Intranasal steroids in the treatment of allergy-induced rhinorrhea

Intranasal delivery of mitochondria targeted neuroprotective compounds for traumatic brain injury: screening based on pharmacological and physiological properties

Targeting drugs to the mitochondrial level shows great promise for acute and chronic treatment of traumatic brain injury (TBI) in both military and civilian sectors. Perhaps the greatest obstacle to the successful delivery of drug therapies is the blood brain barrier (BBB). Intracerebroventricular and intraparenchymal routes may provide effective delivery of small and large molecule therapies for preclinical neuroprotection studies. However, clinically these delivery methods are invasive, and risk inadequate exposure to injured brain regions due to the rapid turnover of cerebral spinal fluid. The direct intranasal drug delivery approach to therapeutics holds great promise for the treatment of central nervous system (CNS) disorders, as this route is non-invasive, bypasses the BBB, enhances the bioavailability, facilitates drug dose reduction, and reduces adverse systemic effects. Using the intranasal method in animal models, researchers have successfully reduced stroke damage, reversed Alzheimer's neurodegeneration, reduced anxiety, improved memory, and delivered neurotrophic factors and neural stem cells to the brain. Based on literature spanning the past several decades, this review aims to highlight the advantages of intranasal administration over conventional routes for TBI, and other CNS disorders. More specifically, we have identified and compiled a list of most relevant mitochondria-targeted neuroprotective compounds for intranasal administration based on their mechanisms of action and pharmacological properties. Further, this review also discusses key considerations when selecting and testing future mitochondria-targeted drugs given intranasally for TBI.

Mixed Mucoadhesive Amphiphilic Polymeric Nanoparticles Cross a Model of Nasal Septum Epithelium in Vitro

Intranasal administration of nano-drug-delivery systems emerged as an appealing strategy to surpass the blood-brain barrier and thus increase drug bioavailability in the central nervous system. However, a systematic study of the effect of the structural properties of the nanoparticles on the nose-to-brain transport is missing. In this work, we synthesized and characterized mixed amphiphilic polymeric nanoparticles combining two mucoadhesive graft copolymers, namely, chitosan- g-poly(methyl methacrylate) and poly(vinyl alcohol)- g-poly(methyl methacrylate), for the first time. Chitosan enables the physical stabilization of the nanoparticles by ionotropic cross-linking with tripolyphosphate and confers mucoadhesiveness, while poly(vinyl alcohol) is also mucoadhesive and, owing to its nonionic nature, it improves nanoparticle compatibility in nasal epithelial cells by reducing the surface charge of the nanoparticles. After a thorough characterization of the mixed nanoparticles by dynamic light scattering and nanoparticle tracking analysis, we investigated the cell uptake by fluorescence light and confocal microscopy and imaging flow cytometry. Mixed nanoparticles were readily internalized at 37 °C, while the uptake was inhibited almost completely at 4 °C, indicating the involvement of energy-dependent mechanisms. Finally, we assessed the nanoparticle permeability across liquid-liquid and air-liquid monolayers of a nasal septum epithelial cell line and studied the effect of nanoparticle concentration and temperature on the apparent permeability. Overall, our findings demonstrate that these novel amphiphilic nanoparticles cross this in vitro model of intranasal epithelium mainly by a passive (paracellular) pathway involving the opening of epithelial tight junctions.

Inhibitory effects of bisdemethoxycurcumin on mast cell-mediated allergic diseases

Most allergic reactions are induced by mast cell activation. Mast cells play vital roles in the pathogenesis of allergic diseases. Bisdemethoxycurcumin (BDMC), a natural curcuminoid, has potential anti-allergic effects. Hence, we explored the effect of BDMC on mast cell-mediated allergic diseases. The study proved that BDMC suppresses β-hexosaminidase release, granule release, and membrane ruffling in monoclonal anti-2,4,6-dinitrophenyl-immunoglobulin (Ig) E/human serum albumin (DNP-IgE/HSA)-stimulated rat basophilic leukaemia cells (RBL-2H3 cells), and BDMC suppressed ovalbumin (OVA)-induced allergic rhinitis (AR) symptoms and OVA-specific IgE levels in AR mice. Furthermore, BDMC increased the survival of compound 48/80 anaphylaxis shock mice and elevated the decreased rectal temperature in OVA-induced active systemic anaphylaxis mice. These findings indicate that BDMC regulates the degranulation of mast cells, demonstrating its potential in the treatment of mast cell-induced allergic reactions.

