Validation of the Nasal Mucus Index, a Novel Measurement of Acute Respiratory Infection Severity

Dorresteijn, Paul M; Müller, Daniel; Xie, Yaoguo; Zhang, Zhengjun; Barrett, Bruce

doi:10.2500/ajra.2016.30.4337

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…In PP analysis, sample size of 33 participants had the power of 82%, with an α level (2-tailed) of 5%, suggesting that there was enough power to detect the effect of OPE on NK cell activity. Symptom score of WURSS-21 can be interpreted as the severity of acute respiratory infection [ 48 ], which can impair the innate immune system, including changes in NK cell activity [ 49 ]. In the present study, NK cell activity (%) was lower in participants with higher than median WURSS-21 symptom score as compared with those with lower than median WURSS-21 symptom score (10.69 ± 6.60 vs. 14.98 ± 12.55) in OPE.…”

Section: Discussionmentioning

confidence: 99%

Effect of onion (Allium cepa L.) peel extract on natural killer cell and cytokines in a randomized, double-blind, placebo-controlled trial

Cho,

Kim,

Lee

et al. 2024

Nutr Res Pract

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BACKGROUND/OBJECTIVES Onion, particularly onion peel, is a quercetin-rich food with, anti-inflammatory and immunomodulatory effects. However, the effect of onion peel extract (OPE) in humans is unclear. Thus, the present study aimed to investigate whether OPE improves natural killer (NK) cell activity and cytokine concentration in a randomized double-blind placebo-controlled trial. SUBJECTS/METHODS Eighty participants aged 19–64 yrs old with a white blood cell count of 4,000–10,000 cells/µL, symptoms of upper respiratory infection at least once within the previous 12 mon, and perceived stress scale (PSS) over 14 were included. Participants were randomly assigned to take either 1,000 mg/day OPE or a placebo for 8 weeks. RESULTS Compliance were 87.4 ± 8.6% and 86.9 ± 79.0% in OPE and placebo groups. Compared to the placebo, OPE supplementation improved “Hoarseness” ( P = 0.038) of the Wisconsin Upper Respiratory Symptom Survey (WURSS)-21 symptom, and stress scores ( P = 0.001; 0.021) of PSS. Supplementation of OPE had no significant effect on NK cell activity and concentrations of cytokines such as interleukin (IL)-2, IL-6, IL-12, IL-1β, interferon-γ, and tumor necrosis factor-α. At baseline, the WURSS-21 symptom and PSS score ( P = 0.024; 0.026) were higher in the OPE group than the placebo group. Among participants with higher than median WURSS-21 symptom score, OPE supplementation increased NK cell activity ( P = 0.038). Supplementation of OPE had no significant effects on safety measurements and adverse events. CONCLUSIONS The present study suggested that OPE supplementation improves NK cell activity in participants with moderate upper respiratory symptoms without any significant adverse effects. Trial Registration ClinicalTrials.gov Identifier: NCT05666752

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Section: Discussionmentioning

confidence: 99%

Effect of onion (Allium cepa L.) peel extract on natural killer cell and cytokines in a randomized, double-blind, placebo-controlled trial

Cho,

Kim,

Lee

et al. 2024

Nutr Res Pract

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“…On the other hand, ENA‐78 and IL‐8 are chemokines related to function of neutrophils and they are produced by nasal epithelial cells, monocytes and macrophages following stimulation of these cells with pro‐inflammatory cytokines IL‐1β and TNF‐α 19 . These chemokines stimulate the chemotaxis of neutrophils to the site of inflammation caused by bacterial infection 19,20 . MIP‐1α and MIP‐1β are strong pro‐inflammatory chemokines, well known as chemoattractants for neutrophils, monocytes, as well as eosinophils in patients with acute and chronic upper airway inflammations 21 .…”

Section: Discussionmentioning

confidence: 99%

Effects of Pelargonium sidoides extract vs roxithromycin on chemokine levels in nasal secretions of patients with uncomplicated acute rhinosinusitis

