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1.
Nasal mucociliary clearance was measured in both healthy subjects and patients with chronic sinusitis using saccharin granule technique. Nasal mucociliary transit time (ST) was significantly slower in the patients with chronic sinusitis compared with that in controls (p less than 0.005). Nasal mucus collected from each nasal cavity was used for in vitro bullfrog palate clearance studies and compared to the in vivo nasal ST. Mucociliary clearance rate (MTR) on frog palate was 12.5 +/- 2.5 mm/min in the mucus from control subjects, 6.1 +/- 1.5 mm/min in the mucus from the patients. The difference was statistically significant (p less than 0.005). The MTR on frog palate in the patients whose nasal ST was within normal range was significantly slower than that in controls (p less than 0.005), but not significantly different from that in the patients whose nasal ST was over the normal range. These results suggest that the nasal mucous properties which decreased the mucociliary clearance on frog palate did not contribute to the mucociliary clearance of the patients who had a normal one. No significant correlation existed between MTR on frog palate and nasal ST in both control and chronic sinusitis. In chronic sinusitis patients, decelerated nasal ST was recovered significantly by normal saline nebulization compared with the value before the nebulization (p less than 0.01). None of the significant change of ST was observed in control before and after the nebulization.  相似文献   

2.
目的:探讨通窍鼻炎片联合克拉霉素对慢性鼻窦炎患者嗅觉功能、鼻黏液纤毛传输速度及血清炎性因子的影响。方法:于2017年11月~2020年6月期间,选取我院门诊收治的慢性鼻窦炎患者86例。根据入院序号奇偶性将患者分为对照组和观察组,各43例。对照组采用克拉霉素治疗,观察组采用通窍鼻炎片联合克拉霉素治疗,均治疗4周。对比两组疗效、临床症状评分、嗅觉功能、鼻黏液纤毛传输速度及血清炎性因子,记录两组不良反应发生情况。结果:观察组的临床总有效率高于对照组(P<0.05)。两组治疗4周后T&T主观嗅觉测试法分级均较治疗前改善,且观察组的改善效果优于对照组(P<0.05)。两组不良反应发生率对比无明显差异(P>0.05)。治疗4周后,两组鼻黏膜纤毛输送率(MTR)和鼻黏膜纤毛清除率(MCC)均较治疗前升高,且观察组高于对照组(P<0.05)。治疗4周后,两组血清白介素-5(IL-5)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均较治疗前降低,且观察组低于对照组(P<0.05)。治疗4周后,观察组鼻塞、头晕头痛、鼻漏、嗅觉下降、流涕、喷嚏症状评分低于对照组(P<0.05)。结论:通窍鼻炎片联合克拉霉素治疗慢性鼻窦炎患者疗效显著,可有效改善患者嗅觉功能及鼻黏液纤毛传输速度,缓解临床症状并降低机体炎性因子水平,且安全性较好。  相似文献   

3.
Apical membranes of human airway epithelial cells have significant chloride permeability, which is reduced in cystic fibrosis (CF), causing abnormal electrochemistry and impaired mucociliary clearance. At least four types of chloride channels have been identified in these cells, but their relative roles in total permeability and CF are unclear. Noise analysis was used to measure the conductance of chloride channels in human nasal epithelial cells. The data indicate that channels with a mean conductance of 4.5 pS carry most of the chloride current, and that the mean number of such channels per cell is approximately 4,000. Chloride channels in this conductance range were also seen in single-channel recordings.  相似文献   

4.
Airway surface liquid (ASL) contains substances important in mucociliary clearance and airway defense. Little is known about substance concentrations in ASL because of its small volume and sampling difficulties. We used in vivo microdialysis (IVMD) to sample liquid lining the nasal cavity without net volume removal and incorporated into IVMD a potential difference (PD) electrode to assess airway integrity. The cystic fibrosis (CF) mouse nasal epithelia exhibit ion transport defects identical to those in CF human airways and, thus, are a good model for CF disease. We determined that nasal liquid [Na+] (107 +/- 4 mM normal; 111 +/- 9 mM CF) and [Cl-] (120 +/- 6 mM normal; 122 +/- 4 mM CF) did not differ between genotypes. The nasal liquid [K+] (8.7 +/- 0.4 mM) was significantly less in normal than in CF mice (16.6 +/- 4 mM). IVMD accurately samples nasal liquid for ionic composition. The ionic composition of nasal liquid in the normal and CF mice is similar.  相似文献   

