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Schleusener J, Lohan SB, Busch L, Zamudio Díaz DF, Opitz N, Sicher C, Lichtenthäler T, Danker K, Dommerich S, Filler T, Meinke MC, Zwicker P. Irradiation of human oral mucosa by 233 nm far UV-C LEDs for the safe inactivation of nosocomial pathogens. Sci Rep 2023; 13:22391. [PMID: 38104221 PMCID: PMC10725486 DOI: 10.1038/s41598-023-49745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023] Open
Abstract
The inactivation of multi resistant pathogens is an important clinical need. One approach is UV-C irradiation, which was previously not possible in vivo due to cytotoxicity. Recently, far UV-C irradiation at λ < 240 nm was successfully used on skin with negligible damage. A potential application site is the nasal vestibule, where MRSA accumulates and cannot be treated using antiseptics. We irradiated 3D mucosa models and excised human mucosa with 222 and 233 nm far UV-C in comparison to 254 nm and broadband UV-B. Eradication efficiency was evaluated by counting colony forming units; irritation potential was evaluated by hen's egg-chorioallantoic membrane assay and trans epithelial electrical resistance; cell viability was assessed by MTT. DNA damage and cell protective mechanisms were evaluated immunohistopathologically. On mucosa models, MRSA reduced by ≈ 5 log10 for 60 mJ/cm2 irradiation at 233 nm. A slightly increased cell viability was observed after 24 h. Lower doses showed lower irritation potential than the positive controls or commercial mouthwash, while 80 mJ/cm2 had strong irritation potential. DNA damage occurred only superficially and decreased after 24 h. On excised human mucosa, < 10% of keratinocytes were affected after 150 mJ/cm2 222 nm or 60 mJ/cm2 233 nm.
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Affiliation(s)
- Johannes Schleusener
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Silke B Lohan
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Loris Busch
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Pharmaceutics and Biopharmaceutics, Philipps-Universität Marburg, Robert‑Koch‑Str. 4, 35032, Marburg, Germany
| | - Daniela F Zamudio Díaz
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Technische Universität Berlin, Institute of Food Technology and Food Chemistry, Gustav-Meyer-Allee 25, 13355, Berlin, Germany
| | - Nevin Opitz
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
| | - Claudia Sicher
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
| | - Tom Lichtenthäler
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
| | - Kerstin Danker
- Institute of Biochemistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Steffen Dommerich
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Thomas Filler
- Ferdinand-Braun-Institut (FBH), Gustav‑Kirchhoff‑Str. 4, 12489, Berlin, Germany
| | - Martina C Meinke
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Paula Zwicker
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
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Measuring DNA modifications with the comet assay: a compendium of protocols. Nat Protoc 2023; 18:929-989. [PMID: 36707722 DOI: 10.1038/s41596-022-00754-y] [Citation(s) in RCA: 86] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 07/05/2022] [Indexed: 01/28/2023]
Abstract
The comet assay is a versatile method to detect nuclear DNA damage in individual eukaryotic cells, from yeast to human. The types of damage detected encompass DNA strand breaks and alkali-labile sites (e.g., apurinic/apyrimidinic sites), alkylated and oxidized nucleobases, DNA-DNA crosslinks, UV-induced cyclobutane pyrimidine dimers and some chemically induced DNA adducts. Depending on the specimen type, there are important modifications to the comet assay protocol to avoid the formation of additional DNA damage during the processing of samples and to ensure sufficient sensitivity to detect differences in damage levels between sample groups. Various applications of the comet assay have been validated by research groups in academia, industry and regulatory agencies, and its strengths are highlighted by the adoption of the comet assay as an in vivo test for genotoxicity in animal organs by the Organisation for Economic Co-operation and Development. The present document includes a series of consensus protocols that describe the application of the comet assay to a wide variety of cell types, species and types of DNA damage, thereby demonstrating its versatility.
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Costa TMR, Carneiro FM, Oliveira KASD, Souza MFB, Avelino MAG, Wastowski IJ. Rhinophototherapy, an alternative treatment of allergic rhinitis: Systematic review and meta-analysis. Braz J Otorhinolaryngol 2021; 87:742-752. [PMID: 33663975 PMCID: PMC9422690 DOI: 10.1016/j.bjorl.2020.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/25/2020] [Accepted: 12/30/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, mediated by immunoglobulin E, affecting 1 in 6 individuals. The treatment aims at attaining symptomatic control with minimal side effects, a requirement for new alternative therapies, including phototherapy, as it has an immunosuppressive and immunomodulatory effect. Objective To identify the effectiveness of phototherapy in the treatment of allergic rhinitis through a meta-analysis. Methods We searched Web of Science, Scielo, PubMed, SCOPUS, PEDro, and LILACS databases, using the terms: “intranasal irradiation”, “phototherapy” and “allergic rhinitis”. The R software Metafor package was used for the meta-analysis and the effect size was calculated for each symptom individually. Results All symptoms decreased considerably after phototherapy: rhinorrhea (ES• = −1.35; p < 0.0001; I2 = 91.84%), sneezing (ES• = −1.24; p < 0.0001; I2 = 91.43%), nasal pruritus (ES• = −1.10; p < 0.0001; I2 = 91.43%); nasal obstruction (ES• = −1.11; p < 0.0001; I2 = 91.88%). The effects were more significant in perennial allergic rhinitis than in the seasonal type. Conclusion Considering the effect size and the statistical significance attained in our study, rhinophototherapy showed to be an effective treatment for reducing the nasal symptom scores triggered by AR.
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Affiliation(s)
- Tatyana Machado Ramos Costa
- Universidade Estadual de Goiás (UEG), Campus Anápolis de Ciências Exatas e Tecnológicas Henrique Santillo, Anápolis, GO, Brazil.