Subjective and objective parameters in paediatric respiratory conditions: cultural adaptation to Portuguese population

Abstract Introduction: Young children are at high risk of respiratory infections. The severity of the disease is based on the assessment of signs and symptoms, although there is a lack of validated scales to the Portuguese population. Objective: The aim of this study was to accomplish the cultural adaptation and validation of the subjective and objective parameters in paediatric respiratory conditions, according to Postiaux. Methods: We ensured the cultural adaptation of the “Paramètres anamnestiques et cliniques utiles au suivi et à l’achèvement de la toilette bronchopulmonaire du nourrisson et de l’enfant”, created by Guy Postiaux. Then we analysed content, conceptual and construct validity, as well as test-retest reliability. The Portuguese version was applied in a sample of 59 children, with a mean age of 23.05 ± 8.34 months, 55.9% male. Results: We stablished semantics and construct validity and adopted the title “Paediatric Respiratory Severity Score” (PRSS). PRSS obtained a good internal consistency (α de Cronbach = 0.80) and an excellent intra-rater reliability (ICC = 0.91). Subjective parameters revealed a Cronbach’ α = 0.80 and an ICC = 0.90. Objective parameters obtained a Cronbach’ α = 0.73 and an ICC = 0.85. The application of PRSS to the sample showed that 37.3% of the children had a normal health condition (PRSS = 8) and 62.7% of the children had a moderate impairment of their health condition (9 ≤ PRSS ≤ 16). Conclusion: Paediatric Respiratory Severity Score is a valid and reliable measure to assess the severity of acute respiratory infections in children under 36 months of age.

The practical understanding and treatment of asthma

Asthma is a syndrome which is seen by physicians in nearly every specialty and affects millions of people throughout the world. Although the geoepidemiology with respect to prevalence and incidence of asthma does vary, even under the most mild of circumstance, asthma is among the leading causes of school absenteeism, work loss, and physician visits. In the past, it was considered primarily a disorder of childhood. Hence, the adage that children outgrow their asthma. We now realize that children really only outgrow their pediatrician and the genetic predisposition to asthma and bronchial hyperactivity persists throughout life. This issue is devoted to key papers that focus on important clinical problems in allergies and asthma. This issue is dedicated to helping the many sufferers of asthma with the hope that this topic will eventually become a medical anachronism.

Intranasal treatment of central nervous system dysfunction in humans

One of the most challenging problems facing modern medicine is how to deliver a given drug to a specific target at the exclusion of other regions. For example, a variety of compounds have beneficial effects within the central nervous system (CNS), but unwanted side effects in the periphery. For such compounds, traditional oral or intravenous drug delivery fails to provide benefit without cost. However, intranasal delivery is emerging as a noninvasive option for delivering drugs to the CNS with minimal peripheral exposure. Additionally, this method facilitates the delivery of large and/or charged therapeutics, which fail to effectively cross the blood-brain barrier (BBB). Thus, for a variety of growth factors, hormones, neuropeptides and therapeutics including insulin, oxytocin, orexin, and even stem cells, intranasal delivery is emerging as an efficient method of administration, and represents a promising therapeutic strategy for the treatment of diseases with CNS involvement, such as obesity, Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, depression, anxiety, autism spectrum disorders, seizures, drug addiction, eating disorders, and stroke.

Novel challenges for the allergist

The last years have witnessed novel findings with exciting developments in the field of allergy-related diseases including asthma, bronchial hyperresponsiveness, eczema, and atopy that have enormously increased over the past few years. This issue of the Reviews is timely dedicated to comprehensive articles discussing the current trends in the study of these conditions. In particular, the impact of new data in genomics, environmental factors through epigenetics and proteomics will be reviewed and critically discussed.