5.
As the main mucosal immune inductive site of nasal cavity, nasal-associated lymphoid tissue (NALT) plays an important role in both antigen recognition and immune activation after intranasal immunization. However, the efficiency of intranasal vaccines is commonly restricted by the insufficient intake of antigen by the nasal mucosa, resulting from the nasal mucosal barrier and the nasal mucociliary clearance. The distribution of NALT and the characteristic of nasal cavity have already been described in humans and many laboratory rodents, while data about poultry are scarce. For this purpose, histological sections of the chicken nasal cavities were used to examine the anatomical structure and histological characteristics of nasal cavity. Besides, the absorptive capacity of chicken nasal mucosa was also studied using the materials with different particle size. Results showed that the NALT of chicken was located on the bottom of nasal septum and both sides of choanal cleft, which mainly consisted of second lymphoid follicle. A large number of lymphocytes were distributed under the mucosal epithelium of inferior nasal meatus. In addition, there were also diffuse lymphoid tissues located under the epithelium of the concha nasalis media and the walls of nasal cavity. The results of absorption experiment showed that the chicken nasal mucosa was capable to absorb trypan blue, OVA, and fluorescent latex particles. Inactivated avian influenza virus (IAIV) could be taken up by chicken nasal mucosa except for the stratified squamous epithelium sites located on the forepart of nasal cavity. The intake of IAIV by NALT was greater than that of the nasal mucosa covering on non-lymphoid tissue, which could be further enhanced after intranasal inoculation combined with sodium cholate or CpG DNA. The study on NALT and nasal absorptive capacity will be benefit for further understanding of immune mechanisms after nasal vaccination and development of nasal vaccines for poultry.  相似文献   

6.
Application of chitosan microspheres for nasal delivery of vaccines   总被引:3,自引:0,他引:3  
Nasal vaccines offer several benefits, such as highly vascular mucous membranes, low enzymatic degradation compared to oral vaccines, and greater acceptability to patients. Nasal vaccines, however, have to overcome several limitations, including mucociliary clearance and the inefficient uptake of soluble antigens. Therefore, nasal vaccines require potent adjuvants and delivery systems to enhance their immunogenicity and to protect their antigens. Chitosan is a cheap, biocompatible, biodegradable, mucoadhesive, and nontoxic natural polymer. Chitosan microspheres have been investigated to determine whether they allow the controlled release of drugs and vaccines. They have figured in various studies on the vaccine delivery system through the nasal route. Several researchers have developed modified chitosan microspheres through their concomitant use with adjuvants or immunomodulators for an additive and a synergistic effect, and through the mannosylation of chitosan for receptor-mediated targeting antigen-presenting cells. The results of the recent researches on chitosan microspheres used as a nasal vaccine delivery system are discussed in this review.  相似文献   

7.
The objective of this study was to investigate absorption enhancing approaches for systemic delivery of methionine enkephalin via the nose. Absorption promotion of methionine enkephalin in the presence of protease inhibitors (bestatin, puromycin) and absorption enhancers (glycocholate, dimethyl-beta-cyclodextrin) were investigated in human nasal epithelium. Co-administration of the peptide with protease inhibitors and absorption enhancers resulted in a remarkable increase in Met-Enk permeation (4- to 94-fold). The increase was proportional to transepithelial resistance reduction and permeation of paracellular marker dye. Perturbation of the epithelial tight junctions seen in vitro may not occur in vivo due to mucus protection and mucociliary clearance.  相似文献   