| | - Fernanda Melo Carneiro
- Universidade Estadual de Goiás (UEG), Campus Anápolis de Ciências Exatas e Tecnológicas Henrique Santillo, Anápolis, GO, Brazil; Universidade Estadual de Goiás (UEG), Campus Laranjeiras, Goiânia, GO, Brazil
| | | | | | - Melissa Ameloti Gomes Avelino
- Universidade Federal de Goiás (UFG), Faculdade de Medicina (FM), Goiânia, GO, Brazil; Universidade Federal de Goiás (UFG), Hospital das Clínicas (HC), Goiânia, GO, Brazil
| | - Isabela Jubé Wastowski
- Universidade Estadual de Goiás (UEG), Campus Anápolis de Ciências Exatas e Tecnológicas Henrique Santillo, Anápolis, GO, Brazil; Universidade Estadual de Goiás (UEG), Campus Laranjeiras, Goiânia, GO, Brazil
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Jung HJ, Chung YJ, Choi YS, Chung PS, Mo JH. Clinical Efficacy and Safety of Low-Level Laser Therapy in Patients with Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Trial. J Clin Med 2021; 10:jcm10040772. [PMID: 33671931 PMCID: PMC7919054 DOI: 10.3390/jcm10040772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Allergic rhinitis (AR) is a common disease that interferes with the daily activities and reduces the quality of life. Conventional treatments often do not provide complete resolution of the symptoms, and many new treatment modalities have been tried. This study aimed to evaluate the efficacy and safety of low-level laser therapy (LLLT) for AR in a randomized, double-blind, placebo-controlled trial. Patients diagnosed with AR were randomly allocated to receive LLLT or sham treatment. The primary outcome was a change in the reflective total nasal symptom score (TNSS). The secondary outcome was quality of life scores assessed using the Rhinoconjunctivitis Quality of Life Questionnaire. Incidences of adverse events were also recorded. Among 67 randomized subjects, 41 subjects (22 in LLLT group and 19 in sham treatment group) were included for efficacy analysis. The LLLT group showed a significantly improved TNSS score compared to the sham treatment group for decreasing AR symptom severity (p = 0.011) and improving quality of life regarding nasal symptoms (p = 0.036) at the end of treatment. Throughout the treatment period, no severe adverse events occurred. This clinical trial showed that LLLT is an effective and safe option for the management of AR regarding symptom relief and quality of life improvement.
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Affiliation(s)
- Hahn Jin Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju 361711, Korea; (H.J.J.); (Y.-S.C.)
| | - Young-Jun Chung
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan 31116, Korea; (Y.-J.C.); (P.S.C.)
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Korea
- Laser Translational Clinical Trial Center, Dankook University Hospital, Cheonan 31116, Korea
| | - Young-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju 361711, Korea; (H.J.J.); (Y.-S.C.)
| | - Phil Sang Chung
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan 31116, Korea; (Y.-J.C.); (P.S.C.)
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Korea
- Laser Translational Clinical Trial Center, Dankook University Hospital, Cheonan 31116, Korea
| | - Ji-Hun Mo
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan 31116, Korea; (Y.-J.C.); (P.S.C.)
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Korea
- Laser Translational Clinical Trial Center, Dankook University Hospital, Cheonan 31116, Korea
- Correspondence: ; Tel.: +82-40-550-3933
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Open, prospective, multicenter study on postoperative intranasal phototherapy in nasal polyposis. Ir J Med Sci 2021; 191:375-383. [PMID: 33547613 DOI: 10.1007/s11845-021-02518-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The therapeutic effect of ultraviolet (UV) light is generally attributed to its immunosuppressive and immunomodulatory effects. Since chronic inflammation is the major factor in the development of nasal polyposis, we have previously used mixed ultraviolet-visible light (mUV-VIS, Rhinolight®) phototherapy for the treatment of nasal polyps. AIMS In the present open, multicenter study, our aim was to delineate whether mUV-VIS applied postoperatively in vivo together with intranasal steroid treatment could reduce the recurrence of nasal polyps. METHODS After functional endoscopic sinus surgery, one group of patients received mUV-VIS light together with standard intranasal steroid (mometason furoate 2 × 200 μg) application for a 12-week treatment period, whereas the other patient group obtained only intranasal steroid for the same duration. We recorded nasal endoscopy images and obtained demographical and clinical data, total nasal score (TNS), and nasal obstruction symptom evaluation (NOSE). We performed acoustic rhinometry and measured nasal inspiratory peak flow. Follow-up was 12 months. RESULTS We found that the recurrence of nasal polyps was significantly diminished, and based on video-endoscopic measurements, the size and grade of recurrent polyps were significantly smaller in the phototherapy-receiving group. Nasal obstruction values and NOSE were significantly better throughout the follow-up period in the mUV-VIS light-treated group than in the intranasal steroid monotreatment group. CONCLUSIONS Rhinophototherapy together with standard nasal steroid application may have a supportive role in the treatment of recurrent bilateral nasal polyps.
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Kamimura S, Kitamura Y, Fujii T, Okamoto K, Sanada N, Okajima N, Wakugawa T, Fukui H, Mizuguchi H, Takeda N. Effects of narrow-band UVB on nasal symptom and upregulation of histamine H 1 receptor mRNA in allergic rhinitis model rats. Laryngoscope Investig Otolaryngol 2021; 6:34-41. [PMID: 33614927 PMCID: PMC7883611 DOI: 10.1002/lio2.518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/14/2020] [Accepted: 12/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Phototherapy with narrow-band ultraviolet B (narrow-band UVB) is clinically effective treatment for atopic dermatitis. In the present study, we examined the effects of intranasal irradiation with narrow-band UVB on nasal symptom, upregulation of histamine H1 receptor (H1R) gene expression and induction of DNA damage in the nasal mucosa of allergic rhinitis (AR) model rat. METHODS AR model rats were intranasally irradiated with 310 nm of narrow-band UVB. Nasal mucosal levels of H1R mRNA were measured using real-time quantitative reverse transcriptase (RT)-PCR. DNA damage was evaluated using cyclobutane pyrimidine dimer (CPD) immunostaining. RESULTS In toluene 2,4-diisocyanate (TDI)-sensitized rats, TDI provoked sneezes and H1R gene expression in the nasal mucosa. Intranasal pre-irradiation with 310 nm narrow-band UVB at doses of 600 and 1400, but not 200 mJ/cm2 significantly inhibited the number of sneezes and upregulation of H1R gene expression provoked by TDI. CPD-positive cells appeared in the nasal mucosa after intranasal narrow-band UVB irradiation at a dose of 1400, but not 200 and 600 mJ/cm2. The suppression of TDI-provoked sneezes and upregulation of H1R gene expression lasted 24 hours, but not 48 hours, after narrow-band UVB irradiation with a dose of 600 mJ/cm2. CONCLUSIONS Intranasal pre-irradiation with narrow-band UVB dose-dependently inhibited sneezes and upregulation of H1R gene expression of the nasal mucosa in AR model rats, suggesting that the inhibition of nasal upregulation of H1R gene expression suppressed nasal symptom. The suppression after narrow-band UVB irradiation at a dose of 600 mJ/cm2 was reversible without induction of DNA damage. These findings indicated that low-dose narrow-band UVB phototherapy could be effectively and safely used for AR treatment in a clinical setting. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Seiichiro Kamimura
- Department of OtolaryngologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Yoshiaki Kitamura
- Department of OtolaryngologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Tatsuya Fujii
- Department of OtolaryngologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Kentaro Okamoto
- Department of Molecular PharmacologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Nanae Sanada
- Department of Molecular PharmacologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Natsuki Okajima
- Department of Molecular PharmacologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Tomoharu Wakugawa
- Department of Molecular PharmacologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Hiroyuki Fukui
- Department of OtolaryngologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
| | - Hiroyuki Mizuguchi
- Laboratory of Pharmacology, Faculty of PharmacyOsaka Ohtani UniversityOsakaJapan
| | - Noriaki Takeda
- Department of OtolaryngologyInstitute of Biomedical Sciences, Tokushima University Graduate SchoolTokushimaJapan
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Hsue VB, Itamura K, Wu AW, Illing EA, Sokoloski KJ, Weaver BA, Anthony BP, Hughes N, Ting JY, Higgins TS. Topical Oral and Intranasal Antiviral Agents for Coronavirus Disease 2019 (COVID-19). ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1327:169-189. [PMID: 34279838 DOI: 10.1007/978-3-030-71697-4_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
With the largest viral loads in both symptomatic and asymptomatic patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) present in the oral and nasal cavities, agents that act on these two areas have the potential for large therapeutic and prophylactic benefit. A literature review was conducted to elucidate the possible agents useful in treatment of SARS-CoV-2. These agents were evaluated for their current applications, adverse reactions, their current state of study, and any future considerations in their management of coronavirus disease 2019 (COVID-2019). Our review has found that, while there are many promising agents with proven efficacy in their in-vitro efficacy against SARS-CoV-2, more clinical trials and in-vivo studies, as well as safety trials, must be conducted before these agents can be effectively implemented.
