Trigeminal-specific stimulants have been shown to activate different receptors preferentially and this likely accounts for variation in sensory perception.It is unclear whether trigeminal sensitivity is similar across...Trigeminal-specific stimulants have been shown to activate different receptors preferentially and this likely accounts for variation in sensory perception.It is unclear whether trigeminal sensitivity is similar across different transient receptor potential(TRP)receptors or if dysfunction of different receptors results in differing patient symptoms.Therefore,a prospective cohort study was conducted,consisting of trigeminal lateralization testing with three different stimulants(eucalyptol,isothiocyanate,acetic acid),olfaction testing with Sniffin'Sticks,and measurement of various patient‐reported outcome measures(PROMs).A total of 50 participants were enrolled across the olfactory spectrum.Mean TDI score was 27.1±8.3(range 7.0–39.5)with 38%normosmic and 62%dysosmic.Mean trigeminal lateralization scores out of 20 in the overall cohort were 16.18(2.78)for eucalyptol,14.94(3.49)for mustard oil,and 15.28(3.68)for vinegar.Eucalyptol showed a significant correlation with threshold scores of Sniffin'Sticks.A significant correlation was found between acetic acid and various PROMs.None of the lateralization scores of the trigeminal stimulants correlated to each other significantly and there was no correlation to age.The lack of correlation suggests that the measured sensitivity of one type of TRP receptor may not translate to similar sensitivity of the other receptors.Additional investigations with TRPV1 and TRPA1 agonists are needed to corroborate our findings.展开更多
Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The pu...Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens,comparing normosmic and dysosmic CRS patients without polyps(CRSsNP).Methods:Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery.Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic(n=7)and normosmic(n=4)patients.Results:Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes.Using stringent criteria for multiple comparisons,one upregulated gene(Immediate Early Response 3[IER3])had an false discovery rate(FDR)correction adjustedP value considered statistically significant(P<0.001,fold change 2.69).Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients(P<0.05,FDR correction)including IL-4 and IL-13 signaling,IL-10 signaling,and rhodopsin-like receptors.Conclusions:RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction.This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP.This study also prompts questions regarding the role of IL-10,rhodopsin-like receptors,andIER3 in the pathogenesis of olfactory dysfunction.展开更多
Objective:To identify whether irrigation devices become contaminated when used by patients with allergic rhinitis (AR).Methods:Ten AR patients with no clinical or endoscopic evidence of active sinonasal infection were...Objective:To identify whether irrigation devices become contaminated when used by patients with allergic rhinitis (AR).Methods:Ten AR patients with no clinical or endoscopic evidence of active sinonasal infection were given a sinus rinse system and instructed on its proper use,cleaning,and storage.Two squeeze bottles (bottle A and bottle B) were given to each patient for twice-a-day rinsing.Bottle A was used in the morning and analyzed after four weeks.Bottle B was used in the evening and analyzed after 8 weeks of use.Microbial contaminants were cultured from the nose pieces and the inner surface of the bottles obtained from patients.Results:Seventeen sinus rinse devices (17/20) from all individuals in this study grew bacteria commonly in the nozzles.Twenty-four bacterial isolates consisting of 14 different species were cultured and identified with most common organisms being bacilli and staphylococcus.In addition,no correlation was apparent between the length of bottle use and the degree of contamination (r =0.13,p =0.76).During the study period,no patient developed acute sinus infections.Conclusion:Microbial contamination of the sinus rinse system occurs commonly,even in uninfected AR patients;however no evidence exists linking this to clinically relevant sinus infections.展开更多
Background:The SARS-CoV-2 virus continues to spread rapidly across the globe af-flicting many with Coronavirus Disease 2019(COVID-19).As the infection rates rise,a growing number of SARS-CoV-2 positive individuals hav...Background:The SARS-CoV-2 virus continues to spread rapidly across the globe af-flicting many with Coronavirus Disease 2019(COVID-19).As the infection rates rise,a growing number of SARS-CoV-2 positive individuals have been reported to complain of olfactory distur-bances at an alarming rate.Postviral olfactory dysfunction(PVOD)is a well-known phenome-non that may explain the olfactory dysfunction reported by SARS-CoV-2 infected individuals.Methods:A scoping literature review was performed to identify studies that investigated the mechanisms of postviral olfactory dysfunction.Studies demonstrating pathophysiological,his-tological,immunochemical,and epidemiological outcomes of PVOD were included.Results:Fourteen studies were included in addition to one international news article.Three studies reported destruction of the olfactory epithelium following intranasal inoculation of various viral strains in mice.Three studies isolated pathogenic,anosmia inciting viruses(Para-influenza virus,Human Coronavirus,Rhinovirus)through nucleic acid amplification.Eleven studies demonstrated female predilection in patients with PVOD and COVID-19 associated ol-factory dysfunction,of which the majority were over 50 years old.Conclusions:PVOD and COVID-19 associated olfactory dysfunction demonstrates considerable similarities in epidemiological trends and disease sequela of other viruses to suggest identical pathophysiological mechanisms.Further studies such as intranasal inoculation and histological biopsies are needed to support our hypothesis.展开更多