8.
The purpose of these studies was to identify the rheologic properties of polyacrylic acid gels necessary for optimal reductions in mucociliary clearance. The mucociliary transport of 2 bioadhesive polyacrylic acid polymers, polycarbophil and carbopol, was assessed in vitro by measuring their clerance rates across explants of ciliated bovine tracheal tissue. The viscoelastic properties of polymer gels were measured in the presence of mucus using controlled stress rheometry. Combinations of apparent viscosity (η) and complex modulus (G*) were found to be the most useful parameters in the identification of polyacrylic acid formulations capable of decreasing mucociliary transport rate (MTR). A narrow range of η and G* values suitable for reducing mucociliary clearance, while remaining sufficiently fluid for intranasal administration, were identified. The correlations between the rheologic parameters of the polycarbophil gels and their mucociliary transport rates were used to identify other polyacrylic acid gels that also had suitable mucociliary clearance properties, demonstrating that these parameters can be used to direct the optimization of formulations using simple in vitro rheologic testing. Published: April 20, 2007  相似文献   

9.
Particles inhaled and deposited in the alveoli of the lung, i.e., distal to the tracheobronchial mucociliary escalator, may theoretically be cleared by several routes, including solubilization, lymphatic drainage, and the mucociliary pathway. We studied the clearance routes and kinetics of an inert insoluble carbonized polystyrene particle of supramicron size (2.85 micron count median diameter) tagged with 57Co (half-life 270 days) in the adult unanesthetized sheep. The rate of particle clearance, assessed by gamma scintillation camera of the whole lung, showed a three-exponential function, comprising a rapid initial phase in the first 44 h of clearance for tracheobronchial deposition followed by a slower phase of mostly alveolar clearance in the next 30 days and a final phase of very slow relatively pure alveolar clearance. A balance study of particle route during clearance and autopsy of regional thoracic lymph nodes, blood, liver, and spleen demonstrated that this supramicron-sized particle cleared from alveoli predominantly via the mucociliary escalator of the tracheobronchial tree. Whole-lung lavage studies showed particle and macrophage recovery rates suggesting a sequestered state for alveolar-deposited particles, which may partly account for their slow clearance rates. The failure to find interstitial penetration by alveolar-deposited particles indicates that the macrophages engulfing these particles, at low particle burdens, travel normally in only one direction, i.e., from interstitium to alveolus and then to the mucociliary escalator.  相似文献   

10.
Causey RC 《Theriogenology》2007,68(3):386-394
Uterine infections are a major cause of infertility, but the role of mucus in equine uterine defense is not well understood. Mucociliary currents play an important role in protecting mucous membranes, including the upper and lower respiratory tracts of mammals, and are required for feeding and oxygenation of many aquatic invertebrates. Although phagocytosis has long been considered the first line of uterine defense in the mare, there are concerns about its efficacy in the uterine lumen. Additional local defenses, such as mucociliary currents, have therefore been proposed. The uterine epithelium exhibits alternating mucus-secreting and ciliated cells supporting a mucopolysaccharide blanket, features shared with mucociliary membranes throughout the animal kingdom. Gross uterine anatomy, such as continuity of uterine and cervical folds, may indicate adaptations to mucociliary clearance. In addition, ciliated cells obtained in uterine lavages often display motility. Disruptions of mucociliary clearance play major roles in pathogenesis of mucosal infections in humans, including pneumonia, chronic sinusitis, and otitis media. Establishing drainage is a major goal of therapy in treatment of chronic sinusitis, hastening return of mucociliary function. Similar disruptions may occur in equine uterine infections, associated with accumulations of uterine fluid, loss of endometrial folds, and cervical trauma. Possible clinical implications of mucociliary clearance in the mare are discussed, however the role of mucociliary clearance in the mare remains speculative.  相似文献   