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Affiliation(s)
- Victor B Hsue
- Department of Otolaryngology-Head and Neck Surgery, Cedars Sinai, Los Angeles, CA, USA
| | - Kyohei Itamura
- Department of Otolaryngology-Head and Neck Surgery, Cedars Sinai, Los Angeles, CA, USA
| | - Arthur W Wu
- Department of Otolaryngology-Head and Neck Surgery, Cedars Sinai, Los Angeles, CA, USA
| | - Elisa A Illing
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - Kevin J Sokoloski
- Department of Microbiology and Immunology, University of Louisville, Louisville, KY, USA
| | - Bree A Weaver
- Division of Infectious Diseases, Departments of Internal Medicine and Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Benjamin P Anthony
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - Nathan Hughes
- Pharmacy Operations, Kindred Healthcare Support Center, Louisville, KY, USA
| | - Jonathan Y Ting
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - Thomas S Higgins
- Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville, Louisville, KY, USA. .,Rhinology, Sinus & Skull Base, Kentuckiana Ear, Nose, and Throat, Louisville, KY, USA.
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Kang J, Lee G, Kim J, Kim Y, Park S, Lee D. Effects and safety of intranasal phototherapy for allergic rhinitis: Study protocol for a single-center, randomized, double-blind, parallel, placebo-controlled, investigator-initiated, pilot study. Medicine (Baltimore) 2020; 99:e20835. [PMID: 32791671 PMCID: PMC7387024 DOI: 10.1097/md.0000000000020835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Allergic rhinitis (AR) is an immunoglobulin E (Ig E)-mediated inflammatory disease. Intranasal phototherapy is a promising treatment modality because it has a profound immunosuppressive effect, but the available evidence of its use for AR is insufficient. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. Our objective is to describe the protocol for a feasibility trial to assess the effects and safety of intranasal phototherapy for the treatment of AR. METHODS AND ANALYSIS This is a study protocol for a single-center, randomized, double-blind, parallel, placebo-controlled, investigator-initiated pilot study. A total of 40 patients with AR will be randomly assigned to the medical device or sham device group in a 1:1 ratio. The participants will receive intranasal phototherapy with a medical or sham device for 20 min 5 times a week for 2 weeks. The primary outcome will be the mean change in the Total Nasal Symptom Score (TNSS) from baseline to 2 weeks. The secondary outcomes will include the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, Nasal Endoscopy Index, total serum Ig E level, and eosinophil count. DISCUSSION The findings of this study will provide the basis for subsequent large-scale definitive RCTs to confirm the effects and safety of intranasal phototherapy for the treatment of nasal symptoms in patients with AR who do not respond well to conventional therapy. This study may assist in the development of noninvasive treatment for patients with AR. TRIAL REGISTRATION This study was registered at the Korean National Clinical Trial Registry, Clinical Research Information Service (KCT0003253).
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Affiliation(s)
- Jeongin Kang
- Department of Ophthalmology, Otolaryngology, and Dermatology, College of Korean Medicine, Woo-Suk University, Jeonju
| | - Goeun Lee
- Department of Oriental Rehabilitation, National Rehabilitation Center, Seoul
| | - Jeonghun Kim
- Evidence-Based Healthcare Research Collaborating Center, Woo-Suk University, Jeonju
| | - Youngeun Kim
- Future Medicine Division, Korea Institute of Oriental Medicine
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea
| | - Donghyo Lee
- Department of Ophthalmology, Otolaryngology, and Dermatology, College of Korean Medicine, Woo-Suk University, Jeonju
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Higgins TS, Wu AW, Illing EA, Sokoloski KJ, Weaver BA, Anthony BP, Hughes N, Ting JY. Intranasal Antiviral Drug Delivery and Coronavirus Disease 2019 (COVID-19): A State of the Art Review. Otolaryngol Head Neck Surg 2020; 163:682-694. [PMID: 32660339 DOI: 10.1177/0194599820933170] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To provide a state of the art review of intranasal antiviral drug delivery and to discuss current applications, adverse reactions, and future considerations in the management of coronavirus disease 2019 (COVID-19). DATA SOURCES PubMed, Embase, and Clinicaltrials.gov search engines. REVIEW METHODS A structured search of the current literature was performed of dates up to and including April 2020. Search terms were queried as related to topics of antiviral agents and intranasal applications. A series of video conferences was convened among experts in otolaryngology, infectious diseases, public health, pharmacology, and virology to review the literature and discuss relevant findings. CONCLUSIONS Intranasal drug delivery for antiviral agents has been studied for many years. Several agents have broad-spectrum antiviral activity, but they still require human safety and efficacy trials prior to implementation. Intranasal drug delivery has potential relevance for future clinical trials in the settings of disease spread prevention and treatment of SARS-CoV-2 and other viral diseases. IMPLICATIONS FOR PRACTICE Intranasal drug delivery represents an important area of research for COVID-19 and other viral diseases. The consideration of any potential adverse reactions is paramount.
