Topical Drug Delivery for Chronic Rhinosinusitis

Liang, Jonathan; Lane, Andrew P.

doi:10.1007/s40136-012-0003-4

Cited by 31 publications

(22 citation statements)

References 95 publications

(102 reference statements)

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“…Clinical trials and meta-analyses have shown irrigation to be effective in reducing CRS symptoms and improving quality of life in both pre-surgical and post-operative periods 1–6 . This, together with its low-cost and favorable safety profile, makes nasal saline irrigation a robust choice for the management of sinonasal symptoms.…”

Section: Introductionmentioning

confidence: 99%

Impact of saline irrigation and topical corticosteroids on the postsurgical sinonasal microbiota

Liu

Kohanski

Mendiola

et al. 2014

Int Forum Allergy Rhinol

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Introduction Topical treatments with nasal saline irrigation, topical steroid sprays, or corticosteroid rinses can improve sinonasal symptoms in chronic rhinosinusitis (CRS). However, the impact of these therapies on commensals (Corynebacterium) and on biofilm pathogens associated with CRS (Staphylococcus aureus and Pseudomonas) is not well characterized. Methods Paired nasal and sinus swabs were collected endoscopically from 28 controls and 14 CRS patients with nasal polyposis (CRSwNP) who had not received systemic antibiotics or corticosteroids in the previous eight weeks. Total DNA from swab eluents were extracted and analyzed by 16S rRNA gene-based pyrosequencing. A total 359,077 reads were obtained and classified taxonomically. The association of use of topical therapies with sinonasal microbiota composition was assessed by factor and vector-fitting. The proportional abundances of sinonasal bacteria between topical therapy users and non-users were further compared by two-tailed Kolmogorov-Smirnov test among controls and among CRSwNP participants. Result Nasal saline irrigation, with or without added budesonide, was not associated with significantly distinct sinonasal microbiota composition or significantly decreased Pseudomonas or S. aureus abundances among either controls or CRSwNP participants. Corynebacterium was slightly lower in controls that reported using saline irrigation than those who did not. No significant association was found between nasal saline irrigation and the proportional abundances of Pseudomonas, S. aureus, and Corynebacterium in CRSwNP participants. However, male CRSwNP patients were noted to have significantly higher Corynebacterium proportional abundances than their female counterparts. The use of topical steroid sprays was associated with a distinct microbiota in control subjects, characterized by higher proportional abundances of Dolosigranulum and Simonsiella and a lower proportional abundance of Campylobacter. Conclusion Nasal saline irrigation is not associated with a distinct alteration in the proportional abundance of commensal bacteria or biofilm-forming pathogens in CRSwNP patients. However, use of topical intranasal corticosteroid sprays in control subjects is associated with a distinct sinonasal microbiota.

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Section: Introductionmentioning

confidence: 99%

Impact of saline irrigation and topical corticosteroids on the postsurgical sinonasal microbiota

Liu

Kohanski

Mendiola

et al. 2014

Int Forum Allergy Rhinol

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“…[42,43] Intranasal saline irrigation has been shown to increase drug delivery in comparison to the low sinus distribution efficiency of other methods, such as nasal sprays and nebulizers. [44–46] We therefore examined the ability of fluorescently labeled GM-0111 to be intranasally delivered in saline to mice.…”

Section: Resultsmentioning

confidence: 99%

Prevention of sinonasal inflammation by a synthetic glycosaminoglycan

Pulsipher

Qin

Thomas

et al. 2016

Int Forum Allergy Rhinol

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Background Glycosaminoglycans (GAGs) are polysaccharides that are distributed on respiratory epithelial cells, endothelial cells, and submucosal glands. Uniquely positioned, certain GAGs exhibit anti-inflammatory properties in respiratory diseases and serve important roles in repairing mucosal surfaces and modulating mucociliary clearance. We hypothesized that topical administration of a synthetic GAG (GM-0111) would prevent sinonasal inflammation in a mouse model of rhinosinusitis (RS). Methods To test our hypothesis, C57BL/6 mice were intranasally administered fluorescent GM-0111, and sinonasal tissues were examined for coating and penetration ability. To test therapeutic feasibility, mice (n = 6) were given GM-0111 or hyaluronic acid (HA) (800 μg dose) prior to inducing RS with inflammatory molecule LL-37 (115 μg dose). After 24 h, sinonasal tissues were harvested for histological and biochemical analysis of inflammatory markers (inflammatory cell infiltration, lamina propria (LP) thickening, and neutrophil enzyme myeloperoxidase (MPO)) and cell death. Results (1) GM-0111 was observed within sinonasal tissues 1 h and 24 h after intranasal administration, indicating rapid and effective coating and penetration. (2) GM-0111 prevented sinonasal tissues from developing inflammatory changes, with significant reductions in mast cell infiltration (p < 0.05), LP thickening (p < 0.001), and MPO levels (p < 0.01) when compared to tissues treated with LL-37 and those pre-treated with HA. (3) GM-0111 reduced cell death within sinonasal tissues in contrast to LL-37-treated tissues. Conclusions We report a new synthetic GAG (GM-0111) that uniformly coats and penetrates into the sinonasal mucosa to prevent sinonasal inflammation and cell death in a mouse model of RS.

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“…In regard to the type of saline used, nasal irrigation with isotonic saline improves the nasal MCC of allergic patients due to changes in the rheological properties of mucous (33) and is better tolerated. Chusakul et al (23) investigated three types of isotonic saline solutions according to their alkalinity.…”

Section: Discussionmentioning

confidence: 99%

Isotonic saline nasal irrigation in clinical practice: a literature review

2017

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Introduction: Nasal instillation of saline solution has been used as part of the treatment of patients with upper respiratory tract diseases. Despite its use for a number of years, factors such as the amount of saline solution to be used, degree of salinity, method and frequency of application have yet to be fully explained. Objective: Review the reported outcomes of saline nasal irrigation in adults with allergic rhinitis, acute or chronic sinusitis and after functional endoscopic sinus surgery (FESS), and provide evidence to assist physiotherapists in decision making in clinical practice. Methods: A search was conducted of the Pubmed and Cochrane Library databases between 2007 and 2014. A combination of the following descriptors was used as a search strategy: nasal irrigation, nasal lavage, rhinitis, sinusitis, saline, saline solution. Results: Eight clinical trials were included, analyzed according to participant diagnosis. Conclusion: The evidence found was heterogeneous, but contributed to elucidating uncertainties regarding the use of nasal lavage in the clinical practice of physical therapy, such as the protocols used.

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Topical Drug Delivery for Chronic Rhinosinusitis

Cited by 31 publications

References 95 publications

Impact of saline irrigation and topical corticosteroids on the postsurgical sinonasal microbiota

Impact of saline irrigation and topical corticosteroids on the postsurgical sinonasal microbiota

Prevention of sinonasal inflammation by a synthetic glycosaminoglycan

Isotonic saline nasal irrigation in clinical practice: a literature review

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