11.
BACKGROUND: Cystic fibrosis (CF) is a syndrome caused by mutations in the cystic fibrosis transmembrane regulator (CFTR) gene. Despite advances in our understanding of the molecular pathogenesis of CF, the link between CFTR gene mutations and the pathogenesis of CF lung disease remains poorly defined. CFTR has been assigned a number of putative functions that may contribute to innate airway defense, including the regulation of adenosine 5'-triphosphate (ATP) release into the extracellular environment. Because extracellular ATP and uridine 5'-triphosphate (UTP) may regulate airway mucociliary clearance via interaction with luminal P2Y2 receptors, the loss of CFTR-mediated nucleotide release could explain the defect in CF airway defense. MATERIALS AND METHODS: We tested the physiologic importance of CFTR-mediated nucleotide release in vivo by directly measuring levels of ATP and UTP in nasal airway surface liquid from normal and CF subjects. Because these basal nucleotide levels reflect the net activities of nucleotide release and metabolic pathways, we also measured constitutive rates of nucleotide release and metabolism on well-differentiated normal and CF airway cultures in vitro. The measurement of ATP release rates were paralleled by in vivo studies employing continuous nasal perfusion in normal and CF subjects. Finally, the regulation of ATP release by isoproterenol and methacholine-stimulated submucosal gland secretion was tested. RESULTS: These studies revealed that steady-state ATP and UTP levels were similar in normal (470 +/- 131 nM and 37 +/- 7 nM, respectively) and CF (911 +/- 199 nM and 33 +/- 12 nM, respectively) subjects. The rates of both ATP release and metabolism were also similar in normal and CF airway epithelia both in vitro and in vivo. Airway submucosal glands did not secrete nucleotides, but rather, secreted a soluble nucleotidase in response to cholinergic stimuli. CONCLUSION: The concentration of ATP in airway surface liquid is in a range that is relevant for the activation of airway nucleotide receptors. However, despite this finding that suggests endogenous nucleotides may be important for the regulation of mucociliary clearance, our data do not support a role for CFTR in regulating extracellular nucleotide concentrations on airway surfaces.  相似文献   

12.
The human tracheobronchial tree surface is covered with mucus. A healthy mucus is a heterogeneous material flowing toward the esophagus and a major defense actor against local pathogen proliferation and pollutant deposition. An alteration of mucus or its environment such as in cystic fibrosis dramatically impacts the mucociliary clearance. In the present study, we investigate the mechanical organization and the physics of such mucus in human lungs by means of a joint experimental and numerical work. In particular, we focus on the influence of the shear-thinning mucus mobilized by a ciliated epithelium for mucociliary clearance. The proposed robust numerical method is able to manage variations of more than 5 orders of magnitude in the shear rate and viscosity. It leads to a cartography that allows to discuss major issues on defective mucociliary clearance in cystic fibrosis. Furthermore, the computational rheological analysis based on measurements shows that cystic fibrosis shear-thinning mucus tends to aggregate in regions of lower clearance. Yet, a rarefaction of periciliary fluid has a greater impact than the mucus shear-thinning effects.  相似文献   

13.
BackgroundThe existing data demonstrate the potential role of trace elements in nasal mucociliary clearance, although the association between trace element and mineral status and ciliary function in children with chronic rhinosinusitis is insufficiently studied. Therefore, the objective of the present study is evaluation of trace element and mineral status and mucociliary function in pediatric CRS patients before and after functional endoscopic sinus surgery.MethodsThe present study involved 30 children with chronic rhinosinusitis without nasal polyps. During this follow-up the patients were examined preoperatively (point 0), underwent functional endoscopic sinus surgery, and were repeatedly examined at three months postoperatively (point 1). At both points the patients were subjected to quality-of-life assessment using SNOT-20 questionnaire; endoscopic and computer tomography examination of the nasal sinuses; evaluation of ciliary function and mucosal cytology using high-speed videomicroscopy; assessment of blood count and inflammatory markers; as well as analysis of trace element and mineral levels in whole blood, serum, and hair using inductively-coupled plasma mass-spectrometry.ResultsThe obtained data demonstrate that endoscopic sinus surgery significantly improved sinonasal pathology in children with chronic rhinosinusitis, as evidenced by significantly reduced Lund-Mackay, Lund-Kennedy, and SNOT-20 scores. At the same time, no significant improvement of ciliary functions or mucosal cytology was observed postoperatively. Trace element status assessment demonstrated that postoperative serum Zn, whole blood Mg and Cu were significantly lower as compared to preoperative values. In contrast, serum Mn and Cr, as well as whole blood Cr and hair Se were characterized by a significant increase at three months postoperatively. Multiple linear regression analysis demonstrated that serum Zn is significantly associated with the number of ciliated cells and cell viability, whereas serum Mn and whole blood Cu concentrations are inversely associated with cell viability and ciliary length, respectively. Hair Se was found to be associated with the number of neutrophils in the mucosa biopsy.ConclusionRedistribution of trace elements and minerals may at least partially mediate prolonged recovery of mucosal ciliary function in children with chronic rhinosinusitis in three months after functional sinus surgery, although the particular mechanisms of these alterations in trace element levels are to be discovered.  相似文献   

