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Background: Abnormal expression of miRNA is a common feature in many diseases. Some studies have also emphasized that miRNAs play an important role in asthma and allergic rhinitis (AR). This study attempts to reveal the differences between miRNAs expression and normal nasal mucosa in AR patients by microarray method so as to further understand the molecular mechanism of AR development. Method: MiRNA microarrays were used for analyzing six samples of the nasal mucosa of AR and six samples of nonallergic patients. Quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) of some differently expressed miRNAs was used to confirm the array results. Furthermore, pathway analysis was carried out. Results: The microarray identified that 64 miRNAs showed altered expression in the nasal mucosa of the AR group when compared with the control group. Moreover, the expression levels of ten miRNAs were significantly altered in the AR group. To verify the results of microarray, three differentially expressed miRNA were determined by RT-PCR, and the results also confirmed these changes. Ten differentially expressed miRNAs were present in the nasal mucosa of AR patients compared with the control group, and three differentially expressed miRNAs as miR-1244, miR- 4651, and miR-7641 were determined by RT-PCR. The results also confirmed the changes, indicating that they play important roles in the process of AR. Conclusion: MiR-1244, miR-4651, and miR-7641 may play important roles in the process of AR. Sequencing analysis indicated that three kinds of mutations existed in MAPK8 3’UTR, which may play a role in binding with miR-7641, and then influence the AR process. Single miRNA or, more probably, their sets hold the promise for their use as biomarkers of allergic rhinitis. They are also a promising target of future therapies.

Introduction Pregnancy rhinitis is a common sex hormone-related otorhinolaryngological disorder. There are some epidemiological and physiological studies on pregnancy rhinitis, but histopathological and biomolecular changes have not been studied thoroughly. Objectives The receptors VPAC1 and VPAC2 are known for their roles in allergic rhinitis. On the other hand, activation of subclinical allergy has been suggested in the pathophysiology of pregnancy rhinitis. Therefore, we aimed to compare the physiological and gestational pattern of VPAC1 and VPAC2 expression in rat nasal mucosa. Methods Twenty adult Wister albino female rats were enrolled into the study. Two groups constituted as 10 control (group A) and 10 pregnant (group B) rats. They were fed ad libitum and sheltered at room temperature (22°±2 °C). The rats were sacrificed at the 20th day of gestation by intraperitoneal injection of 400 mg/kg Na-pentobarbitone. Then, 10 − 15 mL of blood was taken, and samples were reserved for the detection of serum estradiol and progesterone levels by ELISA test. The nasal septum was resected and divided in half for immunohistochemical analyses and real time polymerase chain reaction testing of VPAC1 and VPAC2. Results VPAC1 and VPAC2 were found to be in all layers of septal specimens, but the immunostaining of surface epithelium was more distinct in specimens of both groups. We demonstrated higher overall staining intensity in the pregnant group. PCR revealed significant increase in expression of VPAC1 (p = 0.023) and VPAC2 (p = 0.021) in pregnant group when compared with control group. In addition, we demonstrated upregulatory effect of estradiol and progesterone on the vasoactive intestinal peptide receptor expression. Conclusions Gestational up-regulation of nasal VPAC1 and VPAC2 was shown both by PCR and immunohistochemical analysis. These findings support the hypothesis that PR is caused by the activation of subclinical allergy that is present before pregnancy.

The nasal mucosa functions as a frontline biological defense against various foreign substances and pathogens. Maintaining homeostasis of the nasal epithelium is necessary to promote good health. Nasal epithelia are constantly replaced under normal conditions. However, hereditary diseases, including primary ciliary dyskinesia and cystic fibrosis, can result in intractable dysfunction of the nasal mucosa. Since there is no treatment for this underlying condition, extrinsic manipulation is necessary to recover and maintain nasal epithelia in cases of hereditary diseases. In this study, we explored the use of airway epithelial cells (AECs), including multiciliated airway cells, derived from human induced pluripotent stem cells (iPSCs) on porcine atelocollagen vitrigel membranes, as a candidate of a therapeutic method for irreversible nasal epithelial disorders. To confirm the regenerative capacity of iPSC-derived AECs, we transplanted them into nasal cavities of nude rats. Although the transplanted cells were found within cysts isolated from the recipient nasal respiratory epithelia, they survived in some rats. Furthermore, the surviving cells were composed of multiple cell types similar to the human airway epithelia. The results could contribute to the development of novel transplantation-related technologies for the treatment of severe irreversible nasal epithelial disorders. Impact Statement Nasal respiratory epithelia are important for the functions of nasal cavity, including humidifying the air and filtering various toxic substances. However, hereditary diseases, including primary ciliary dyskinesia and cystic fibrosis, can result in intractable dysfunction of the nasal mucosa. Our novel method to transplant airway epithelial cells derived from human induced pluripotent stem cells will be a candidate method to replace malfunctioned nasal respiratory epithelia in such a situation. To secure our method's safety, we used porcine atelocollagen vitrigel membranes, which prevent the immune response and bovine spongiform encephalopathy, as a scaffold.

BACKGROUNDNasopharyngeal carriage of pathogenic bacteria precedes invasive disease and higher rates are found in low socioeconomic-status (SES) settings. Local immune responses are important for controlling colonization, but whether SES affects these responses is currently unknown.OBJECTIVEExamining bacterial colonization and cytokine response in nasal mucosa of children from high and low SES.METHODSTwenty-five cytokines were measured in nasal fluid. qPCR was performed to determine carriage and density of Haemophilus influenzae (H. influenzae), Streptococcus pneumoniae (S. pneumoniae), Moraxella catarrhalis (M. catarrhalis) and Staphylococcus aureus (S. aureus).RESULTSThe densities of H. influenzae and S. pneumoniae were increased in low compared to the high SES (p=0.006, p=0.026), with respectively 6 and 67 times higher median densities. Densities of H. influenzae and S. pneumoniae were positively associated with levels of IL-1beta (p=0.002, p=0.008) and IL-6 (pp=0.006). After correcting for bacterial density, IL-6 levels were increased in colonized children from high compared to low SES for both H. influenzae and S. pneumoniae (both p=0.039).CONCLUSIONIncreased density of H. influenzae and S. pneumoniae was observed in low SES children, while IL-6 levels associated with colonization were reduced in these children, indicating that immune responses to bacterial colonization were altered by SES.

Background Allergic rhinitis (AR) is a complex disease involving both mucosal and systemic immune compartments. Greater understanding of the immune networks underpinning AR pathophysiology may assist with further refining disease‐specific biomarkers. Objective To compare immune gene expression profiles in nasal mucosa and peripheral blood samples between adults with AR and controls without AR. Methods This cross‐sectional study included 45 adults with moderate‐severe and persistent AR (37.6 ± 12.8 years; mean ± SD) and 24 adults without AR (36.6 ± 10.2). Gene expression analysis was performed using the NanoString nCounter PanCancer Immune profiling panel (n = 730 immune genes) in combination with the panel plus probe set (n = 30 allergy‐related genes) with purified RNA from peripheral blood and cell lysates prepared from combined nasal lavage and nasal brushing. Results One hundred and thirteen genes were significantly differentially expressed in peripheral blood samples between groups (p, A series of genes were differentially expressed in both peripheral blood and nasal mucosal samples from adults with moderate‐severe persistent allergic rhinitis compared with adults without a history of allergic rhinitis.

Background: Allergic rhinitis (AR) is caused by allergic reaction to allergens such as pollen. Galanin (GAL), a neuropeptide that regulates inflammatory processes, is widely expressed in the central and peripheral nervous systems. Although neuropeptides are implicated in arthritis and chemically induced ileitis, their roles in AR remain unclear. Methods: We developed a murine model of AR and generated control, systemic sensitization, mild AR, and severe AR groups. We examined GAL and GAL receptor (GALR) mRNA and protein levels and localization patterns in each group using reverse transcription PCR, western blotting, and immunohistochemical analyses. Additionally, we evaluated the effects of M871, a GALR2 antagonist, on mice with severe AR. Results: Gal and Galr2 are expressed in nasal mucosa and brain (control) samples from control and AR mice. GAL and GALR2 were expressed at similar levels and localized to ciliated epithelial and submucosal gland cells of the nasal mucosa in all four groups. Intranasal M871 administration significantly reduced the incidence of nose rubbing behaviors and sneezing (p