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Affiliation(s)
- Thomas S Higgins
- Department of Otolaryngology-Head and Neck Surgery and Communica-tive Disorders, University of Louisville, Louisville, Kentucky, USA.,Rhinology, Sinus, and Skull Base, Kentuckiana Ear, Nose, and Throat, Louisville, Kentucky, USA
| | - Arthur W Wu
- Department of Otolaryngology-Head and Neck Surgery, Cedars Sinai, Los Angeles, California, USA
| | - Elisa A Illing
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
| | - Kevin J Sokoloski
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky, USA.,Center for Predictive Medicine and Emerging Infectious Diseases, University of Louisville, Louisville Kentucky, USA
| | - Bree A Weaver
- Division of Infectious Diseases, Departments of Internal Medicine and Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Benjamin P Anthony
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
| | - Nathan Hughes
- Pharmacy Operations, Kindred Healthcare Support Center, Louisville, Kentucky, USA
| | - Jonathan Y Ting
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
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Senturk E, Tugrul S, Doğan R, Eren SB, Ozturan O, Koçyiğit A, Kesgin S. Effect of Radiofrequency on DNA Damage and Oxidative Status in Patients with Turbinate Hypertrophy. Indian J Otolaryngol Head Neck Surg 2019; 71:1810-1815. [PMID: 31763251 DOI: 10.1007/s12070-017-1176-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 07/28/2017] [Indexed: 10/19/2022] Open
Abstract
The radiofrequency devices that are used generate radiofrequency in the frequency range of 1.5 and 2.5 MHz. This study aims to demonstrate whether systematic oxidative status and DNA are influenced in this frequency range. In study, 27 patients who received radiofrequency treatment on inferior turbinate as they were diagnosed with inferior turbinate hypertrophy. DNA damage was assessed by alkaline comet assay in peripheral lymphocyte cells. Plasma levels of total antioxidant status (TAS), total oxidative status (TOS) were determined by using an automated measurement method and oxidative stress index (OSI) was calculated (OSI was calculated as: OSI = (TOS/TAS) × 100). There were increased in the OSI and TOS values on days 1 and 15 as compared to the samples taken before the radiofrequency administration. Significant decreases were seen in TAS values on days 1 and 15. As for the DNA damage, no significant differences were found on day 15 compared to the preoperative values even though there was a statistically insignificant increase on day 1. Administration of radiofrequency radiation on inferior turbinates results in increased oxidative stress in the acute period and a decrease in the anti-oxidative system. Although this effect causes a slight increase in the DNA damage in the early post-operative period, the damage is restored to the pre-operative levels on day 15. Therefore, we believe that a more conservative approach should be selected for radiofrequency treatment instead of using it routinely.
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Affiliation(s)
- Erol Senturk
- Department of Otorhinolaryngology, Alaca State Hospital, Alaca, Corum, Turkey
| | - Selahattin Tugrul
- 2Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Remzi Doğan
- 2Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Sabri Baki Eren
- 2Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Orhan Ozturan
- 2Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Abdurrahim Koçyiğit
- 3Department of Medical Biochemistry, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Sıddıka Kesgin
- 3Department of Medical Biochemistry, Bezmialem Vakif University, Fatih, Istanbul, Turkey
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Fujii T, Kitamura Y, Mizuguchi H, Okamoto K, Sanada N, Yamada T, Sugiyama M, Michinaga S, Kitayama M, Fukui H, Takeda N. Effects of irradiation with narrowband-ultraviolet B on up-regulation of histamine H 1 receptor mRNA and induction of apoptosis in HeLa cells and nasal mucosa of rats. J Pharmacol Sci 2018; 138:54-62. [PMID: 30301597 DOI: 10.1016/j.jphs.2018.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 08/21/2018] [Accepted: 08/28/2018] [Indexed: 01/01/2023] Open
Abstract
Narrowband-ultraviolet B (NB-UVB) phototherapy is used for the treatment of atopic dermatitis. Previously, we reported that irradiation with 200 mJ/cm2 of 310 nm NB-UVB suppressed phorbol-12-myristate-13-acetate (PMA)-induced up-regulation of histamine H1 receptor (H1R) gene expression without induction of apoptosis in HeLa cells. However, the effect of NB-UVB irradiation on nasal symptoms is still unclear. Here, we show that low dose irradiation with 310 nm NB-UVB alleviates nasal symptoms in toluene 2,4-diisocyanate (TDI)-sensitized allergy model rats. Irradiation with 310 nm NB-UVB suppressed PMA-induced H1R mRNA up-regulation in HeLa cells dose-dependently at doses of 75-200 mJ/cm2 and reversibly at a dose of 150 mJ/cm2 without induction of apoptosis. While, at doses of more than 200 mJ/cm2, irradiation with 310 nm NB-UVB induced apoptosis. Western blot analysis showed that the suppressive effect of NB-UVB irradiation on H1R gene expression was through the inhibition of ERK phosphorylation. In TDI-sensitized rat, intranasal irradiation with 310 nm NB-UVB at an estimated dose of 100 mJ/cm2 once a day for three days suppressed TDI-induced sneezes and up-regulation of H1R mRNA in nasal mucosa without induction of apoptosis. These findings suggest that repeated intranasal irradiation with low dose of NB-UVB could be clinically used as phototherapy of AR.
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Affiliation(s)
- Tatsuya Fujii
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Yoshiaki Kitamura
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan.
| | - Hiroyuki Mizuguchi
- Laboratory of Pharmacology, Faculty of Pharmacy, Osaka Ohtani University, Osaka, 584-8540, Japan
| | - Kentaro Okamoto
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Nanae Sanada
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Takuya Yamada
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan; Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Manabu Sugiyama
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Shotaro Michinaga
- Laboratory of Pharmacology, Faculty of Pharmacy, Osaka Ohtani University, Osaka, 584-8540, Japan
| | - Mika Kitayama
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Hiroyuki Fukui
- Molecular Studies for Incurable Diseases, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
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Kiricsi Á, Tiszlavicz L, Rázga Z, Krasznai M, Vóna I, Hirschberg A, Szabó Z, Kemény L, Rovó L, Kadocsa E, Bella Z. Prospective, multicenter, randomized clinical study to evaluate the clinical efficacy and tolerability of long term mixed ultraviolet and visible light phototherapy in eosinophil nasal polyps. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 176:118-123. [DOI: 10.1016/j.jphotobiol.2017.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 09/21/2017] [Accepted: 09/28/2017] [Indexed: 01/18/2023]
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Bella Z, Kiricsi Á, Viharosné ÉDR, Dallos A, Perényi Á, Kiss M, Koreck A, Kemény L, Jóri J, Rovó L, Kadocsa E. Rhinophototherapy in persistent allergic rhinitis. Eur Arch Otorhinolaryngol 2016; 274:1543-1550. [PMID: 27864672 DOI: 10.1007/s00405-016-4358-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
Previous published results have revealed that Rhinolight® intranasal phototherapy is safe and effective in intermittent allergic rhinitis. The present objective was to assess whether phototherapy is also safe and effective in persistent allergic rhinitis. Thirty-four patients with persistent allergic rhinitis were randomized into two groups; twenty-five subjects completed the study. The Rhinolight® group was treated with a combination of UV-B, UV-A, and high-intensity visible light, while the placebo group received low-intensity visible white light intranasal phototherapy on a total of 13 occasions in 6 weeks. The assessment was based on the diary of symptoms, nasal inspiratory peak flow, quantitative smell threshold, mucociliary transport function, and ICAM-1 expression of the epithelial cells. All nasal symptom scores and nasal inspiratory peak flow measurements improved significantly in the Rhinolight® group relative to the placebo group and this finding persisted after 4 weeks of follow-up. The smell and mucociliary functions did not change significantly in either group. The number of ICAM-1 positive cells decreased non-significantly in the Rhinolight® group. No severe side-effects were reported during the treatment period. These results suggest that Rhinolight® treatment is safe and effective in persistent allergic rhinitis.