Perić

Kovačević

Barać

et al. 2020

Laryngoscope Investig Oto

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Background Previous investigations suggest the use of extract from the roots of Pelargonium sidoides (EPs 7630) for the therapy of uncomplicated rhinosinusitis. The aim of this prospective study was to compare the effects of herbal drug EPs 7630 and antibiotic roxithromycin on chemokine production in nasal mucosa and clinical parameters in patients with uncomplicated acute bacterial rhinosinusitis (ABRS). Methods Seventy‐eight ABRS patients were divided into 26 patients receiving EPs 7630 tablets, 3 × 20 mg/day per os (group 1), 26 patients receiving roxithromycin tablets, 2 × 150 mg/day per os (group 2), both for 10 days, and 26 patients who received no therapy (Control group). We measured chemokine levels in nasal secretions by flow cytometry and assessed clinical parameters on day 0 and day 10 of investigation. Results EPs 7630 increased concentrations of MCP‐1 (P = .001) and IP‐10 (P = .049) and decreased levels of MIP‐1α (P < .001), ENA‐78 (P < .001), and IL‐8 (P < .001). Roxithromycin increased levels of IP‐10 (P = .049) and decreased levels of MCP‐1 (P < .001), MIP‐1α (P < .016), ENA‐78 (P < .001), and IL‐8 (P < .001). Comparison of the non‐treated patients' group with groups 1 and 2 revealed significant improvement of all clinical parameters in treated patients (P < .001), but therapy with roxithromycin resulted in better improvement in nasal symptoms and endoscopic findings than therapy with EPs 7630. Conclusion Our results suggest the presence of similar modulatory effects of both therapies on production of chemokines that regulate the function of neutrophils and monocytes in nasal mucosa. Roxithromycin shows better clinical efficacy than EPs 7630 in patients with uncomplicated ABRS. Level of Evidence 1b.

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“…Dorresteijn et al 3 reported on a newly developed severity metric, the Nasal Mucus Index. They studied the association of various inflammatory biomarkers and self-reported severity measures with the newly developed Nasal Mucus Index.…”

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confidence: 99%

“…The impact that the quality metrics will have on physician reimbursements makes it imperative that otolaryngologists provide input into what specialty-specific performance measures are used. Dorresteijn et al 3 reported on a newly developed severity metric, the Nasal Mucus Index. They studied the association of various inflammatory biomarkers and self-reported severity measures with the newly developed Nasal Mucus Index.…”

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confidence: 99%

Reality Bites: The Establishment of Accountable Care Organizations in Otolaryngology

Woodard¹

2016

Am J Rhinol�Allergy

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Although United States health care costs are significantly higher than any other industrialized country, we still lag behind many countries in health care equity and quality metrics. One feature of the Affordable Care Act that intended to address this was the establishment of Accountable Care Organizations (ACO). ACOs create a network of physicians that ostensibly will enhance care coordination among providers, improve patient experience and health outcomes, and lower overall costs. ACOs emphasize prevention and management of chronic diseases, and reward quality and cost-effective care, while attempting to move away from fee-for-service medicine. Unfortunately, although not always responsible for many of the metrics that determine cost or quality of care, physicians are largely held accountable for the delivery of high-quality and low-cost care. With otolaryngology having been slow to transition to this new payment model, it is imperative that we stay engaged and take a proactive role in this process because it has great implications on our patients' outcomes and our own practices. Several articles in this issue of American Journal of Rhinology & Allergy contain themes relevant to this type of change.First is an intriguing article by Barry et al.,1 who examined what the contemporary literature shows about early versus aggressive management of chronic rhinosinusitis (CRS) as it relates to patient experience, health outcomes, and overall cost burden. Their review demonstrated that early intervention with endoscopic sinus surgery in appropriately selected patients has the potential to improve outcomes and reduce the long-term cost burden of CRS.Besides early surgical intervention, medical management is another area that is likely to be affected by the ACO model. Aggressive medical management as a first-line therapy option may potentially improve clinical outcomes and reduce health care costs. Novel topical medicines in the treatment of CRS provide targeted therapy and reduce the adverse effects associated with systemic use of certain medications. Sodium hyaluronate has been described to promote wound and mucosal healing, but it has not been described in its use in CRS therapy. Cantone and Iengo 2 evaluated it use in combination with topical steroids and found improvement in symptoms, endoscopic examinations, and discomfort associated with CRS with nasal polyps (CRSwNP) compared with steroids alone.The impact that the quality metrics will have on physician reimbursements makes it imperative that otolaryngologists provide input into what specialty-specific performance measures are used. Dorresteijn et al. 3 reported on a newly developed severity metric, the Nasal Mucus Index. They studied the association of various inflammatory biomarkers and self-reported severity measures with the newly developed Nasal Mucus Index. The Nasal Mucus Index was found to correlate significantly with same-day interleukin-8 levels, polymorphonuclear neutrophils count, and Wisconsin Upper Respiratory Symptom Survey-21 scores. It is propose...

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Validation of the Nasal Mucus Index, a Novel Measurement of Acute Respiratory Infection Severity

Abstract: ABSTRACT

Cited by 4 publications

References 14 publications

Effect of onion (Allium cepa L.) peel extract on natural killer cell and cytokines in a randomized, double-blind, placebo-controlled trial

Effect of onion (Allium cepa L.) peel extract on natural killer cell and cytokines in a randomized, double-blind, placebo-controlled trial

Effects of Pelargonium sidoides extract vs roxithromycin on chemokine levels in nasal secretions of patients with uncomplicated acute rhinosinusitis

Reality Bites: The Establishment of Accountable Care Organizations in Otolaryngology

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