Introduction Allergic rhinitis is a form of IgE mediated inflammation of the nasal mucosa in response to specific allergens, resulting in typical symptoms. Objectives This study was designed with the primary goal of comparing the clinical efficacy of posterior nasal neurectomy with or without pharyngeal neurectomy for the treatment of moderate-to-severe perennial allergic rhinitis. Secondary study aims included a comparison of the severity of comorbidities, including chronic cough and asthma, between patients in these two surgical treatment groups. Methods A total of 52 patients were enrolled in this randomized controlled trial and were assigned to either the control group (posterior nasal neurectomy) or the experimental group (posterior nasal neurectomy + pharyngeal neurectomy). The visual analog scale and rhinoconjunctivitis quality of life questionnaire were used to compare the differences in patient symptoms between baseline and 6-, 12-, and 24-months post-treatment. In addition, patient cough and asthma symptoms were monitored during follow-up via visual analog scale and asthma control test respectively. Results No significant differences in preoperative scores were evident between groups (p> 0.05). At 6-months post-treatment, there were significant differences in visual analog scale, rhinoconjunctivitis quality of life questionnaire, and asthma control test scores relative to baseline values in experimental group and control group patients (p< 0.05), and this remained true upon 12- and 24-month follow-up. No significant differences in visual analog scale, rhinoconjunctivitis quality of life questionnaire, or asthma control test scores were observed between the two treatment groups at any postoperative follow-up time point (p> 0.05), while coughing severity was found to be significantly reduced in the experimental group relative to the control group (p< 0.05). Conclusion posterior nasal neurectomy can be safely implemented with or without pharyngeal neurectomy in order to effectively treat allergic rhinitis. Combined posterior nasal neurectomy and pharyngeal neurectomy treatment may offer greater value than posterior nasal neurectomy alone for the treatment of allergic rhinitis patients with chronic cough. Resumo Introdução A rinite alérgica é uma forma de inflamação da mucosa nasal mediada por IgE em resposta a alérgenos específicos, resulta em sintomas típicos. Objetivos Comparar a eficácia clínica da neurectomia nasal posterior com ou sem neurectomia faríngea para o tratamento da rinite alérgica perene de moderada a grave. Além disso, comparar a gravidade das comorbidades, inclusive tosse crônica e asma, entre os pacientes nesses dois grupos de tratamento cirúrgico. Método Foram incluidos neste ensaio clínico randomizado e designados para o grupo controle (neurectomia nasal posterior) ou para o grupo experimental (neurectomia nasal posterior + neurectomia faríngea) 52 pacientes. A escala visual analógica e o questionário de qualidade de vida na rinoconjuntivite (rhinoconjunctivitis quality of life questionnaire) foram usados para comparar as diferenças nos sintomas dos pacientes entre o período inicial e 6, 12 e 24 meses após o tratamento. Além disso, a tosse e os sintomas de asma dos pacientes foram monitorados durante o acompanhamento por meio da escala visual analógica e do teste de controle da asma (asthma control test ), respectivamente. Resultados Nenhuma diferença significante nos escores pré‐operatórios foi evidenciada entre os grupos (p > 0,05). Aos seis meses pós‐tratamento, houve diferenças significantes nos escores da escala visual analógica, no questionário de qualidade de vida na rinoconjuntivite e no teste de controle de asma em relação aos valores basais dos pacientes no grupo experimental e no grupo controle (p < 0,05), o que permaneceu verdadeiro após 12 e 24 meses de acompanhamento. Não foram observadas diferenças significantes nos escores da escala visual analógica e nem no questionário de qualidade de vida para conjuntivite ou no teste de controle da asma entre os dois grupos de tratamento em qualquer momento do acompanhamento pós‐operatório (p > 0,05), enquanto a gravidade da tosse foi significantemente reduzida no grupo experimental em relação ao grupo controle (p < 0,05). Conclusão A neurectomia nasal posterior pôde ser feita com segurança com ou sem neurectomia faríngea para o tratamento eficaz da rinite alérgica. O tratamento combinado com neurectomia nasal posterior e neurectomia faríngea pode oferecer mais benefício do que a neurectomia nasal posterior isolada para o tratamento de pacientes com rinite alérgica e tosse crônica.

There are various defensive mechanisms in upper respiratory tract mucosal linings such as mechanical and functional barriers. The mechanical barrier of sinonasal mucosa consists of mucus, motile cilia, and respiratory epithelial cells linked by adhesion complexes that include tight junctions. On the other hand, the functional barrier in sinonasal mucosa is dynamic and more complex, being equipped with innate and acquired immune response among resident cells on the epithelia and immunocompetent cells in sinonasal submucosa. Importantly, various types of nasal defensive proteins in human nasal mucosa are responsible for exerting those defensive mechanisms. Those proteins are essential for a defense system against various invading pathogens such as bacteria and viruses and modulate allergic or infective chronic inflammations as well. Those proteins derived from epithelial cells or recruited inflammatory cells are also one of the important key players in the pathogenesis of rhinosinusitis and allergic rhinitis at the epithelial linings of nasal cavity and paranasal sinuses. Those defensive proteins could be classified from constitutional and functional aspects such as surfactants, mucins, antimicrobial peptides, and inflammatory cell-derived enzymes. More widely considered, chemokines, cytokines, and various antibodies can be dealt with as defensive proteins, to provoke cellular interactions against microbial infections or pathogenesis of sinonasal persistent inflammations. In this chapter, the general concept of various types of nasal defensive proteins and its function is introduced, as we focus on surfactants, mucins, and antimicrobial peptides.

Background Chronic jet lag (CJL)-induced circadian rhythm disruption (CRD) is positively correlated with an increased risk of allergic diseases. However, little is known about the mechanism involved in allergic rhinitis (AR). Methods Aberrant light/dark cycles-induced CRD mice were randomly divided into negative control (NC) group, AR group, CRD+NC group, and CRD+AR group (n = 8/group). After ovalbumin (OVA) challenge, nasal symptom scores were recorded. The expression of Occludin and ZO-1 in both nasal mucosa and lung tissues was detected by reverse transcription-quantitative polymerase chain reaction (RT-PCR) and immunohistochemical staining. The level of OVA-specific immunoglobulin E (sIgE) and T-helper (Th)-related cytokines in the plasma was measured by enzyme-linked immunosorbent assay (ELISA), and the proportion of Th1, Th2, Th17, and regulatory T cell (Treg) in splenocytes was evaluated by flow cytometry. Results The nasal symptom score in the CRD+AR group was significantly higher than those in the AR group with respect to eosinophil infiltration, mast cell degranulation, and goblet cell hyperplasia. The expression of ZO-1 and Occludin in the nasal mucosa and lung tissues in the CRD+AR group were significantly lower than those in the AR group. Furthermore, Th2 and Th17 cell counts from splenocytes and OVA-sIgE, interleukin 4 (IL-4), IL-6, IL-13, and IL-17A levels in plasma were significantly increased in the CRD+AR group than in the AR group, whereas Th1 and Treg cell count and interferon γ (IFN-γ) level were significantly decreased in the CRD+AR group. Conclusion CRD experimentally mimicked CJL in human activities, could exacerbate local and systemic allergic reactions in AR mice, partially through decreasing Occludin and ZO-1 level in the respiratory mucosa and increasing Th2-like immune response in splenocytes.

Background: Microbial infection or exposure to endotoxin later in life exacerbates established asthma. Mast cells are involved in the exacerbation of asthma. This exacerbation involves a toll-like receptor (TLR)–mediated response of mast cells. In the clinical practice of otolaryngology, otolaryngologists experience an exacerbation of nasal congestion when infectious rhinitis develops in patients with allergic rhinitis, but the mechanisms are unknown. Therefore, this study investigated the effect of lipopolysaccharide (LPS) on allergic rhinitis using a mouse allergic rhinitis model. Methods: Female BALB/c mice, TLR4 gene mutant C3H/HeJ mice or mast cell–deficient WBB6F1-W/Wv mice were sensitized intraperitoneally with ovalbumin (OVA)/alum, and were intranasal challenged with OVA and/or LPS. Nasal symptoms and histologic changes were examined. Cytokines in nasal tissue were examined by Western blot. The effects of LPS on degranulation and cytokine production of bone marrow–derived mast cells (BMMCs) were investigated. Results: Nasal administration of LPS together with the antigen exacerbated nasal symptoms, eosinophil infiltration of the nasal mucosa, and increased IL-5 production in the nasal mucosa. It was not observed in C3H/HeJ mice and WBB6F1-W/Wv mice. The addition of LPS increased the production of IL-5 from BMMCs in a dose-dependent manner, but no effect on degranulation was observed. Conclusions: Intranasal administration of LPS exacerbates allergic rhinitis through Th2 cytokine production from mast cells. This observation provides clues to the mechanism of exacerbation of allergic rhinitis caused by an infection in daily clinical practice.

A male term infant presents with skin erosions at delivery. ### Prenatal and Birth Histories ### Presentation Soon after delivery, the infant was noted to have large areas of superficially eroded skin with central granulation tissue and desquamation of borders at the head, nape of the neck, back of the ear (Fig 1), calf, and buttocks (Fig 2). The Nikolsky sign was absent, and no vesicles were noted. Because of these skin findings, the infant was admitted to the NICU for further evaluation and management. Figure 1. Erosion over the back of the neck and ear, with a part of the erosion visible at the top of the head. Figure 2. Erosion over the sacrum and buttocks of the patient. With a history of prolonged rupture of membranes, unknown maternal GBS status, and prior maternal HSV infection, a blood specimen was collected for aerobic bacterial cultures and HSV polymerase chain reaction (PCR). Empiric treatment with ampicillin, gentamicin, and acyclovir was initiated. Swabs of the skin erosions, conjunctiva, nasal mucosa, and rectum were obtained for HSV-PCR. Because of the skin sloughing, a lumbar puncture was not performed. An umbilical venous catheter was placed for maintenance fluid administration. ### Vital Signs