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Affiliation(s)
- Zsolt Bella
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary.
| | - Ágnes Kiricsi
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - Éva Dósa-Rácz Viharosné
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Attila Dallos
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Ádám Perényi
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - Mária Kiss
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Andrea Koreck
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - József Jóri
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - László Rovó
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - Edit Kadocsa
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
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Surda P, Fokkens WJ. Novel, Alternative, and Controversial Therapies of Rhinitis. Immunol Allergy Clin North Am 2016; 36:401-23. [PMID: 27083111 DOI: 10.1016/j.iac.2015.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Rhinitis is a multifactorial disease characterized by sneezing, rhinorrhea, postnasal drip, and nasal congestion. This condition affects 10% to 40% of the population and is responsible for billions of spent health care dollars and impairment in quality of life for those affected. Currently available medical and vaccine therapies are effective for a large segment of this population; however, a subset of patients still has difficult-to-control rhinitis. This article reviews the current progress being made in novel drug and vaccine development and delves into alternative medical, surgical, and homeopathic strategies that may be promising adjunctive treatments for the difficult-to-treat rhinitis patient.
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Affiliation(s)
- Pavol Surda
- Department of Otorhinolaryngology, Academic Medical Center, Meibergdreef 29, Amsterdam 1105 AZ, The Netherlands
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Meibergdreef 29, Amsterdam 1105 AZ, The Netherlands.
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15
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Rojas E, Lorenzo Y, Haug K, Nicolaissen B, Valverde M. Epithelial cells as alternative human biomatrices for comet assay. Front Genet 2014; 5:386. [PMID: 25506353 PMCID: PMC4246922 DOI: 10.3389/fgene.2014.00386] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 10/22/2014] [Indexed: 01/01/2023] Open
Abstract
The comet assay is a valuable experimental tool aimed at mapping DNA damage in human cells in vivo for environmental and occupational monitoring, as well as for therapeutic purposes, such as storage prior to transplant, during tissue engineering, and in experimental ex vivo assays. Furthermore, due to its great versatility, the comet assay allows to explore the use of alternative cell types to assess DNA damage, such as epithelial cells. Epithelial cells, as specialized components of many organs, have the potential to serve as biomatrices that can be used to evaluate genotoxicity and may also serve as early effect biomarkers. Furthermore, 80% of solid cancers are of epithelial origin, which points to the importance of studying DNA damage in these tissues. Indeed, studies including comet assay in epithelial cells have either clear clinical applications (lens and corneal epithelial cells) or examine genotoxicity within human biomonitoring and in vitro studies. We here review improvements in determining DNA damage using the comet assay by employing lens, corneal, tear duct, buccal, and nasal epithelial cells. For some of these tissues invasive sampling procedures are needed. Desquamated epithelial cells must be obtained and dissociated prior to examination using the comet assay, and such procedures may induce varying amounts of DNA damage. Buccal epithelial cells require lysis enriched with proteinase K to obtain free nucleosomes. Over a 30 year period, the comet assay in epithelial cells has been little employed, however its use indicates that it could be an extraordinary tool not only for risk assessment, but also for diagnosis, prognosis of treatments and diseases.
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Affiliation(s)
- Emilio Rojas
- Depto. Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México México, México
| | - Yolanda Lorenzo
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital, Ullevål, University of Oslo Oslo, Norway
| | - Kristiane Haug
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital, Ullevål, University of Oslo Oslo, Norway
| | - Bjørn Nicolaissen
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital, Ullevål, University of Oslo Oslo, Norway
| | - Mahara Valverde
- Depto. Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México México, México
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16
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Intranasal phototherapy versus azelastine in the treatment of seasonal allergic rhinitis. Auris Nasus Larynx 2013; 40:447-51. [DOI: 10.1016/j.anl.2012.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/07/2012] [Accepted: 11/09/2012] [Indexed: 11/21/2022]
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17
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Agrawal A, Shindell E, Jordan F, Baeva L, Pfefer J, Godar DE. UV Radiation Increases Carcinogenic Risks for Oral Tissues Compared to Skin. Photochem Photobiol 2013; 89:1193-8. [DOI: 10.1111/php.12140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 07/09/2013] [Indexed: 12/17/2022]
Affiliation(s)
- Anant Agrawal
- US Food and Drug Administration; Center for Devices and Radiological Health; Silver Spring; MD
| | | | - Fredrick Jordan
- US Food and Drug Administration; Center for Devices and Radiological Health; Silver Spring; MD
| | - Larissa Baeva
- US Food and Drug Administration; Center for Devices and Radiological Health; Silver Spring; MD
| | - Joshua Pfefer
- US Food and Drug Administration; Center for Devices and Radiological Health; Silver Spring; MD
| | - Dianne E. Godar
- US Food and Drug Administration; Center for Devices and Radiological Health; Silver Spring; MD
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18
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Effects of rhinophototherapy on quality of life in persistant allergic rhinitis. Clin Exp Otorhinolaryngol 2013; 6:73-7. [PMID: 23799163 PMCID: PMC3687065 DOI: 10.3342/ceo.2013.6.2.73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 06/23/2012] [Accepted: 07/18/2012] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the effect of rhinophototherapy with medical therapy on quality of life in persistent allergic rhinitis. Methods A prospective, randomized study was being performed between December 2009 and March 2010. The study included 65 patients with persistent allergic rhinitis. The diagnosis was confirmed with positive skin tests. All of the patients had house dust mite allergies. We divided the patients into two groups. First group (n=33) was given topical mometasone furoate 200 mcg/day and levocetirizine 5 mg/day for a month. Rhinophototherapy was applied with the same medical therapy to the second group (n=32), twice a week for three weeks continuously. Rhinophototherapy included visible light, ultraviolet A and ultraviolet B. We evaluated patients before the treatment, at the first month and at the third month after treatment with rhinoconjunctivitis quality of life questionnaire, nasal symptom scores and visual analogue scale (VAS) scores. Results Improvements of all variables of the quality of life questionnaire, nasal symptom scores and VAS were statistically significant in the second group both on the first and the third months when compared with the first group. Conclusion Allergic rhinitis is a social problem and impairs quality of life. Rhinophototherapy with medical therapy improves the quality of life in allergic rhinitis.
