the pressure was decreased, NO levels increased from 256±15 to 316±19 ppb (n =13, p <0.001). The NO levels remained elevated (282±21 ppb; p <0.05) when measurements were repeated 20 min after leaving the chamber. The nasal airway resistance (V2[sub tot] ) also increased as a result of the chamber session (from 16±2° before to 21±3° after; p <0.05). An increase in NO levels was also found when the experiments were repeated with NO sampled directly from the maxillary sinus (225±6 before and 265±9 ppb after; n =6, p <0.001). For control purposes the nasal analyses were repeated again, this time under hyperbaric conditions (+4.9 kPa). This resulted in a slight decrease in the NO levels (from 273±22 to 241±17 ppb; n =10, p <0.001), but there was no change in the nasal airway resistance. We conclude that a reduction in sinus pressure, as seen in upper airway allergy or infection, may result in an increase in upper airway NO production. [ABSTRACT FROM AUTHOR]

Until recently, it was not feasible to conduct genome-wide screening for gene transcript variations that play key roles in the pathogenesis of otitis media. In this study microarray technology was used to profile differential gene expression patterns from rat middle ear mucosa at 12 and 48 h after Streptococcus pneumoniae challenge. Real-time polymerase chain reaction was performed for independent verification of the microarray results. Three ion transport mRNAs were simultaneously suppressed more than 4-fold at 12 h in bacteria-challenged ears, including Na,K-ATPase alpha 1 subunit (SPATPa1), sodium channel beta 2 subunit (SCNB2) and sodium -hydrogen exchange protein isoform 2 subunit (NHE2). At 48 h after infection, the mRNA levels of SCNB2 and NHE2 had decreased 7- and 10-fold, respectively, whereas the relatively abundant SPATPa1 transcript showed recovery. The downregulation of Na[sup +] -transporting transcripts suggests a reduced number of epithelial cells and transporting proteins and/or the dysfunction of sodium transporters secondary to the bacterial infection. These changes can disrupt the coupling of the apical Na[sup +] entry and basolateral Na[sup +] extrusion, deplete the electrochemical Na[sup +] transmembrane gradient, disrupt the intracellular osmotic equilibrium and lead to intracellular acidification and the accumulation of excess sodium, water and other organic and inorganic molecules in the middle ear cavity. Any or all of these changes may contribute to the initiation and persistence of middle ear mucosa inflammation and effusion during an episode of bacterial acute otitis media. [ABSTRACT FROM AUTHOR]

Trefoil factor family (TFF) peptides are typical secretory products of gastrointestinal mucus epithelia. Three TFF peptides exist in humans, TFF1 (formerly pS2), TFF2 (formerly hSP) and TFF3 (formerly hP1.B hITF), acting as link peptides and influencing the rheological properties of mucous gels. The combined actions of TFF peptides and mucins have been shown to provide significant protection to mucosal surfaces. In this respect, TFF peptides may play a key role in the maintenance of the surface integrity of nasal mucosa. The present study aimed to investigate the expression of mRNA of TFF peptides in human inferior turbinate mucosa using reverse transcription polymerase chain reaction and in situ hybridization. TFF1 and TFF3 mRNA were detected in the human turbinate tissues examined. In contrast, TFF2 mRNA was not expressed in any samples. Using in situ hybridization, TFF1 and TFF3 mRNA were predominantly localized in epithelial cells and submucosal glandular epithelium. These data suggest that nasal epithelia and submucosal glands may secrete TFF1 and TFF3, contributing to the stabilization of the mucous lining of human nasal mucosa. [ABSTRACT FROM AUTHOR]

Primarily to evaluate the potential of contact endoscopy, the nasopharyngeal mucosa were examined using contact microscopy. With contact endoscopy it has been possible to visualize (60×, 150×) the superficial cell layers of the nasopharyngeal epithelium, previously stained with methylene blue in vivo and in situ. Normal nasopharyngeal epithelium (20 cases) and cases with pathology (18 cases of chronic nasopharyngitis, 5 cases of nasopharyngeal cyst, and 57 cases of poorly differentiated squamous carcinoma) were assessed with contact endoscopy. The results showed that contact endoscopy can offer clear morphology and arrangement of the epithelial cells of the superficial layers and microvascular networks, such as the size and shapes of the cells or nuclei, nucleus/cytoplasm ratio, karyokinesis, etc. Our study indicated that contact endoscopy can permit the mapping of cellular alteration over mucosa and constitutes a new method of monitoring a high-risk population or precancerous lesions of nasopharyngeal carcinoma. [ABSTRACT FROM AUTHOR]

Hypersecretion of mucin is a common feature of chronic and mucoid otitis media which may play an important role in hearing loss. The mechanisms controlling mucin secretion in the middle ear are not completely understood. Our reverse transcriptase-polymerase chain reaction results demonstrate that mRNAs of MUC1, MUC2, MUC3, MUC4 and MUC5AC are expressed in normal rat middle ear mucosa. Moreover, the expression of mRNA of the secretory mucins MUC2, MUC3 and MUC5AC was threefold lower in normal middle ear mucosa than that in the intestine or trachea. In contrast, expression of the membrane-bound mucins MUC1 and MUC4 was approximately the same in both middle ear mucosa and the intestine or trachea. MUC5AC proteins were also identified immunohistochemically in normal rat middle ear epithelium. The methodology used in this study provides useful baseline information for investigation of the mechanisms of regulation of mucin gene expression during otitis media. [ABSTRACT FROM AUTHOR]