Introduction: Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, mediated by immunoglobulin E, affecting 1 in 6 individuals. The treatment aims at attaining symptomatic control with minimal side effects, a requirement for new alternative therapies, including phototherapy, as it has an immunosuppressive and immunomodulatory effect. Objective: To identify the effectiveness of phototherapy in the treatment of allergic rhinitis through a meta-analysis. Methods: We searched Web of Science, Scielo, PubMed, SCOPUS, PEDro, and LILACS databases, using the terms: ‘‘intranasal irradiation’’, ‘‘phototherapy’’ and ‘‘allergic rhinitis’’. The R software Metafor package was used for the meta-analysis and the effect size was calculated for each symptom individually. Results: All symptoms decreased considerably after phototherapy: rhinorrhea (ES• = -1.35; p < 0.0001; I2 = 91.84%), sneezing (ES• = -1.24; p < 0.0001; I2 = 91.43%), nasal pruritus (ES• = -1.10; p < 0.0001; I2 = 91.43%); nasal obstruction (ES• = -1.11; p < 0.0001; I2 = 91.88%). The effects were more significant in perennial allergic rhinitis than in the seasonal type. Conclusion: Considering the effect size and the statistical significance attained in our study, rhinophototherapy showed to be an effective treatment for reducing the nasal symptom scores triggered by AR. Resumo Introdução: A rinite alérgica é uma doença inflamatória crônica da mucosa nasal, imunomediada por imunoglobulina E, que afeta 1/6 dos indivíduos. O tratamento visa o controle dos sintomas com efeitos colaterais mínimos, uma prerrogativa para novas terapias alternativas, como a fototerapia, por apresentar efeitos imunossupressor e imunomodulador. Objetivo: Identificar, mediante uma metanálise, a eficácia da fototerapia no tratamento da rinite alérgica. Método: Usamos as bases de dados: Web of Science, Scielo, PubMed, SCOPUS, PEDro e LILACS, com os termos de busca: intranasal irradiation, phototherapy, allergic rhinitis. Para a metanálise foi usado o pacote metafor do software R, o tamanho do efeito foi calculado para cada sintoma separadamente. Resultados: Todos os sintomas apresentaram diminuição significante após a fototerapia: coriza (ES =-1,35; p < 0,0001; I2 = 91,84%), espirros (ES =-1,24; p < 0,0001; I2 = 91,43%), prurido nasal (ES =-1,10; p < 0,0001; I2 = 91,43%); obstrução nasal (ES =-1,11; p < 0,0001; I2 = 91,88%), com efeitos mais expressivos na rinite alérgica perene do que na rinite alérgica sazonal. Conclusão: Considerando-se a magnitude do efeito e a significância estatística alcançadas em nosso estudo, a rinofototerapia demonstrou-se um tratamento eficaz para a redução dos escores dos sintomas nasais desencadeados pela rinite alérgica.

Graphical abstract, Unlike conventional Coronavirus 2019 (COVID-19) vaccines, intranasal vaccines display a superior advantage because the nasal mucosa is often the initial site of infection. Preclinical and clinical studies concerning intranasal immunization elicit high neutralizing antibody generation and mucosal IgA and T cell responses that avoid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in both; the upper and lower respiratory tract. A nasal formulation is non-invasive with high appeal to patients. Intranasal vaccines enable self-administration and can be designed to survive at ambient temperatures, thereby simplifying logistical aspects of transport and storage. In this review, we provide an overview of nasal vaccines with a focus on formulation development as well as ongoing preclinical and clinical studies for SARS-CoV-2 intranasal vaccine products.

The nasal drug application has drawn much attention as the strategy for the delivery route of many drug modalities such as the poorly absorbed drugs, peptides, nucleic acid, and central nervous system drugs. The absorption of drug after intranasal (IN) application depends on the nasal residence time of applied drug, affected by mucociliary clearance (MC). MC is a decisive factor in the nasal absorption of drug. We describe the establishment of in vitro evaluation system of nasal MC via the moving velocity of a marker particle on nasal mucosa, and the development of the pharmacokinetic model to which in vitro parameters on nasal MC was incorporated to enable the prediction of drug absorption after IN application. Moreover, the pharmacokinetics of norfloxacin after IN application was investigated using MC-modified rats pretreated with MC modulators. Nasal absorption fluctuated due to changes in the nasal residence time of drug in response to changes in MC. The prediction system enables quantitative evaluation of changes in drug absorption associated with MC fluctuations. In addition, for a precise prediction system for drug absorption after IN application from the drug absorption model, the relationships between in vitro drug permeability through Calu-3 layers, in vivo transnasal permeation of drug and in vivo bioavailability after IN application were evaluated. The significant correlations between these parameters were obtained, suggesting that transnasal permeability and drug absorption after IN application can be predicted from in vitro membrane permeability.

Nasal septal perforation (NSP) is a common complication of nasal surgery and can cause nasal obstruction, crust, and epistaxis. Many surgical methods have been introduced for repair of NSP, among which mucosal flap and artificial dermis have been widely used. However, mucosal graft can shrink and migrate and is difficult to fix at the perforation site. Mucosal advancement flap requires a wide extent of septal mucosa dissection, and artificial dermis can cause nasal obstruction because of its bulkiness and lower biocompatibility than autologous mucosa. To overcome these problems, we reported successful outcomes in 4 cases of small NSP by free mucosal graft with bioscaffold.

During this COVID-19 pandemic, except steroid, none of the therapeutic measures have showed any evidence of efficacy. Traditionally jala-neti using lukewarm salted water remains a yogic way of maintaining upper airway hygiene. Saline irrigation decreases the concentration of inflammatory mediators (e.g. histamine, leukotriene etc.) in nasal secretions, reduces the severity and frequency of sinusitis, reduce need of antibiotic therapy and restores competency of nasal mucosa. Jala-neti is an integral part of six cleansing techniques of yogic kriyas practised in India since thousands of years. Jala-neti can clean the upper airways, prevents colonization of infectious agents, removes foreign bodies, prevents stasis of mucous and subsequently enhances the drainage of paranasal sinuses and maintain health. Regular practice of Jala neti improves nasal symptoms and overall health status of patients with sinusitis. Jala-neti sample can even be used for COVID-19 diagnosis. Povidone iodine (PVP-I) has been utilized as a time tested antimicrobial agent with broad spectrum coverage against wide range of bacteria and viruses. Anti-SARS-CoV-2 action of PVP-I was seen at a concentration as low as 0.45%. PVP-I is generally well tolerated upto 5%, however nasal ciliotoxicity is reported at this concentration, however, this toxicity is not reported with lower concentrations(1.25% and 0.5%). So, theoretically, by using neti-kriya with povidone iodine (0.5–1%) as irrigation solution can combine and enhance the protection against COVID-19 and this can be an important armor in the fight against COVID-19. However, this hypothesis needs to be validated in real life clinical trial scenario before implementing.

Background- Vataja Pratishyaya is a Nasagataroga and one among five types of Pratishyaya. It is most common and annoying nasal problem which affect the people of all age group. Vataja Pratishaya is a disease which possesses symptoms like Nasagata Tanusrava, Kshavathu and Nasaavarodha. These symptoms are also found in allergic rhinitis which is induced by an IgE mediated inflammation of the nasal mucosa. While treating the Pratishyaya, special attention should be given to the stages of the disease because the treatment approach of Amavastha, Pakwavastha and Dushta stages are entirely different. Nasya is the most important Shodhana method in Urdhwgatrugata Vyadhies and can execute Uttamanga Shuddhi, Snehana, and Swedana. The continuous sneezing is a main disturbing symptom of allergic rhinitis. Shunthyadi Taila was selected for this purpose which is given in Kshavathu Adhikara for managing the allergic conditions of the nose. Method – The patient with Vataja Pratishyaya was given two courses of Shunthyadi Taila Nasya, each course consisting of one sitting per day for 7 days. Six drops of Shunthyadi Taila were poured into each nostril during each session. Result- Patients clinical status was assessed on 7th, 15th, 21st and 28th day. Remission of symptoms like sneezing, rhinorrhoea, itching, nasal congestion etc. was observed after 2 courses of treatment. Patient was followed up for 1 month and no recurrences of symptoms were observed. Key words: Vataja Pratishyaya, allergic rhinitis, Shunthyadi Taila.

Background: Angiotensin-converting enzyme 2 (ACE2), a receptor targeted by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly expressed in the nasal mucosa. Chronic rhinosinusitis (CRS) shows diverse endotypes and is aggravated by viral infection. Whether viral stimulation and CRS endotype influence ACE2 expression remains unclear. We investigated the expression of ACE2 and the transmembrane protease, serine 2 (TMPRSS2), which mediate the entry of SARS-CoV-2 into cells, and assessed polyinosinic:polycytidylic acid (poly[I:C])-induced changes based on CRS endotype. Methodology: ACE2 and TMPRSS2 expression was evaluated based on CRS phenotype, endotype, and tissue type. Correlations between ACE2/TMPRSS2 expression and inflammatory mediators in nasal polyps (NP) were examined. Air-liquid interface culture experiments were performed to assess the effects of major cytokines or poly(I:C) stimulation on ACE2/TMPRSS2 expression in primary epithelial cells from healthy nasal mucosa, eosinophilic NP (ENP), and non-eosinophilic NP (NENP). Results: In primary nasal epithelial cells, interleukin (IL)-13 decreased ACE2 expression but increased TMPRSS2. Eosinophilic CRS showed lower ACE2 expression than non-eosinophilic CRS, regardless of CRS phenotype. CRS endotype was an independent factor associated with ACE2/TMPRSS2 expression in NP. Serum and tissue eosinophilic marker levels were inversely correlated with ACE2 expression, whereas tissue neutrophilic marker levels and ACE2 expression were positively correlated in NP. ACE2 expression was suppressed in ENP tissues; however, a combination of poly(I:C) and IL-13 induced ACE2/TMPRSS2 upregulation in ENP. Conclusions: ENP tissues have lower ACE2 expression than NENP; however, viral stimulation promotes ACE2/TMPRSS2 upregulation in ENP.

Allergic Rhinitis is one of the most common disease causing much debility and loss of efficiency of an individual. Allergic rhinitis can occur continuously or intermittently throughout the year by an allergen to which the individual is more or less always exposed, characterized by sudden attack of sneezing, swelling of nasal mucosa, profuse watery discharge, itching of eyes and lachrymation. This study is to know the effectiveness of Homoeopathic medicines in the treatment of Allergic Rhinitis.