14.
目的:比较鼻内镜下中鼻道联合下鼻道小视窗双路径术和单独下中鼻道开窗术治疗真菌球型上颌窦炎的临床疗效。方法:采用前瞻性随机对照试验,将2013年8月~2015年5月在我院择期行手术治疗的50例真菌球型上颌窦炎患者分为观察组与对照组,每组25例,对照组行鼻内镜单独下中鼻道开窗术,观察组在对照组的基础上联合下鼻道小视窗术。术前及术后6个月采用鼻腔鼻窦结局测试20条量表(SNOT-20)对两组患者进行评分,术后6个月对鼻黏膜纤毛清除功能及疗效进行评估,比较两组手术时间及术中出血量。结果:术后6个月两组SNOT-20量表评分显著低于术前,且观察组显著低于对照组(P0.05)。术后6个月观察组粘膜纤毛传输时间(MTT)显著低于对照组(P0.05)。两组总有效率、手术时间及术中出血量比较,差异均无统计学意义(P0.05)。结论:鼻内镜下以上两种手术路径治疗真菌球型上颌窦炎的疗效相近,但鼻内镜下中鼻道联合下鼻道小视窗双路径术更有利于减轻患者症状及促进鼻黏膜纤毛清除功能恢复。  相似文献   

15.
15-lipoxygenase-1 (15-LO-1) is involved in the differentiation of human tracheobronchial epithelial cells. Here, we investigated the relation between 15-LO-1 expression and the differentiation of human nasal epithelium. In retinoic acid (RA)-sufficient culture media, 15-LO-1 expression in normal human nasal epithelial cell time-dependently increased, but its expression was undetectable in RA-deficient culture media. Moreover, in RA-deficient culture media, IL-4 at 1 ng/ml concentration time-dependently induced 15-LO-1 expression. In addition, MUC8 gene expression, a marker of mucociliary differentiation, was up-regulated by 15-LO-1, which was itself induced by IL-4. In murine nasal mucosa, the expression of leukocyte type-12-LO, a functional equivalent of 15-LO-1, reduced after postnatal day 7. Our findings suggest that 15-LO-1 is related to the differentiation of human nasal epithelium, and that it may mediate the mucociliary differentiation of human nasal epithelium.  相似文献   

16.
Primary ciliary dyskinesia represents a group of heritable disorders of cilia and sperm affecting between 1 in 15,000 and 1 in 30,000 persons. Those affected lack measurable mucociliary clearance and suffer the constant misery of rhinorrhea and chronic productive cough. Because mucociliary clearance constitutes one of the respiratory system''s major lines of defense, these patients are vulnerable to chronic sinusitis, bronchitis, pneumonia, and otitis media. Left untreated, these problems may progress to bronchiectasis, found frequently in adult patients, or pulmonary hypertension with eventual cor pulmonale. Screening for this disorder includes some simple and inexpensive methods as well as more exotic techniques requiring special camera equipment and an electron microscope to make a definitive diagnosis. Physiotherapy techniques can be taught to patients with primary ciliary dyskinesia and go a long way toward making up for the lack of mucociliary clearance. Vigorous bronchopulmonary toilet and palliative measures may enable these patients to enjoy relatively normal lives.  相似文献   

17.
Pseudomonas aeruginosa rhamnolipid causes ciliostasis and cell membrane damage to rabbit tissue, is a secretagogue in cats, and inhibits epithelial ion transport in sheep tissue. It could therefore perturb mucociliary clearance. We have investigated the effect of rhamnolipid on mucociliary transport in the anesthetized guinea pig and guinea pig and human respiratory epithelium in vitro. Application of rhamnolipid to the guinea pig tracheal mucosa reduced tracheal mucus velocity (TMV) in vivo in a dose-dependent manner: a 10-microgram bolus caused cessation of TMV without recovery; a 5-micrograms bolus reduced TMV over a period of 2 h by 22.6% (P = 0.037); a 2.5-microgram bolus caused no overall changes in TMV. The ultrastructure of guinea pig tracheal epithelium exposed to 10 micrograms of rhamnolipid in vivo was normal. Application of 1,000 micrograms/ml rhamnolipid had no effect on the ciliary beat frequency (CBF) of guinea pig tracheal rings in vitro after 30 min, but 250 micrograms/ml stopped ciliary beating after 3 h. Treatment with 100 micrograms/ml rhamnolipid caused immediate slowing of the CBF (P less than 0.01) of human nasal brushings (n = 7), which was maintained for 4 h. Mono- and dirhamnolipid had equivalent effects. The CBF of human nasal turbinate organ culture was also slowed by 100 micrograms/ml rhamnolipid, but only after 4 h (CBF test, 9.87 +/- 0.41 Hz; control, 11.48 +/- 0.27 Hz; P less than 0.05, n = 6), and there was subsequent recovery by 14 h.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