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19
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Moustafa Y, Kassab AN, El Sharnoubi J, Yehia H. Comparative study in the management of allergic rhinitis in children using LED phototherapy and laser acupuncture. Int J Pediatr Otorhinolaryngol 2013; 77:658-65. [PMID: 23394792 DOI: 10.1016/j.ijporl.2013.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/05/2013] [Accepted: 01/09/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this study was to compare the outcomes of LED phototherapy and laser acupuncture treatment on allergic rhinitis in children. METHODS 40 patients with perennial allergic rhinitis were divided randomly into two groups. Patient's ages ranged from 7 to 18 years. One group was subjected to LED phototherapy and the other group was managed by laser acupuncture .The patients were followed-up for 1 year. RESULTS There was a significant improvement in the severity score symptoms in both groups through and by the end of the follow up period. CONCLUSION This led to the conclusion that both techniques are equally safe, reliable, non invasive and successful.
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Affiliation(s)
- Yousry Moustafa
- Otorhinolaryngology Unit, Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Egypt
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20
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Breger J, Baeva L, Agrawal A, Shindell E, Godar DE. UVB-induced inflammatory cytokine release, DNA damage and apoptosis of human oral compared with skin tissue equivalents. Photochem Photobiol 2013; 89:665-70. [PMID: 23253030 DOI: 10.1111/php.12030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 12/03/2012] [Indexed: 01/09/2023]
Abstract
People can get oral cancers from UV (290-400 nm) exposures. Besides high outdoor UV exposures, high indoor UV exposures to oral tissues can occur when consumers use UV-emitting tanning devices to either tan or whiten their teeth. We compared the carcinogenic risks of skin to oral tissue cells after UVB (290-320 nm) exposures using commercially available 3D-engineered models for human skin (EpiDerm™), gingival (EpiGing™) and oral (EpiOral™) tissues. To compare the relative carcinogenic risks, we investigated the release of cytokines, initial DNA damage in the form of cyclobutane pyrimidine dimers (CPDs), repair of CPDs and apoptotic cell numbers. We measured cytokine release using cytometric beads with flow cytometry and previously developed a fluorescent immunohistochemical assay to quantify simultaneously CPD repair rates and apoptotic cell numbers. We found that interleukin-8 (IL-8) release and the initial CPDs are significantly higher, whereas the CPD repair rates and apoptotic cell numbers are significantly lower for oral compared with skin tissue cells. Thus, the increased release of the inflammatory cytokine IL-8 along with inefficient CPD repair and decreased death rates for oral compared with skin tissue cells suggests that mutations are accumulating in the surviving population of oral cells increasing people's risks for getting oral cancers.
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21
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Lee HM, Park MS, Park IH, Lee SH, Lee SK, Kim KS, Choi H. A comparative pilot study of symptom improvement before and after phototherapy in Korean patients with perennial allergic rhinitis. Photochem Photobiol 2013; 89:751-7. [PMID: 23253070 DOI: 10.1111/php.12032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 12/05/2012] [Indexed: 11/30/2022]
Abstract
Although allergic rhinitis is not life threatening, it significantly influences the quality of a patient's life. This study is intended to evaluate the safety and efficacy of phototherapy with low-level energy of a 650 nm laser irradiation system in perennial allergic rhinitis patients. This clinical trial was an open-label, single-center study with 42 perennial allergic rhinitis subjects. Following laser irradiation in the nasal cavity with a laser irradiation system, the efficacy at weeks 1 through 4 was determined. The symptoms were scored with four parameters (nasal obstruction, rhinorrhea, sneezing and itching) before and after illumination of the laser, and the total score was recorded. A survey of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was conducted by patients before and after treatment. Following treatment, significant improvement in the clinical symptoms of nasal obstruction (P < 0.001), rhinorrhea (P = 0.005), sneezing (P = 0.001) and itching (P = 0.003) was reported by 68% of perennial allergic rhinitis patients. The overall RQLQ scores significantly improved by 45% from the baseline with the treatment after 4 weeks. These results indicate that phototherapy is an effective modality for treating perennial allergic rhinitis and is another option in the steroid-free management of immune-mediated mucosal diseases.
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Affiliation(s)
- Heung-Man Lee
- Medical Devices Clinical Trial Center, Guro Hospital, Korea University, Seoul, Korea
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22
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Németh IB, Zsíros O, Koreck A, Bella Z, Kiricsi Á, Ignácz F, Kadocsa E, Kemény L. Ultraviolet light and photodynamic therapy induce apoptosis in nasal polyps. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2012; 117:179-84. [DOI: 10.1016/j.jphotobiol.2012.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 09/16/2012] [Accepted: 09/25/2012] [Indexed: 12/12/2022]
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23
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Mitchell D, Paniker L, Godar D. Nucleotide excision repair is reduced in oral epithelial tissues compared with skin. Photochem Photobiol 2012; 88:1027-32. [PMID: 22519509 DOI: 10.1111/j.1751-1097.2012.01163.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ultraviolet radiation (UVR) exposure to internal tissues for diagnostic, therapeutic and cosmetic procedures has increased dramatically over the past decade. The greatest increase in UVR exposure of internal tissues occurs in the cosmetic industry where it is combined with oxidizing agents for teeth whitening, often in conjunction with indoor tanning. To address potential carcinogenic risks of these procedures, we analyzed the formation and repair of the DNA photoproducts associated with the signature mutations of UVR. Radioimmunoassay was used to quantify the induction and repair of cyclobutane pyrimidine dimers and pyrimidine(6-4)pyrimidone photoproducts in DNA purified from three reconstructed tissues, EpiDerm(TM) , EpiGingival(TM) and EpiOral(TM) . We observed comparable levels of DNA damage in all tissues immediately after UVR exposure. In contrast, repair was significantly reduced in both oral tissues compared with EpiDerm(TM) . Our data suggest that UVR exposure of oral tissues can result in accumulation of DNA damage and increase the risk for carcinoma and melanoma of the mouth. Because NER is a broad-spectrum defense against DNA damage caused by a variety of agents in addition to UVR, our data suggest that the relatively low NER efficiency observed in oral tissues may have wide-ranging consequences in this highly exposed environment.