Recently, depleted tissue zinc levels were found in nasal mucosa from patients with chronic rhinosinusitis (CRS) in correlation with tissue eosinophilia, however, no clinical biomarkers for tissue zinc levels have been identified. Metallothionein-3 (MT3) is an intracellular zinc chelator and previous data showed MT3 mRNA levels to be reduced in CRS patients with nasal polyps (CRSwNP). In this study, we examined the correlation between MT3 expression and zinc levels in nasal mucosa and primary human nasal epithelial cells (HNECs) to investigate whether MT3 could be a clinical biomarker for tissue zinc levels.Tissue was harvested from 36 patients and mounted on tissue micro-array (TMA) slides. MT3 expression and tissue zinc fluorescence intensity were measured at different areas within the mucosa (surface epithelium and lamina propria) and compared between controls, CRSwNP and CRS without nasal polyps (CRSsNP) patients. MT3 mRNA and protein expression were examined in zinc-depleted HNECs by qPCR and immunofluorescence microscopy.MT3 expression in CRSwNP was significantly decreased in both surface epithelium (p0.001 to controls) and lamina propria (p = 0.0491 to controls). There was a significant positive correlation between tissue zinc levels and MT3 expression in nasal mucosa (r = 0.45, p = 0.007). In zinc-deplete HNECs, MT3 expression was significantly decreased at mRNA (p = 0.02) and protein level (p0.01). There was a significant positive correlation between tissue zinc levels and MT3 expression within individual HNECs (r = 0.59, p0.001).MT3 expression reflects intramucosal zinc levels in both nasal mucosa and HNECs indicating MT3 could be used as a clinical biomarker for monitoring intracellular zinc levels in the nasal mucosa.

Topicality: Chronic rhinosinusitis is an polyetiological disease with shch basic complaints as nasal obstruction, nasal discharge, headache or facial pain and reduction of smell. The SNOT-22 questionnaire is widely used to detail patient complaints in various fields. Chronic rhinosinusitis is most often divided into chronic rhinosinusitis with polyps and without nasal polyps. Given the large number of phenotypes and endotypes of the disease, it is important to study further the mechanisms of pathogenesis and selec- tion of individualized treatment. Aim: to determine the role of topical application of Streptococcus salivarius 24SMBc and Streptococcus orals 89a in the form of nasal spray in improving the condition of the nasal mucosa in chronic rhinosinusitis and reducing the recurrence rate. Materials and methods: The study was conducted at the Department of Otolaryngology of National Medical University on the basis of KNP "Oleksandrivs’ka Clinical Hospital of Kyiv". It was attended by 82 patients (38 women and 44 men) aged 18 to 60 years, who were randomly divided into two groups. The 1st group (main, 43 patients) received treatment: irrigation therapy with isotonic saline, topical corticosteroid mometasone furoate in combination with a nasal spray, which contains autochthonous saprophytes (AC) – Streptococcus salivarius 89SMBc and Streptococcus orals 89a nasal mucus. The 2nd group (control, 39 patients) received nasal saline irrigation therapy, topical corticosteroid mometasone furoate in combination with topical antibiotic framicetin sulfate. Assessment was performed according to the VAS scale, SNOT-22 questionnaire (before treatment, on the 10th day of treatment and one month after the end of therapy) and determining the frequency of relapses in patients of both groups. Results: According to the obtained results, the indicators of patients of both groups before treatment and on the 10th day had no statistically significant difference (p>0.05). However a month later patients in the main group had better results (p

Introduction. The main place of pathogens accumulation and growth in childhood is the lymphoid tissue of the nasopharynx. Often, the development of rhinosinusitis begins with the adenoiditis. The most vulnerable in this situation are the children of preschool age with hyperplasia of the pharyngeal lymphoid ring. In this group, recurrent diseases of the upper respiratory tract are observed. Objective: optimization of the program for therapy of acute rhinosinusitis in children with pharyngeal lymphoid ring hyperplasia. Materials and methods. We observed 100 patients aged 2 to 6 years randomly divided into 2 groups of 50 children each. Regimen of 0.05% xylometazoline solution application: one injection into each nostril twice a day. Sodium chloride 0.9% was used in the form of nasal irrigation in the first group of children twice a day before xylometazoline administration. Clinical method consisted of the evaluation of anamnesis, clinical pattern, general clinical research methods. We took a smear for cytomorphological analysis of the nasal mucosa; performed staining with Giemsa’s diluted solution followed by microscopy, quantitative determination of the secretory IgA (sIgA) in saliva by enzyme immunoassay. The results were processed by the Mann-Whitney test, Fisher’s exact test. Results. Application of 0.05% xylometazoline in combination with a nasal irrigation by NaCl 0.9% has a statistically significant regenerating and sanation effect on the nasal mucosa. Use in xylometazoline with nasal irrigation by sodium chloride 0.9%, in contrast to xylometazoline administration without preparation of the nasal cavity, is not associated with a reduction of sIgA level in saliva, but leads to some increase of it. Conclusion. The use of 0.05% xylometazoline solution with nasal irrigation by sodium chloride 0.9% in the therapeutic regimen for acute rhinosinusitis in children with hyperplasia of the pharyngeal lymphoid ring has significant advantages over the xylometazoline administration without preparation of the nasal cavity., Актуальность. Основным местом скопления и роста возбудителей в детском возрасте является лимфоидная ткань носоглотки. Часто развитие риносинусита начинается с аденоидита. Наиболее уязвимыми в этой ситуации оказываются дети дошкольного возраста с гиперплазией лимфоглоточного кольца. В этой группе отмечается рекуррентное течение заболеваний верхних отделов респираторного тракта. Цель исследования: оптимизация программы терапии острых риносинуситов у детей с гиперплазией лимфоглоточного кольца. Материалы и методы. Под наблюдением находилось 100 пациентов в возрасте от 2 до 6 лет, случайно распределенных в 2 группы по 50 детей в каждой. Режим применения 0,05% раствора ксилометазолина: по одному впрыскиванию в каждый носовой ход два раза в сутки. Натрия хлорид 0,9% применялся в виде носового душа у детей первой группы два раза в сутки перед использованием ксилометазолина. Клинический метод состоял из оценки данных анамнеза, клинической картины, общеклинических методов исследования. Брался мазок для цитоморфологического анализа слизистой оболочки носа; проводилось окрашивание препаратов разведенным раствором Гимзы с последующей микроскопией, количественное определение секреторного IgA (sIgA) в слюне методом иммуноферментного анализа. Результаты обрабатывались посредством критерия Манна — Уитни, критерия Фишера. Результаты. Применение 0,05% ксилометазолина в сочетании с носовым душем NaCl 0,9% оказывало статистически значимое регенерирующее и санирующее действие на слизистую оболочку носа. Использование ксилометазолина с предварительным носовым душем натрия хлоридом 0,9% в отличие от применения ксилометазолина без подготовки полости носа не сопровождается снижением уровня sIgA в слюне, а приводит к его некоторому повышению. Заключение. Использование 0,05% раствора ксилометазолина с предварительным носовым душем раствором натрия хлорида 0,9% в программе терапии острых риносинуситов у детей с гиперплазией лимфоглоточного кольца имеет существенные преимущества перед применением ксилометазолина без предварительной подготовки полости носа., Актуальність. Основним місцем скупчення і зростання збудників у дитячому віці є лімфоїдна тканина носоглотки. Часто розвиток риносинуситу починається з аденоїдиту. Найбільш уразливими в цій ситуації є діти дошкільного віку iз гіперплазією лiмфоглоткового кільця. У цій групi відзначається рекурентний перебіг захворювань верхніх відділів респіраторного тракту. Мета дослідження: оптимізація програми терапії гострих риносинуситiв у дітей iз гіперплазією лімфоглоткового кільця. Матеріали і методи. Під спостереженням перебувало 100 пацієнтів віком від 2 до 6 років, випадково розподілених у 2 групи по 50 дітей у кожній. Режим застосування 0,05% розчину ксилометазоліну: по одному впорскуванню в кожну ніздрю два рази на добу. Натрію хлорид 0,9% застосовувався як носовий душ у дітей першої групи два рази на добу перед використанням ксилометазоліну. Клінічний метод складався з оцінки даних анамнезу, клінічної картини, загальноклінічних методів дослідження. Брався мазок для цитоморфологічного аналізу слизової оболонки носа; проводилося фарбування препаратів розведеним розчином Гімзи iз подальшою мікроскопією, кількісне визначення секреторного IgA (sIgA) у слині методом імуноферментного аналізу. Результати оброблялися за допомогою критерію Манна — Уїтні, критерію Фішера. Результати. Застосування 0,05% ксилометазоліну в поєднанні з носовим душем NaCl 0,9% мало статистично значущу регенеруючу і сануючу дію на слизову оболонку носа. Використання 0,05% розчину ксилометазоліну iз попереднім носовим душем натрію хлоридом 0,9% на відміну від застосування ксилометазоліну без підготовки порожнини носа не супроводжується зниженням рівня sIgA в слині, а призводить до його деякого підвищення. Висновки. Використання 0,05% розчину ксилометазоліну iз попереднім носовим душем розчином натрію хлориду 0,9% у програмі терапії гострих риносинуситів у дітей iз гіперплазією лімфоглоткового кільця має істотні переваги перед застосуванням ксилометазоліну без попередньої підготовки порожнини носа.