18.
Intranasal drug delivery has attracted significant attention because of the opportunity to deliver systemic drugs directly to the blood stream. However, the mucociliary clearance poses a challenge in gaining high efficacy of intranasal drug delivery because cilia continuously carry the mucus blanket towards the laryngeal region. To better understand mucus flow behaviour on the human nasal cavity wall, we present computational model development, and evaluation of mucus motion on a realistic nasal cavity model reconstructed from CT-scans. The model development involved two approaches based on the actual nasal cavity geometry namely: (i) unwrapped-surface model in 2D domain and (ii) 3D-shell model. Conservation equations of fluid motion were applied to the domains, where a mucus production source term was used to initiate the mucus motion. The analysis included mucus flow patterns, virtual saccharin tests and quantitative velocity magnitude analysis, which demonstrated that the 3D-shell model results provided better agreement with experimental data. The unwrapped-surface model also suffered from mesh-deformations during the unwrapping stage and this led to higher mucus velocity compared to experimental data. Therefore, the 3D-shell model was recommended for future mucus flow simulations. As a first step towards mucus motion modelling this study provides important information that accurately simulates a mucus velocity field on a human nasal cavity wall, for assessment of toxicology and efficacy of intranasal drug delivery.  相似文献   

19.
Surfactant proteins (SPs), designated SP-A, SP-B, SP-C, and SP-D, play an important role in surfactant metabolism and host defense mechanisms in the lung. This study investigates expression of the different SP types in human nasal mucosa and cultured normal human nasal epithelial (NHNE) cells and whether the expression of SP mRNA is influenced by the degree of mucociliary differentiation. RT-PCR was performed with mRNA from cultured NHNE cells and nasal mucosa. Immunohistochemical staining for SPs was performed on nasal mucosa specimens. Western blot analysis was performed on cell lysates from cultured NHNE cells. SP-A2, SP-B, and SP-D mRNAs were expressed in normal NHNE cells and human nasal mucosa. SPs were localized in ciliated cells of the surface epithelium and serous acini of the submucosal glands. SP-A, SP-B, and SP-D proteins were expressed in cultured NHNE cells. The degree of mucociliary differentiation influenced expression of the SP gene. We demonstrate that SP-A, SP-B, and SP-D are expressed in human nasal mucosa and cultured NHNE cells. Further study of the functional role of SPs in the upper airway is required.  相似文献   

20.
Regulation of periciliary liquid (PCL) depth is of central importance to mucociliary clearance by the airway epithelium. Without adequate hydration mucociliary transport would cease, leading to build up of mucus in the airways, and impairing the clearance of any trapped inhaled particulates. Airway epithelial cells are known to release ATP under a number of stress conditions. Cell surface receptors bind ATP and trigger an intracellular calcium response which regulates the gating of specific ion channels on the apical and basolateral cell membranes. This shifts the electrochemical balance, resulting in the accumulation of Na+ and Cl- in the periciliary liquid, and providing an osmotic driving force for water flux.In this study, we present a mathematical model of a single airway epithelial cell which describes the fluid secretion elicited after a rise in intracellular calcium. The model provides a basis to quantitatively analyse the influence of intracellular calcium signalling on fluid movement. The model demonstrates behaviour consistent with a number of experimental data on manipulating periciliary liquid volume and tonicity, and provides a quantitative basis for analysing the role of the different membrane ion channels in determining water flux following different physiological stimuli.  相似文献   

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