文摘Trigeminal-specific stimulants have been shown to activate different receptors preferentially and this likely accounts for variation in sensory perception.It is unclear whether trigeminal sensitivity is similar across different transient receptor potential(TRP)receptors or if dysfunction of different receptors results in differing patient symptoms.Therefore,a prospective cohort study was conducted,consisting of trigeminal lateralization testing with three different stimulants(eucalyptol,isothiocyanate,acetic acid),olfaction testing with Sniffin'Sticks,and measurement of various patient‐reported outcome measures(PROMs).A total of 50 participants were enrolled across the olfactory spectrum.Mean TDI score was 27.1±8.3(range 7.0–39.5)with 38%normosmic and 62%dysosmic.Mean trigeminal lateralization scores out of 20 in the overall cohort were 16.18(2.78)for eucalyptol,14.94(3.49)for mustard oil,and 15.28(3.68)for vinegar.Eucalyptol showed a significant correlation with threshold scores of Sniffin'Sticks.A significant correlation was found between acetic acid and various PROMs.None of the lateralization scores of the trigeminal stimulants correlated to each other significantly and there was no correlation to age.The lack of correlation suggests that the measured sensitivity of one type of TRP receptor may not translate to similar sensitivity of the other receptors.Additional investigations with TRPV1 and TRPA1 agonists are needed to corroborate our findings.
基金National Institute of General Medical Sciences,Grant/Award Number:NIGMS GM103499MUSC's Office of the Vice President for Research。
文摘Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens,comparing normosmic and dysosmic CRS patients without polyps(CRSsNP).Methods:Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery.Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic(n=7)and normosmic(n=4)patients.Results:Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes.Using stringent criteria for multiple comparisons,one upregulated gene(Immediate Early Response 3[IER3])had an false discovery rate(FDR)correction adjustedP value considered statistically significant(P<0.001,fold change 2.69).Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients(P<0.05,FDR correction)including IL-4 and IL-13 signaling,IL-10 signaling,and rhodopsin-like receptors.Conclusions:RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction.This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP.This study also prompts questions regarding the role of IL-10,rhodopsin-like receptors,andIER3 in the pathogenesis of olfactory dysfunction.
文摘Objective:To identify whether irrigation devices become contaminated when used by patients with allergic rhinitis (AR).Methods:Ten AR patients with no clinical or endoscopic evidence of active sinonasal infection were given a sinus rinse system and instructed on its proper use,cleaning,and storage.Two squeeze bottles (bottle A and bottle B) were given to each patient for twice-a-day rinsing.Bottle A was used in the morning and analyzed after four weeks.Bottle B was used in the evening and analyzed after 8 weeks of use.Microbial contaminants were cultured from the nose pieces and the inner surface of the bottles obtained from patients.Results:Seventeen sinus rinse devices (17/20) from all individuals in this study grew bacteria commonly in the nozzles.Twenty-four bacterial isolates consisting of 14 different species were cultured and identified with most common organisms being bacilli and staphylococcus.In addition,no correlation was apparent between the length of bottle use and the degree of contamination (r =0.13,p =0.76).During the study period,no patient developed acute sinus infections.Conclusion:Microbial contamination of the sinus rinse system occurs commonly,even in uninfected AR patients;however no evidence exists linking this to clinically relevant sinus infections.
文摘Background:The SARS-CoV-2 virus continues to spread rapidly across the globe af-flicting many with Coronavirus Disease 2019(COVID-19).As the infection rates rise,a growing number of SARS-CoV-2 positive individuals have been reported to complain of olfactory distur-bances at an alarming rate.Postviral olfactory dysfunction(PVOD)is a well-known phenome-non that may explain the olfactory dysfunction reported by SARS-CoV-2 infected individuals.Methods:A scoping literature review was performed to identify studies that investigated the mechanisms of postviral olfactory dysfunction.Studies demonstrating pathophysiological,his-tological,immunochemical,and epidemiological outcomes of PVOD were included.Results:Fourteen studies were included in addition to one international news article.Three studies reported destruction of the olfactory epithelium following intranasal inoculation of various viral strains in mice.Three studies isolated pathogenic,anosmia inciting viruses(Para-influenza virus,Human Coronavirus,Rhinovirus)through nucleic acid amplification.Eleven studies demonstrated female predilection in patients with PVOD and COVID-19 associated ol-factory dysfunction,of which the majority were over 50 years old.Conclusions:PVOD and COVID-19 associated olfactory dysfunction demonstrates considerable similarities in epidemiological trends and disease sequela of other viruses to suggest identical pathophysiological mechanisms.Further studies such as intranasal inoculation and histological biopsies are needed to support our hypothesis.