The article presents current data on acute rhinosinusitis, its essence, classification, etiology, pathogenesis, treatment approaches in children. It is emphasized that the key to successful treatment of this disease is the impact on all parts of pathogenesis. Given the leading etiopathogenetic links of acute rhinosinusitis, its comprehensive treatment requires prescribing of preparations with anti-infection, anti-inflammatory, secretolytic and immune-stimulating action, as well as nasal decongestants — to eliminate the swelling of the nasal mucosa and to improve the quality of life of the patient. The detailed description of nasal decongestants is presented, the attention is paid to the next generation drug without preservatives — dosed nasal drops Nasivin® Sensitive.

Acute infectious rhinosinusitis is the most common clinical form of respiratory pathology in childhood. Despite the fact that in 90 % of cases the main etiological factor leading to the development of rhinosinusitis is viral infection, 13 % of them are complicated by bacterial inflammation. Acute respiratory di­seases with manifestations of rhinosinusitis constantly recurring in the child can lead to the formation of allergic, non-allergic rhinitis and chronic rhinosinusitis — multifactorial chronic inflammatory diseases of the upper respiratory tract. The pathogenesis of acute infectious rhinosinusitis, in spite of the abundance of data, has been underinvestigated. The article highlights the problem of acute infectious rhinosinusitis treatment in children from the standpoint of modern ideas about the development of inflammatory process in the nasal mucosa, the role of innate immunity, and the functioning of mucociliary clearance. Data on the clinical manifestations of acute infectious rhinosinusitis are presented, clinical and diagnostic criteria for its detection are given. The mechanisms of action of nasal decongestants are described, as well as the features of their use, the immunological and anti-inflammatory effects of these drugs. Attention is focused on the mechanisms of action of oxymetazoline. Recommendations for the use of oxymetazoline in pediatric practice are given.

Background. Currently, there is a tendency to a chronicity of acute respiratory infections, which requires the development of medications to prevent its development. The purpose of the work was to study the clinical and immunological efficacy of the extract of ivy leaves in the treatment of acute simple bronchitis in children. Materials and methods. We have examined 40 children aged 2 to 6 years with acute simple bronchitis, 14 patients received Pectolvan Hedera. During the work, clinical and laboratory methods of investigation were used. The severity of the patient’s condition was assessed according to the Bronchitis severity score. The laboratory study included: general blood and urine test, the use of nasocytological, immunoassay methods. The etiological diagnosis was established on the basis of virological methods of investigation. When determining lactoferrin concentration, Human Lactoferrin HK329 Edition 06-16 set manufactured by Hycult Biotech (USA) was used, neutrophilic a-defensin (1–3) content — Human HNP HK317 Edition 08-16 reagents manufactured by Hycult Biotech (USA). Results. Acute bronchitis in the examined patients is caused by viral agents. In all children with acute simple bronchitis, the disease began acutely and manifested itself with catarrhal and general inflammatory syndromes. The use of Pectolvan Hedera expectorant in the therapy helped to reduce the clinical manifestations of the disease more rapidly, to prevent chronicity, was accompanied by a significant decrease in the number of leukocytes in the nasal mucosa and an increase in the lactoferrin content in the oropharyngeal secretions until the period of convalescence. Conclusions. Extract of ivy leaves is not only a symptomatic expectorant, but also a pathogenetic drug that can be considered a drug of choice in the treatment of acute simple bronchitis in children., Актуальность. В настоящее время наблюдается тенденция к пролонгированному течению острых респираторных инфекций, что требует разработки медикаментозных способов предупреждения его развития. Цель работы — изучение клинико-иммунологической эффективности экстракта листьев плюща обыкновенного при лечении острого простого бронхита у детей. Материалы и методы. Под наблюдением находились 40 детей в возрасте 2–6 лет, больных острым простым бронхитом, 14 детей получали препарат Пектолван Плющ. При проведении работы использовались клинические и лабораторные методы исследования. Тяжесть состояния больного оценивалась по шкале BSS (Bronchitis severity score). Лабораторное исследование включало в себя: общий анализ крови, мочи, назоцитологические, иммуноферментные методы. Этиологический диагноз устанавливался на основании вирусологических методов обследования. При определении концентрации лактоферрина использовался набор Нuman Lactoferrin NK 329 Edition 06-16 производства компании Hycult Biotech (США), нейтрофильных a-дефензинов (1–3) — реактивы Нuman HNP NK317 Edition 08-16 производства компании Hycult Biotech (США). Результаты. Острый бронхит у наблюдавшихся больных вызван вирусными агентами. У всех детей, больных острым простым бронхитом, заболевание начиналось остро и проявлялось катаральным и общевоспалительным синдромами. Применение в терапии отхаркивающего препарата Пектолван Плющ способствовало более быстрому уменьшению клинических проявлений заболевания, предупреждению затяжного течения, сопровождалось достоверным снижением количества лейкоцитов в слизи носовой полости и увеличением содержания лактоферрина в ротоглотковой жидкости к периоду реконвалесценции. Выводы. Экстракт листьев плюща является не только симптоматическим отхаркивающим, но и патогенетическим лекарственным средством, которое можно считать препаратом выбора при лечении острого простого бронхита у детей., Актуальність. Сьогодні спостерігається тенденція до пролонгованого перебігу гострих респіраторних інфекцій, що вимагає розробки медикаментозних способів запобігання його розвитку. Мета роботи — вивчення клініко-імунологічної ефективності екстракту листя плюща звичайного при лікуванні гострого простого бронхіту в дітей. Матеріали та методи. Під наглядом перебували 40 дітей віком 2–6 років, хворих на гострий простий бронхіт, 14 дітей отримувала препарат Пектолван Плющ. При проведенні роботи використовувалися клінічні і лабораторні методи дослідження. Тяжкість стану хворого оцінювалася за шкалою BSS (Bronchitis severity score). Лабораторне дослідження включало: загальний аналіз крові, сечі, назоцитологічні, імуноферментні методи. Етіологічний діагноз установлювався на підставі вірусологічних методів дослідження. При визначенні концентрації лактоферину використовувався набір Нuman Lactoferrin NK 329 Edition 06-16 виробництва компанії Hycult Biotech (США), нейтрофільних a-дефензинів (1–3) — реактиви Нuman HNP NK317 Edition 08-16 виробництва компанії Hycult Biotech (США). Результати. Гострий бронхіт у хворих, які спостерігалися, викликаний вірусними агентами. У всіх дітей, хворих на гострий простий бронхіт, захворювання мало гострий початок і виявлялося катаральним і загальнозапальним синдромами. Застосування в терапії відхаркувального препарату Пектолван Плющ сприяло більш швидкому зменшенню клінічних проявів захворювання, запобіганню затяжному перебігу, супроводжувалося вірогідним зниженням кількості лейкоцитів слизу носової порожнини і збільшенням вмісту лактоферину в ротоглотковій рідині до періоду реконвалесценції. Висновки. Екстракт листя плюща є не тільки симптоматичним відхаркувальним, але й патогенетичним лікарським засобом, який можна вважати препаратом вибору при лікуванні гострого простого бронхіту в дітей.

Background: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. T-helper 2 lymphocytes, neutrophils, and eosinophils play an active role during the late-phase immune response after exposure to allergen.Objective: We aimed to investigate the usefulness of inflammatory parameters of neutro-phil-to-lymphocyte ratio (NLR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to-lymphocyte ratio (ELR) as markers for distinction between intermittent and persistent allergic rhinitis.Material and Methods: This was a double-center, retrospective study. Patients were enrolled after diagnosed with AR according to the Allergic Rhinitis and Its Impact on Asthma guide-lines. Individuals with an active infection were excluded. A cohort of healthy subjects acted as a control group. NLR, ENR, and ELR were calculated using the results obtained from the patients’ complete blood count. Descriptive statistical analysis was performed for all studied variables.Results: In all, 205 AR patients and 49 healthy individuals were included. AR patients had sig-nificantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than the healthy controls (P < 0.05). A total of 160 (78%) patients with persistent AR had significantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than patients with intermittent AR (P < 0.05). Conclusion: Currently, classification of severity of AR is based on the patient’s anamnesis. It has been shown in this study that serum eosinophil levels in persistent AR patients could be used as traceable parameters in evaluating severity of the disease by looking at the propor-tions of ENR and ELR. We anticipate that in the future this issue would be supported by a larger number of studies.

The upper respiratory tract is highly exposed to airborne pathogens and serves as an important inductive site for protective antibody responses, including mucosal IgA and systemic IgG. However, it is currently unknown to what extent inhaled environmental toxins, such as a cigarette smoke, affect the ability to induce antibody-mediated immunity at this site. Using a murine model of intranasal lipopolysaccharide and ovalbumin (LPS/OVA) immunization, we show that cigarette smoke exposure compromises the induction of antigen-specific IgA in the upper airways and systemic circulation. Deficits in OVA-IgA were observed in conjunction with a reduced accumulation of OVA-specific IgA antibody-secreting cells (ASCs) in the nasal mucosa, inductive tissues (NALT, cervical lymph nodes, spleen) and the blood. Nasal OVA-IgA from smoke-exposed mice also demonstrated reduced avidity during the acute post-immunization period in association with an enhanced mutational burden in the cognate nasal Igha repertoire. Mechanistically, smoke exposure attenuated the ability of the nasal mucosa to upregulate VCAM-1 and pIgR, suggesting that cigarette smoke may inhibit both nasal ASC homing and IgA transepithelial transport. Overall, these findings demonstrate the immunosuppressive nature of tobacco smoke and illustrate the diversity of mechanisms through which this noxious stimulus can interfere with IgA-mediated immunity in the upper airways.