Among a variety of other histopathologic changes, polyps and fibrous adhesions are readily formed in the middle ear mucosa during experimental acute otitis media (AOM) caused by Streptococcus pneumoniae. Quantitative studies on experimental AOM caused by other bacteria have shown that some of these histopathologic changes, such as adaptive bone modeling and increase in goblet cell density, differ according to the type of bacteria. This investigation surveys polyp and fibrous adhesion formation in experimental AOM caused by either non-typeable or type b Haemophilus influenzae, or Moraxella catarrhalis. Seventy-five rats were inoculated with 1 of these 3 bacteria (25 rats in each of 3 groups). Five rats from each group were sacrificed on days 4, 8, 16, 60 and 180 post-inoculation. The middle ear mucosae were dissected and histopathologic changes in whole-mount and section preparations were studied using light microscopy. Polyps were found in most ears and in the greatest numbers on the early days; fewer polyps were found on the later days, regardless of the type of bacteria. However, non-typeable and type b H. influenzae induced formation of significantly more polyps than M. catarrhalis. The polyps were primarily located in the epitympanum. Fibrous adhesions were primarily located in the hypotympanum and formed in almost all ears, on all days post-inoculation, regardless of the type of bacteria. Numbers increased to a peak on day 16 and then decreased. Non-typeable and type b H. influenzae induced formation of significantly more adhesions than M. catarrhalis, and the middle ears displayed a higher number of persisting adhesions in the animals inoculated with non-typeable H. influenzae. We conclude that polyps and adhesions are formed in experimental AOM regardless of bacterial type, confirming a pathogenesis based on inflammation. Both types of H. influenzae induce formation of greater numbers of polyps/adhesions than M. catarrhalis, and the non-typeable form causes more adhesive sequelae in the mucosa than the encapsulated type b. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the influence of five intranasal applications of capsaicin, performed after endoscopic polypectomy associated with partial middle turbinectomy and anterior ethmoidectomy, on the recurrence of nasal polyps and the intensity of nasal obstruction and rhinorrhea. Fifty-one patients (19 females, 32 males, mean age 43 years) suffering from nasal polyposis for more than 1 year were included in this double blind, randomized, placebo-controlled study. During post-surgical controls, local anaesthesia and vasoconstriction of the middle meatus area were performed in all patients with a cotton pellet soaked with lidocain and adrenaline. In 29 patients, the same type of cotton pellet soaked with capsaicin (3 × 10-6 mol, dissolved in 70% ethanol) was left into the middle meatus of both nostrils for 20 min. As a control group, 22 patients, matched for age and sex, were treated with the capsaicin vehicle alone (70% ethanol). All patients studied received the intranasal treatment once a week for 5 weeks. Subjective evaluations of nasal airway resistance (NAR) and rhinorrhea were recorded by means of a visual analogue scale. Clinical staging of the nasal polyposis (graded from stage 0=absence of polyp to stage 3=polyps occupying the entire nasal cavity) was evaluated by the same ENT specialist (ZW) using a 0° endoscope. All parameters were recorded for each patient 1 week before surgery, then once a month for 9 months. Patients treated by endoscopic surgery followed by intranasal capsaicin application, reported a marked reduction in their NAR compared with the pretreatment evaluation (p < 0.001). In contrast, patients treated with the vehicle alone did not have any significant improvement of their subjective NAR. Subjective rhinorrhea was not modified by either treatment. Patients treated with capsaicin showed a significant smaller staging of their nasal polyposis compared with the control group (p < 0.001). These observations suggest that endoscopic surgery followed by intranasal capsaicin application reduces polyps and nasal obstruction recurrence and could be an alternative treatment to expensive corticosteroids in developing countries. [ABSTRACT FROM AUTHOR]

Antimicrobial peptides are cationic proteins that are found in a wide range of organisms. Recent reports suggested that human β-defensin 1 (hBD-1), a prominent group of antimicrobial peptides, is an important component of the innate immune response, particularly at mucosal surfaces that are vulnerable to colonization by potential pathogens. Therefore, hBD-1 may participate in providing intrinsic nasal mucosal defence against microbial infections. The present study aimed to look for hBD-1 mRNA in human nasal mucosa without obvious signs of inflammation. Total RNA was isolated from human inferior turbinate mucosa and hBD-1 mRNA was detected in these tissues by using reverse transcription and polymerase chain reaction (RT-PCR). By in situ hybridization, hBD-1 mRNA was predominantly localized in superficial epithelial cells and submucosal glandular epithelium of human inferior turbinate mucosa. These data suggest that nasal epithelia and submucosal glands may secrete hBD-1, contributing to the mucosal defences of the nose. [ABSTRACT FROM AUTHOR]

Objective The total pressure in the middle ear depends on the air composition of this gas pocket, i.e. on gas exchanges occurring through either the Eustachian tube (ET) or mucosa. The aim of this study was to develop an experimental model to investigate the exclusive role of trans-mucosal gas exchanges in the middle ear (ME). Material and Methods Both tympanic membranes of 20 Sprague-Dawley rats were punctured under general anesthesia. Rats were divided into two equal groups. Group 1 had no ET obstruction. In Group 2, the ET was blocked, after velar incision, by cauterization and application of cyanoacrylate glue into the lumen. One open transparent glass tube containing a droplet of colored water was placed horizontally and connected hermetically to each ear canal. The ME was then flushed with room air through the tube. Variations in ME gas volume were measured by reading the displacement of the liquid droplet in the horizontal tube. The kinetics of variations in gas volume between groups were displayed and statistically compared using a two-sided t -test. Results The pattern of variations in ME gas volume with time was similar in the two groups. Both were characterized by a decrease with three phases and an elimination rate of ≈0.152±0.026 μl/min. There was no significant difference in the mean rate of ME volume changes between the two groups. Conclusion This experimental model allows investigation of trans-mucosal gas exchanges. These exchanges exhibit an absorptive function resulting in a negative pressure that must be compensated, under physiological conditions, by air flow through the ET. [ABSTRACT FROM AUTHOR]