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Affiliation(s)
- David Mitchell
- Department of Carcinogenesis, University of Texas MD Anderson Cancer Center, Smithville, TX, USA.
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24
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Histopathological evaluation of the effect of intranasal phototherapy on nasal mucosa in rabbits. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2011; 105:94-7. [PMID: 21890373 DOI: 10.1016/j.jphotobiol.2011.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 07/20/2011] [Accepted: 07/25/2011] [Indexed: 11/21/2022]
Abstract
Allergic rhinitis is a high-incidence allergic inflammation of the nasal airways that impacts quality of life. Of the numerous therapies used to treat allergic rhinitis, intranasal phototherapy has emerged as a promising new treatment modality for inflammatory airway disease. Phototherapy is widely used for the treatment of immune-mediated skin diseases because its profound immunosuppressive effect inhibits hypersensitivity reactions in the skin. Intranasal phototherapy using a combination of Ultraviolet-A (UVA) and Ultraviolet-B (UVB) plus Visible light (VIS) has been shown to suppress the clinical symptoms of allergic rhinitis, but limited data regarding its adverse effects on the nasal mucosa currently exists. In this study, we demonstrate that UV displays no harmful effects on the nasal mucosa cells of rabbits following 2 weeks of intranasal phototherapy.
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25
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Knasmueller S, Holland N, Wultsch G, Jandl B, Burgaz S, Misík M, Nersesyan A. Use of nasal cells in micronucleus assays and other genotoxicity studies. Mutagenesis 2011; 26:231-8. [PMID: 21164207 DOI: 10.1093/mutage/geq079] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Genotoxicity experiments with exfoliated nasal mucosa cells are a promising minimally invasive approach for the detection of DNA-damaging compounds in ambient air. Results of single cell gel electrophoresis (SCGE) assays with individual cells and organ cultures from bioptic material show that DNA damage caused by compounds such as nitrosamines, polycyclic aromatic hydrocarbons and pesticides can be detected. Biochemical studies indicate that enzymes involved in the metabolism of environmental mutagens are represented in nasal cells. Several protocols for experiments with nasal cells have been developed and it was shown that formaldehyde, metals, styrene and crystalline silica induce DNA damage in SCGE and/or in micronucleus studies; furthermore, it was also found that polluted urban air causes DNA instability in nasal epithelial cells. Comparisons of these data with results obtained in lymphocytes and buccal cells indicate that nasal cells are in general equally sensitive. Broad variations in the baseline levels, differences of results obtained in various studies as well as the lack of information concerning the impact of confounding factors on the outcome of experiments with these cells indicate the need for further standardisation of the experimental protocols.
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Affiliation(s)
- Siegfried Knasmueller
- Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna, Borschkegasse 8a, A-1090 Vienna, Austria.
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Garaczi E, Boros-Gyevi M, Bella Z, Csoma Z, Kemény L, Koreck A. Intranasal phototherapy is more effective than fexofenadine hydrochloride in the treatment of seasonal allergic rhinitis: results of a pilot study. Photochem Photobiol 2011; 87:474-7. [PMID: 21366599 DOI: 10.1111/j.1751-1097.2010.00882.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We recently showed that intranasal phototherapy represents an efficient therapeutic modality for the treatment of patients with seasonal allergic rhinitis (SAR). The aim of this pilot study was to compare the efficacy of intranasal phototherapy with that of the new generation antihistamine fexofenadine HCl in SAR. A randomized open study was conducted in patients with a history of moderate-to-severe ragweed-induced SAR. Thirty-one patients were randomly assigned to receive either intranasal irradiation three times a week for 2 weeks, or 180 mg fexofenadine HCl per day for 2 weeks. Each patient kept a diary of symptoms for nasal obstruction, nasal itching, rhinorrhea, sneezing and palate itching. Total nasal score (TNS), a sum of scores for nasal symptoms, was also calculated. In the rhinophototherapy group the individual scores significantly decreased compared with baseline for all of the parameters. In the fexofenadine HCl group none of the scores improved significantly at the end of the treatment except sneezing. TNS was significantly decreased in the rhinophototherapy group, but no significant change was observed in the fexofenadine HCl group after 2 weeks of treatment. In conclusion, we found that intranasal phototherapy is more efficient than fexofenadine HCl in reducing clinical symptoms for SAR.
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Affiliation(s)
- Edina Garaczi
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.
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27
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Cingi C, Cakli H, Yaz A, Songu M, Bal C. Phototherapy for allergic rhinitis: a prospective, randomized, single-blind, placebo-controlled study. Ther Adv Respir Dis 2010; 4:209-13. [DOI: 10.1177/1753465810374610] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Phototherapy has a profound immunosuppressive effect, and phototherapeutic methods using both ultraviolet (UV) and visible light are therefore widely used for the therapy of various inflammatory skin diseases. It is also proposed that phototherapy, using a combination of UV-A (25%), UV-B (5%) and visible light (70%), may represent a therapeutic alternative in patients with allergic rhinitis. Method: Seventy-nine patients were randomly assigned to receive either a combination of UV-A (25%), UV-B (5%) and visible light (70%), in the phototherapy group, or low-intensity visible light, in the control group. The efficacy of treatment was assessed by means of total nasal symptom score before treatment and 1 month after the end of treatment. Results: Total nasal scores decreased in both groups but the decrease was highly significant in the active treatment group when compared with the placebo (p < 0.001). Conclusions: This study demonstrates that phototherapy may be an effective modality in the treatment of allergic rhinitis especially in cases of which commonly used drugs either are contraindicated and/or have insufficient efficacy.
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Affiliation(s)
- Cemal Cingi
- Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey
| | - Hamdi Cakli
- Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey
| | - Aytekin Yaz
- Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey
| | - Murat Songu
- Department of Otorhinolaryngology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey/ Department of Otorhinolaryngology, Izmir Ataturk Research and Training Hospital, Izmir, Turkey
| | - Cengiz Bal
- Department of Biostatistics, Osmangazi University Medical Faculty, Eskisehir, Turkey
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Bella Z, Kadocsa E, Kemény L, Koreck A. Narrow-band UVB phototherapy of nasal polyps: results of a pilot study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 100:123-7. [PMID: 20566294 DOI: 10.1016/j.jphotobiol.2010.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Revised: 04/22/2010] [Accepted: 05/26/2010] [Indexed: 10/19/2022]
Abstract
Nasal polyposis (NP) is characterized by high recurrence rate despite medical and/or surgical treatment. The major mechanism of action of ultraviolet B light (UVB) is induction of apoptosis in inflammatory cells. Therefore phototherapy may represent a new therapeutic approach in NP. A pilot feasibility study was performed to assess the tolerability and clinical efficacy of UVB phototherapy in NP. Thirteen subjects with bilateral grade 1-3 NP were enrolled in an open-labeled prospective pilot study. Patients were exposed to gradually increasing doses of UVB light over a 12 week period (3 exposures/week). Subjects rated their nasal obstruction symptom scores weekly on a visual analogue scale from 0 to 6. The NOSE quality of life questionnaire was used at baseline and end of treatment period. Adverse events were monitored by endoscopy. Ten subjects completed the study. Nasal obstruction symptom scores and quality of life (NOSE) improved at end of treatment compared to baseline. Treatments were well tolerated and no device related adverse events were reported. The results suggest that phototherapy may represent a potential new treatment option in nasal polyps.