ObjectiveTo assess the prevalence of abnormal rhinological findings in a Sjögren's syndrome population.MethodsA cohort-matched, prospective, cross-sectional, observational study was conducted. Sixty-seven subjects (30 patients and 37 controls) were enrolled. Rhinological assessment including smell threshold was evaluated using a standardised, validated clinical test as part of a larger study.ResultsSmell thresholds were –4.4 and –5.4 in the Sjögren's syndrome and control groups, respectively (p = 0.001). Hyposmia (threshold values of less than −4.5) was demonstrated in the Sjögren's syndrome group (47 per cent). Smell was negatively correlated with age (p = 0.040). Nasal septal perforation was noted in 3 Sjögren's syndrome patients (10 per cent) and nasal mucosal dryness in 10 patients (33 per cent), but none of the control group were affected.ConclusionHyposmia in Sjögren's syndrome was demonstrated using the Smell Threshold Test. Nasal septal perforation and nasal mucosa dryness were also noted in patients with Sjögren's syndrome. A diagnosis of Sjögren's syndrome should be considered and investigated in smell deprivation and/or nasal septal perforation patients.

Objective To report the safety, tolerability, exploratory efficacy, and patient acceptability of INP104 for the acute treatment of migraine from the Phase 3 STOP 301 trial. Background Dihydroergotamine (DHE) has long been used to treat migraine, but intravenous administration is invasive, frequently associated with adverse events (AEs), and not suitable for at-home administration. INP104 is an investigational drug device that delivers DHE mesylate to the upper nasal space using a Precision Olfactory Delivery technology and was developed to overcome the shortcomings of available DHE products. Methods STOP 301 was an open-label, 24-week safety study, with a 28-week extension period. After a 28-day screening period where patients used their "best usual care" to treat migraine attacks, patients were given INP104 (1.45 mg) to self-administer nasally with self-recognized attacks. The primary objective of this study was to assess safety and tolerability, with a specific focus on nasal mucosa and olfactory function. Exploratory objectives included efficacy assessments of migraine measures and a patient acceptability questionnaire. Results A total of 360 patients entered the 24-week treatment period, with 354 patients dosing at least once. INP104-related treatment-emergent AEs were reported by 36.7% (130/354) of patients, and 6.8% (24/354) discontinued treatment due to AEs over 24 weeks. No new safety signals were observed following delivery to the upper nasal space. Pain freedom, the most bothersome symptom freedom, and pain relief at 2 h post-INP104 were self-reported by 38.0% (126/332), 52.1% (173/332), and 66.3% (167/252) of patients, respectively. A low recurrence rate at 24 and 48 h was observed (7.1% [9/126] and 14.3% [18/126], respectively). Most patients found INP104 easy to use and preferred it over their current therapy. Conclusions INP104 has the potential to deliver rapid symptom relief, without injection, that is well tolerated and suitable for outpatient use. Results suggest INP104 may be a promising treatment for patients with migraine.

To determine the range of incidental mucosal changes in a general sinonasally asymptomatic population on radiology.Medline (1996-present) and Embase (1974-present) were searched on March 14, 2020, to identify articles that reported radiological sinus mucosal findings in asymptomatic population groups. Bibliographic search of included studies was conducted to identify additional articles.The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search strategy was formulated and articles screened to extract data reporting Lund-Mackay (LM) score, presence of mucous retention cysts, and maxillary mucosal thickening. A random-effects model was used in meta-analysis.A total of 950 articles were identified, of which 33 manuscripts met the inclusion criteria. The included studies involved 16,966 sinonasally asymptomatic subjects. The mean LM score was 2.24 (95% CI, 1.61-2.87), and an LM score of ≥4 in 14.71% (95% CI, 6.86-24.82%) was present across all general asymptomatic population groups. Mucous retention cysts were noted in 13% (95% CI, 8.33-18.55%) and maxillary mucosal thickening of ≥2 mm in 17.73% (95% CI, 8.67-29.08%).The prevalence of incidental mucosal changes in a general asymptomatic population on radiology needs to be considered when making a diagnosis of chronic rhinosinusitis.

Syo-seiryu-to (SST) is a traditional herbal medicine that has been used clinically to treat allergic rhinitis (AR) in Japan. SST improves acute symptoms, such as sneezing and rhinorrhea, as well as chronic symptoms, such as nasal obstruction, in patients with AR. However, its therapeutic mechanisms remain unknown. We examined the effects of SST and eight constituent crude drugs on phorbol 12-myristate-13-acetate (PMA)-induced gene up-regulation of IL-33 and histamine H1 receptor (H1R), which are responsible for the pathogenesis of AR. We found that SST and its crude drugs, except for Pinellia tuber, significantly and dose-dependently suppressed PMA-induced both IL-33 and H1R mRNA up-regulation in vitro. The half-maximal inhibitory concentration values of the seven crude drugs to inhibit PMA-induced IL-33 mRNA up-regulation were correlated with those related to H1R mRNA up-regulation, suggesting that they act on a common signal molecule. These results suggest that SST improves nasal congestion that is induced by IL-33-related eosinophil infiltration and inhibits sneezing and rhinorrhea that are induced by H1R-mediated histamine signaling in the nasal mucosa of AR patients through its inhibition of a common molecule in the gene expression pathways of IL-33 and H1R. The results could explain the advantages of traditional herbal medicine, in which mixing various crude drugs not only acts on a common target to enhance its pharmacological action, similar to the effect of a high concentration of a single crude extract but also has the benefit of reducing the side effects of each crude drug.

Previous studies focusing on the age disparity in COVID-19 severity have suggested that younger individuals mount a more robust innate immune response in the nasal mucosa after infection with SARS-CoV-2. However, it is unclear if this reflects increased immune activation or increased immune residence in the nasal mucosa. We hypothesized that immune residency in the nasal mucosa of healthy individuals may differ across the age range. We applied single-cell RNA-sequencing and measured the cellular composition and transcriptional profile of the nasal mucosa in 35 SARS-CoV-2 negative children and adults, ranging in age from 4 months to 65 years. We analyzed in total of ~ 30,000 immune and epithelial cells and found that age and immune cell proportion in the nasal mucosa are inversely correlated, with little evidence for structural changes in the transcriptional state of a given cell type across the age range. Orthogonal validation by epigenome sequencing indicate that it is especially cells of the innate immune system that underlie the age-association. Additionally, we characterize the predominate immune cell type in the nasal mucosa: a resident T cell like population with potent antiviral properties. These results demonstrate fundamental changes in the immune cell makeup of the uninfected nasal mucosa over the lifespan. The resource we generate here is an asset for future studies focusing on respiratory infection and immunization strategies.

This study was conducted to explore the roles and related mechanisms of lncRNA-TCONS_00147848 (TCONS_00147848) in nasal mucosa cell apoptosis and allergic rhinitis (AR). AR mice were sensitized with ovalbumin (OVA), with the TCONS_00147848 interference lentiviral vector (TCONS_00147848 shRNA) and FOSL2 overexpressing lentiviral vectors (pCDH-FOSL2) constructed respectively. NC shRNA, TCONS_00147848 shRNA and TCONS_00147848 shRNA + pCDH-FOSL2 were transfected into AR mice and mice with TNF-α induced nasal mucosa cells. The allergic reaction symptoms were evaluated by scoring. And in this study, we used Hematoxylin–Eosin (HE) staining and Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) to detect the histological changes of nasal mucosa and apoptosis of nasal mucosa epithelial cells in mice, cell counting kit-8 (CCK-8) assay, Transwell and annexin V/PI to detect proliferation, migration and apoptosis of nasal mucosa cells of mice, respectively, enzyme-linked immunosorbent assay (ELISA) to detect the expression of inflammatory factors, qRT-PCR to detect TCONS_00147848 expression, Western blot assay to detect the expressions of FOSL2, JAK-2, STAT3, p-STAT3, BAX and BCL-2, RNA-binding protein immunoprecipitation (RIP) assay, RNA pull down assay and Co-immunoprecipitation (CoIP) assay to identify TCONS_00147848 targeting FOSL2. All these findings above reveal that knocking down TCONS_00147848 can reduce the allergic reaction symptom score of AR mice and the inflammatory reaction. The expression of IgE, IL-4, IL-5, IL-10, IL-9, IFN-γ and TNF-α in serum decreased. The expression of FOSL2, JAK-2, p-STAT3 and BAX in nasal mucosa and nasal mucosa cells of mice decreased as well, but BCL-2 expression increased. In addition, koncking down TCONS_00147848 can also inhibit the apoptosis of TNF-α induced nasal mucosa cells in mice and promote cell proliferation and migration. However, FOSL2 overexpression neutralized the effect of TCONS_00147848 shRNA. In nasal mucosa cells of mice, TCONS_00147848 can target FOSL2, interacting with STAT3. Inhibition of TCONS_00147848 can regulate JAK/STAT3 signaling pathway and reduce inflammatory response in AR mice.

Background: Nasal polyps is a soft masses filled with fluid in nasal mucosa. The incidence is not high, but nasal polyps are related with inflammatory process. Factors that can affect nasal polyps are eosinophils, polyp size, age and gender of the patient. Objective: This study aims to discuss the association between eosinophils with polyp size, age and gender of polyp patient. Methods: The type of this study was an analytic using a cross sectional approach. This research took place from February- October 2020 in the Pathology Anatomy Diagnostic Central of Faculty of Medicine, Andalas University with 19 total sample and this study used total sampling technique. Results: The results based on bivariate analysis of Chi-Square test between amount of eosinophils with polyp size, age and gender of polyps patients have p values (p = 0, 036), (p = 0.264), (p = 1, 00). Conclusion: There is a significant relationship between eosinophils and polyp size. There is no significant relationship between eosinophils with age and gender of patients with nasal polyps in the Pathology Anatomy Diagnostic Central of Faculty of Medicine, Andalas University in 2017- 2019.