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Affiliation(s)
- Zsolt Bella
- Department of Otolaryngology, Head and Neck Surgery, University of Szeged, Hungary
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29
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Ferguson BJ, Otto BA, Pant H. When surgery, antibiotics, and steroids fail to resolve chronic rhinosinusitis. Immunol Allergy Clin North Am 2010; 29:719-32. [PMID: 19879446 DOI: 10.1016/j.iac.2009.07.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This article examines the modalities in the treatment of chronic rhinosinusitis (CRS). A correct diagnosis is the first requirement in the successful management of CRS. CRS-directed therapy might fail if the actual cause of symptoms is nonsinogenic. Nasal endoscopy and sinus computed tomography are the primary modalities used in the diagnosis of sinusitis. Allergy and gastroesophageal reflux, may not directly cause sinusitis, but they frequently mimic the symptoms of sinusitis. Therapy can include avoidance of allergens and desensitization in the former and antireflux therapy in the latter. Underlying systemic causes of refractory sinusitis include immunodeficiency and systemic granulomatous and eosinophilic syndromes. Correct diagnosis is essential to directed therapy. Patients with aspirin exacerbated respiratory disease may benefit from aspirin desensitization. Optimization of mucociliary clearance can be augmented with nasal lavage and mucolytics. Additional nonsteroidal antiinflammatory modalities include use of the leukotriene modulators, montelukast and zileuton. Patients with elevated IgE may benefit from omalizumab (anti-IgE); however, cost constraints restrict use to those patients who have severe asthma. This article also includes management strategies beyond the usual antibiotics, steroids, and sinus surgery. Once immunodeficiency and confounding local mimics of sinusitis are addressed, additional interventions should be tried separately initially to assess the individual patient's response to therapy.
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Affiliation(s)
- Berrylin J Ferguson
- Division of Sinonasal Disorders and Allergy, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Mercy, 1400 Locust Street, Suite B11500, Pittsburgh, PA 15219, USA.
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30
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Brehmer D. Endonasal phototherapy with Rhinolight for the treatment of allergic rhinitis. Expert Rev Med Devices 2010; 7:21-6. [PMID: 20021238 DOI: 10.1586/erd.09.56] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Allergic rhinitis, although not life threatening, significantly affects the quality of the patient's daily life. The three major steps in the treatment of the condition are avoidance of allergens, treatment of symptoms (in particular, antihistaminics and topical nasal corticosteroids) and specific immunotherapy. Avoidance of the allergen is usually not possible and symptom relief is often limited, despite the availability of a number of pharmacological options. Specific immunotherapy demands a high level of cooperation on the part of the patient for at least 3 years. Endonasal phototherapy with the Rhinolight device (Rhinolight Ltd, Szeged, Hungary) for the treatment of immunoglobulin E-mediated allergic rhinitis is a new option that utilizes the immunosuppressive effects of UV radiation. The method directs a combination of UV-B (5%), UV-A (25%) and visible light (70%) into the nasal cavity, and its effectiveness has been demonstrated in one double-blind, placebo-controlled study. The results of additional studies have been presented at various medical conferences and in abstracts. Reports in the literature confirm that phototherapy is a well-established and successful treatment of atopic dermatitis and other skin diseases.
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Affiliation(s)
- Detlef Brehmer
- University of Witten/Herdecke, Faculty of Medicine, Friedrichstrasse 3/4, 37073 Goettingen, Germany.
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31
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The effects of phototherapy on quality of life in allergic rhinitis cases. Eur Arch Otorhinolaryngol 2009; 266:1903-8. [DOI: 10.1007/s00405-009-1048-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2009] [Accepted: 07/07/2009] [Indexed: 10/20/2022]
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32
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Complementary and alternative medicine for allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg 2009; 17:226-31. [DOI: 10.1097/moo.0b013e3283295791] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mitchell D, Paniker L, Sanchez G, Bella Z, Garaczi E, Szell M, Hamid Q, Kemeny L, Koreck A. Molecular response of nasal mucosa to therapeutic exposure to broad-band ultraviolet radiation. J Cell Mol Med 2008; 14:313-22. [PMID: 18671762 PMCID: PMC3837592 DOI: 10.1111/j.1582-4934.2008.00442.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Ultraviolet radiation (UVR) phototherapy is a promising new treatment for inflammatory airway diseases. However, the potential carcinogenic risks associated with this treatment are not well understood. UV-specific DNA photoproducts were used as biomarkers to address this issue. Radioimmunoassay was used to quantify cyclobutane pyrimidine dimers (CPDs) and (6–4) photoproducts in DNA purified from two milieus: nasal mucosa samples from subjects exposed to intranasal phototherapy and human airway (EpiAirway™) and human skin (EpiDerm™) tissue models. Immunohistochemistry was used to detect CPD formation and persistence in human nasal biopsies and human tissue models. In subjects exposed to broadband ultraviolet radiation, DNA damage frequencies were determined prior to as well as immediately after treatment and at increasing times post-treatment. We observed significant levels of DNA damage immediately after treatment and efficient removal of the damage within a few days. No residual damage was observed in human subjects exposed to multiple UVB treatments several weeks after the last treatment. To better understand the molecular response of the nasal epithelium to DNA damage, parallel experiments were conducted in EpiAirway and EpiDerm model systems. Repair rates in these two tissues were very similar and comparable to that observed in human skin. The data suggest that the UV-induced DNA damage response of respiratory epithelia is very similar to that of the human epidermis and that nasal mucosa is able to efficiently repair UVB induced DNA damage.
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Affiliation(s)
- David Mitchell
- Department of Carcinogenesis, University of Texas MD Anderson Cancer Center, Smithville, TX 78957, USA.
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34
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Photomedicine and LLLT Literature Watch. Photomed Laser Surg 2008; 26:71-2. [DOI: 10.1089/pho.2007.9978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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