Patients with chronic rhinitis causing intractable sneezing which is non-responsive to conventional medication require alternative therapies. The aim of the study was to ascertain the effect of topical 10% silver nitrate solution on the inferior turbinate mucosa as well as quality of life in such patients. Patients with severe chronic rhinitis who failed conventional therapy had application of 10% silver nitrate solution to inferior turbinate mucosa. The number of sneezes/day and mini Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score was noted before and 8 to 16 weeks after treatment. Pre- and post treatment turbinate biopsies were performed to assess histological changes. At baseline, 67 patients had a mean of 36.6 sneezes/day and mean mini RQLQ score of 4.0 ± 0.7. Pre-treatment biopsies showed epithelial denudation and hyalinization of basement membrane. Following 10% silver nitrate application, 64/67 (95.5%) patients showed significant reduction in number of sneezes both at 1 week (p

Given that COVID-19 is a global public health problem and that almost all countries in the world have been severely affected by the COVID-19 pandemic, research is being actively pursued to better understand the effects of the virus on human cells. However, it is not clear what changes are observed in the cells of the main gate of infection – the mucosa of the mouth and the nose at different clinical forms and at different periods of disease. Understanding the ultra-structural cell changes of SARS-CoV-2 targets may help clarify the pathogenic aspects of infection in the lower respiratory tract. In this study, the elements of the life cycle of SARS-CoV-2 virus in the cells of the respiratory epithelium of the nose in patients with COVID-19 were evaluated using electron microscopy for the purpose of detecting the peculiarities of viral activity depending on the form and period of disease. Bioptats of the nasal mucous membrane were taken from COVID-19 patients and subsequently examined by electron microscopy. The severity of structural changes in tissue samples, presence of SARSCoV-2 virus in cells were determined, then bioptats were grouped according to the clinical form of the infection process (inapparent, acute upper respiratory tract infections, viral lung disease) and period of disease. It has been established that the most characteristic changes in the mucous membrane of the nose were observed in the first week of infection caused by SARS-CoV-2 and occurring in the form of acute respiratory disease, while viral lung infections have had the highest virus density in vesicles within cells, the formation of smooth virus-free vesicles is most common in inapparent forms. The data obtained may indicate that the formation of classical virus-induced changes in the respiratory epithelium of the nose mucous (vesicles with viral particles and signs of their release from the cell) is characteristic of localized forms of infection caused by SARS-CoV-2 (respiratory infection of the upper respiratory tract) and in cases of generalized infection (viral infection of the lungs and probably other organs and systems) accumulation of the infectious agent in high concentrations in vesicles.

We investigated the mechanisms underlying the therapeutic effects of Yiqi Jiemin decoction (YJD), a traditional Chinese medicine (TCM), in the ovalbumin (OVA)-induced allergic rhinitis (AR) model in guinea pigs. YJD significantly decreased infiltration of mast cells and eosinophils into the nasal mucosa of AR model guinea pigs. YJD also increased expression of TGF-β in the nasal mucosa, restored the balance of Th1/Th2 immune cell responses, and decreased serum levels of various pro-inflammatory mediators, including histamine (HA), neuropeptide Y (NPY), acetylcholine (ACH), norepinephrine and immunoglobulin E (IgE). Metabolic analyses using liquid chromatography coupled with high-resolution mass spectrometry revealed that YJD improved cellular metabolism in AR model guinea pigs and increased serum levels of glycocholic acid while decreasing levels 1-palmitoyl lysophosphatidic acid. RNA-sequencing analysis identified BPIFB2 as a potential diagnostic biomarker and therapeutic target for AR. Functional enrichment analyses showed that YJD significantly inhibited cytokine secretion pathways in AR model guinea pigs. These findings demonstrate that YJD protects against OVA-induced AR in guinea pigs by suppressing inflammation in the nasal mucosa, restoring Th1/Th2 balance, and improving cellular metabolism.

Background: Allergic rhinitis (AR) is an immunoglobulin E (IgE) mediated inflammatory chronic disorder of the nasal mucosa caused by contact to allergens which affects a significant percentage of population. Th17 cells might be involved in the acute phase of the allergic reaction. Th17 cells are regulated by IL-23, which is a member of the IL-12 cytokine family. IL-23 was suggested to be a pivotal cytokine involved in the pathogenesis of AR and may become a novel target in the treatment of AR. Objective: Here we investigate the role of serum IL-23 and its correlation with serum total IgE level in AR. Methodology: This case control study included the investigation of 48subjects. Blood samples were collected for measuring serum IL-23 and total IgE levels by ELISA. Results: positive correlation was found between IL-23 and total IgE serum level in AR patients. Conclusion: Positive correlation was found between serum IL-23 and serum total IgE levels in allergic rhinitis patients.

Introduction: Middle meatotomy is an effective surgical technique in the management of chronic sinusitis rebels to medical treatment. It is an optimal therapeutic option in the face of a chronic sinusitis particularly of rhinological origin. Patients and method: It is a descriptive retrospective study over an 11-year period from January 2009 to December 2019 at the service of Otolaryngology and Cervico-facial surgery (ORL-CCF) at the Andohatapenaka University Hospital Antananarivo Madagascar. Our study includes subjects who have benefited from an average meatotomy on chronic sinusitis. Results: We collected 320 patients of average age of 33.78 years. Repetitive maxillary sinusitis and rhinogenic allergies are the determinants of chronic sinusitis. Nasal obstruction was the constant functional sign and anterior rhinoscopy revealed a red nasal mucosa with enlarged inferior turbinate. All of our patients received an incidence X-ray of Blondeau. The average meatotomy was achieved in all our patients and among them, a proportion of 12.50% of the cases operated at the same time of a medium meatotomy and opening of other meatus. Complementary turbinal surgery was used in 25% of cases. Therapeutic efficacy was assessed subjectively by the subject’s functional signs. Favourable trends were reported in 75.30% of cases. Conclusion: Chronic sinusitis is a naso-sinus condition requiring medical-surgical management. The middle meatotomy is the first step in the surgical management of chronic rhinological sinusitis rebellious to medical means.

Atopic diseases remain one of the most common childhood diseases. At the beginning of life, atopic dermatitis (AD) occurs, and only then bronchial asthma (BA). This staged development of sensitization and transformation of clinical manifestations is called the atopic march. Are the genetic factors of predisposition to AD the same for BA? There is still no definite answer to this question. Mutations in the filaggrin gene (FLG) are known to impair skin barrier function. Filaggrin is expressed not only in the skin, but also in the respiratory organs of the nasal mucosa, lungs, and bronchi. Filaggrin defects lead not only to disruption of the skin barrier, but also to an increase in the Th2 response and increased production of IgE, typical of bronchial asthma. Therefore, mutations in the FLG gene can be a risk factor for the development of not only AD, but also BA.The aimof this study was to compare the values of the association of mutations in the FLG gene with AD and BA in the Russian sample.Material and methods.Case-control study design. We used 265 blood samples from children. 4 mutations in the filaggrin gene were identified by real-time PCR. The association of mutations with disease was assessed by odds ratio.Results.We showed a strongly pronounced association of the deletion of 4 nucleotides (2282del4) with AD, but not with BA, although for patients with atopic BA the indicator of the association of this mutation with the disease was higher than for the group with symptoms of bronchial asthma identified by the ISAAC questionnaire. These results lead to the conclusion that the role of the filaggrin gene for BA is much less significant than for AD.

Introduction Symptomatic relief of acute rhinosinusitis is commonly achieved with nasal decongestants. The current observational study investigated the efficacy and safety of treatment of acute rhinosinusitis with Ectoin® Rhinitis Spray compared to or in combination with Xylometazoline-containing decongesting nasal spray. Methods Patients with acute rhinosinusitis applied either Ectoin® Rhinitis Spray, Xylometazoline nasal spray or a combination of both products. Rhinosinusitis symptoms were assessed, and nasal oedema and endonasal redness were determined by rhinoscopy. Patient diaries based on the validated SNOT (Sino Nasal Outcome Test) questionnaire evaluated rhinosinusitis parameters over time and influences of the disease on quality of life. Following treatment, investigators and patients judged the efficacy and tolerability. Results Ectoin® Rhinitis Spray diminished common rhinosinusitis symptoms such as nasal obstruction, nasal secretion, facial pain/headache, and smell/taste impairment. Upon treatment over 7 days, rhinosinusitis sum scores decreased statistically significantly (p ® Rhinitis Spray, whereas treatment with Xylometazoline-containing nasal spray resulted in nasal mucosa dryness. Concomitant treatment with both products diminished the development of nasal dryness and required fewer applications of Xylometazoline-containing nasal spray. Conclusion Ectoin® Rhinitis Spray is an effective, natural treatment option for acute rhinosinusitis, which may be used as monotherapy or as add-on treatment with a Xylometazoline-containing nasal spray. The concomitant use of Ectoin® Rhinitis Spray might reduce the needed dose of decongestant nasal spray and counteract bothersome side effects such as dry nasal mucosa. Trial registration The current study was registered in the ClinicalTrials.gov database under the identifier: NCT03693976 (date of registration: Oct 3, 2018).

Objective To summarize the clinical diagnosis and treatment of superabsorbent polymer balls as nasal foreign bodies in children. Methods We retrospectively analysed the clinical data concerning 12 cases of superabsorbent polymer balls as nasal foreign bodies in children and summarized the corresponding clinical features, methods of diagnoses and treatment, and prognoses. Results Twelve children with superabsorbent polymer balls as foreign bodies in their nasal cavities presented with relatively severe symptoms, such as congestion, runny nose, and nasal swelling. When such foreign bodies stay in the nasal cavity for a prolonged period, patients may suffer from general discomfort, such as agitation, poor appetite and high fever. Most of the children had to undergo nasal endoscopy under general anaesthesia to have the foreign bodies completely removed. An intraoperative examination revealed significant mucosal injury within the nasal cavity. With regular follow-up visits and adequate interventions, all the patients recovered. Conclusion The longer superabsorbent polymer balls remain in the nasal cavity, the more damaged the nasal mucosa will be. It is challenging to remove such foreign bodies in the outpatient setting. Transnasal endoscopy under general anaesthesia appears to be safer and more effective in such cases. Since the nasal mucosa is injured to varying degrees, postoperative follow-up and treatment are equally important for preventing the occurrence of complications.

Inflammatory allergic reaction is the main cause of allergic rhinitis (AR). Previous studies indicated that miR-224-5p was downregulated in the nasal mucosa of patients with AR, while the function of miR-224-5p in AR remains unclear. To explore this issue, AR mouse model was established using ovalbumin (OVA). For treatment group, lentivirus (LV)-miR-224-5p or its control was intranasally administrated to AR mice. miR-224-5p expression was detected by reverse transcription-quantitative PCR, followed by assessing the immunoglobulin E (IgE) level. Pathological alterations in nasal mucosa were detected using Hematoxylin-Eosin staining and Sirius red staining, followed by assessing the levels of inflammatory cells and factors. The NLRP3 inflammasome and TLR4/MyD88/NF-κB pathway were measured by Western blot, and then the relationship between miR-224-5p and toll-like receptor 4 (TLR4) was verified. The results showed that miR-224-5p was significantly decreased in nasal mucosa of AR mice. AR mice exhibited increased sneezing and nasal rubbing events, IgE level in serum, and pathological alterations in nasal mucosa, while overexpression of miR-224-5p markedly attenuated these changes. The levels of inflammatory cells in nasal lavage fluid and pro-inflammatory factors in serum and nasal mucosa were significantly increased in AR mice, which were reduced by miR-224-5p overexpression. Of note, LV-miR-224-5p treatment remarkably suppressed the activations of NLRP3 inflammasome and the TLR4/MyD88/NF-κB pathway in AR mice. Furthermore, miR-224-5p could bind to 3'-untranslated region (3'-UTR) of TLR4 and negatively regulate TLR4 level. Overall, we conclude that miR-224-5p may relieve AR by negatively regulating TLR4/MyD88/NF-κB pathway, indicating that miR-224-5p may be a promising target for AR treatment.

Introduction Tympanoplasty techniques with different types of graft have been used to close tympanic perforations since the 19th century. Tragal cartilage and temporalis fascia are the most frequently used types of graft. They lead to similar functional and morphological results in most cases. Although little published evidence is present, nasal mucosa has also been shown to be a good alternative graft. Objective Surgical and audiological outcomes at the six-month follow-up in type I tympanoplasty using nasal mucosa and temporalis fascia grafts were analyzed. Methods A total of 40 candidates for type I tympanoplasty were randomly selected and divided into the nasal mucosa and temporalis fascia graft groups with 20 in each group. The assessed parameters included surgical success; the rate of complete closure of tympanic perforation and hearing results; the difference between post- and pre-operative mean quadritonal airway-bone gap, six months after surgery. Results Complete closure of the tympanic perforation was achieved in 17 of 20 patients in both groups. The mean quadritonal airway-bone gap closures were11.9 and 11.1 dB for the nasal mucosa and temporalis fascia groups, respectively. There was no statistically significant difference between the groups. Conclusion The nasal mucosa graft can be considered similar to the temporal fascia when considering the surgical success rate of graft acceptance and ultimate audiological gain. Resumo Introdução Técnicas de timpanoplastia com diferentes tipos de enxerto têm sido usadas para fechar perfurações timpânicas desde o século XIX. A cartilagem tragal e a fáscia temporal são os tipos de enxerto mais usados, com resultados funcionais e morfológicos semelhantes na maioria dos casos. Embora ainda com poucas evidências publicadas, a mucosa nasal tem se mostrado uma boa opção de enxerto. Objetivo Comparar os resultados cirúrgicos e audiológicos da timpanoplastia tipo I com enxerto de mucosa nasal e de fáscia temporal em seis meses de seguimento. Método Foram selecionados aleatoriamente 40 pacientes candidatos a timpanoplastia tipo I divididos nos grupos enxerto de mucosa nasal e de fáscia temporal com 20 em cada grupo. Os parâmetros avaliados incluíram sucesso cirúrgico, ou seja, a taxa de fechamento completo da perfuração timpânica, e resultados audiológicos; diferença entre o gap quadritonal médio do gap aéreo-ósseo pré e pós-operatório após seis meses da cirurgia. Resultados O fechamento completo da perfuração timpânica foi alcançado em 17 de 20 pacientes no grupo mucosa nasal, como também no grupo fáscia temporal. O ganho quadritonal médio do gap aéreo-ósseo foi de 11,9 dB no grupo mucosa nasal e 11,1 dB no grupo fáscia temporal, respectivamente. Não houve diferença estatisticamente significante entre os grupos. Conclusão O enxerto de mucosa nasal pode ser considerado semelhante ao da fáscia temporal quando se considera o sucesso cirúrgico de pega do enxerto e o ganho audiológico.

Wyciek wydzieliny z nosa (katar), upośledzenie drożności przewodów nosowych i kichanie to objawy charakteryzujące stan zapalny błony śluzowej nosa. Artykuł przedstawia charakterystykę dwóch jednostek chorobowych, dla których powyższe symptomy są wspólne: alergicznego nieżytu nosa i choroby przeziębieniowej. Szczególną uwagę zwrócono na cechy pozwalające na diagnostykę różnicową. Omówiono aktualne zasady postępowania diagnostycznego i terapeutycznego w obu powyższych jednostkach chorobowych.

Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.

Objectives. This study was conducted to determine whether patients with allergic rhinitis might be more susceptible to human rhinovirus (HRV) infection and whether the effects of infection on the elicited immune responses are different in allergic and non-allergic patients with chronic rhinosinusitis (CRS).Methods. Uncinate process tissues were obtained from 61 CRS patients (of whom 39 had allergies and 22 did not) and were infected with HRV-16 using an air-liquid interface organ culture system. The expression levels of programmed cell death-ligand (PD-L)1, PD-L2, intracellular adhesion molecule 1, interferon-gamma (IFN-γ), interleukin (IL)-4, IL-5, and IL-10 were evaluated in the infected nasal mucosa.Results. The HRV infection rates were not significantly different between the allergy (74.4%) and non-allergy (72.7%) groups. In the allergy group, the expression of PD-L1 (P=0.013) and IL-10 (P=0.040) was significantly elevated in the HRV-infected tissues, and there was a strong correlation between PD-L1 and IL-10 (r=0.868, PP=0.039), IL-5 (P=0.023), and IFN-γ (P=0.031), as well as an increased IL-4/IFN-γ ratio, after HRV infection (P=0.043).Conclusion. This study showed that HRV infection rates were similar in the nasal mucosa of patients with CRS regardless of the presence of allergic rhinitis. HRV infection enhanced the Th2 environment by modulating PD-L1 and PD-L2 expression levels in allergic mucosa and by increasing the IL-4/IFN-γ ratio in non-allergic mucosa.

Background Arginine methylation is a posttranslational modification mediated by protein arginine methyltransferases (PRMTs). Although previous studies have shown that PRMT1 contributes to the severity of allergic airway inflammation or asthma, the underlying mechanism is poorly understood. Objective This study aimed to explore the role of PRMT1 and its relevant mechanism in the development of allergic rhinitis (AR). Methods The expression levels of PRMTs and cytokines were determined by RT-PCR, and the localization of PRMT1 was determined by immunohistochemistry and confocal microscopy. The levels of house dust mite (HDM)-specific immunoglobulins in serum and of cytokines in nasal lavage fluids were determined by ELISA. PRMT1 inhibition was achieved by siRNA and treatment with the pan PRMT inhibitor arginine N-methyltransferase inhibitor-1. Results PRMT1 expression was significantly increased in the nasal mucosa of patients and mice with AR. The degree of eosinophilic infiltration in the nasal mucosa was reduced in PRMT1+/− AR mice compared with wild-type mice. PRMT1 haploinsufficiency reduced the levels of HDM-specific immunoglobulins in serum and those of TH2 (IL-4, IL-5, and IL-13) and epithelial (thymic stromal lymphopoietin [TSLP], IL-25, and IL-33) cytokines in the nasal lavage fluids of AR mice. In nasal epithelial cells, HDM and IL-4 cooperate to enhance PRMT1 expression through a mitogen-activated protein kinase–dependent pathway. In addition, PRMT1 was essential for the production of TSLP, IL-25, and IL-33 in response to HDM and IL-4. Arginine N-methyltransferase inhibitor-1 treatment alleviated AR in the mouse model. Conclusions PRMT1 plays an important role in AR development by regulating epithelial-derived cytokine production and might be a new therapeutic target for AR.

Introduction and Objectives Chronic 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 Methods The 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. Results In 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 3.4 mm during the first examination, and 4.5 mm (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: 4.8 mm and 3.6 mm (p = .02), respectively. The differences were significantly smaller in the smokers (.3) compared to non-smokers (1.3; p = .04) mm. Conclusions Records of the entering examination must be considered before turbinoplasty under local anaesthesia.