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Cheon HL, Kizilova N, Flekkøy EG, Mason MJ, Folkow LP, Kjelstrup S. The nasal cavity of the bearded seal: An effective and robust organ for retaining body heat and water. J Theor Biol 2024; 595:111933. [PMID: 39260737 DOI: 10.1016/j.jtbi.2024.111933] [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: 03/21/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/13/2024]
Abstract
We report the effects of varying physiological and other properties on the heat and water exchange in the maxilloturbinate structure (MT) of the bearded seal (Erignathus barbatus or Eb) in realistic environments, using a computational fluid dynamics (CFD) model. We find that the water retention in percent is very high (about 90 %) and relatively unaffected by either cold (-30 °C) or warm (10 °C) conditions. The retention of heat is also high, around 80 % . Based on a consideration of entropy production by the maxilloturbinate system, we show that anatomical and physiological properties of the seal provide good conditions for heat and water exchange at the mucus lining in the seal's nasal cavity. At normal values of tidal volume and maxilloturbinate (MT) length, the air temperature in the MT reaches the body temperature before the air has left the MT channels. This confers a safety factor which is expected to be helpful in exercise, when ventilation increases.
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Affiliation(s)
- Hyejeong Lee Cheon
- Department of Physics, Norwegian University of Science and Technology, NTNU, Høgskoleringen 5, Trondheim, NO-7491, Norway
| | - Nataliya Kizilova
- PoreLab, Department of Physics, Norwegian University of Science and Technology, NTNU, Høgskoleringen 5, Trondheim, NO-7491, Norway; Institute of Aeronautics and Applied Mechanics, Warsaw University of Technology, Nowowiejska 24, Warsaw, 00-665, Poland
| | - Eirik G Flekkøy
- PoreLab, Department of Physics, University of Oslo, Sem Sælandsvei 24, Oslo, N-0371, Norway; PoreLab, Department of Chemistry, Norwegian University of Science and Technology, NTNU, Høgskoleringen 5, Trondheim, NO-7491, Norway
| | - Matthew J Mason
- Department of Physiology, Development & Neuroscience, University of Cambridge, Cambridge, CB2 3EG, UK
| | - Lars P Folkow
- Department of Arctic and Marine Biology, UiT - the Arctic University of Norway, Framstredet 39, Tromsø, 9019, Norway
| | - Signe Kjelstrup
- PoreLab, Department of Chemistry, Norwegian University of Science and Technology, NTNU, Høgskoleringen 5, Trondheim, NO-7491, Norway.
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Benlarbi M, Ding S, Bélanger É, Tauzin A, Poujol R, Medjahed H, El Ferri O, Bo Y, Bourassa C, Hussin J, Fafard J, Pazgier M, Levade I, Abrams C, Côté M, Finzi A. Temperature-dependent Spike-ACE2 interaction of Omicron subvariants is associated with viral transmission. mBio 2024; 15:e0090724. [PMID: 38953636 PMCID: PMC11323525 DOI: 10.1128/mbio.00907-24] [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: 03/26/2024] [Accepted: 05/27/2024] [Indexed: 07/04/2024] Open
Abstract
The continued evolution of severe acute respiratory syndrome 2 (SARS-CoV-2) requires persistent monitoring of its subvariants. Omicron subvariants are responsible for the vast majority of SARS-CoV-2 infections worldwide, with XBB and BA.2.86 sublineages representing more than 90% of circulating strains as of January 2024. To better understand parameters involved in viral transmission, we characterized the functional properties of Spike glycoproteins from BA.2.75, CH.1.1, DV.7.1, BA.4/5, BQ.1.1, XBB, XBB.1, XBB.1.16, XBB.1.5, FD.1.1, EG.5.1, HK.3, BA.2.86 and JN.1. We tested their capacity to evade plasma-mediated recognition and neutralization, binding to angiotensin-converting enzyme 2 (ACE2), their susceptibility to cold inactivation, Spike processing, as well as the impact of temperature on Spike-ACE2 interaction. We found that compared to the early wild-type (D614G) strain, most Omicron subvariants' Spike glycoproteins evolved to escape recognition and neutralization by plasma from individuals who received a fifth dose of bivalent (BA.1 or BA.4/5) mRNA vaccine and improve ACE2 binding, particularly at low temperatures. Moreover, BA.2.86 had the best affinity for ACE2 at all temperatures tested. We found that Omicron subvariants' Spike processing is associated with their susceptibility to cold inactivation. Intriguingly, we found that Spike-ACE2 binding at low temperature was significantly associated with growth rates of Omicron subvariants in humans. Overall, we report that Spikes from newly emerged Omicron subvariants are relatively more stable and resistant to plasma-mediated neutralization, present improved affinity for ACE2 which is associated, particularly at low temperatures, with their growth rates.IMPORTANCEThe persistent evolution of SARS-CoV-2 gave rise to a wide range of variants harboring new mutations in their Spike glycoproteins. Several factors have been associated with viral transmission and fitness such as plasma-neutralization escape and ACE2 interaction. To better understand whether additional factors could be of importance in SARS-CoV-2 variants' transmission, we characterize the functional properties of Spike glycoproteins from several Omicron subvariants. We found that the Spike glycoprotein of Omicron subvariants presents an improved escape from plasma-mediated recognition and neutralization, Spike processing, and ACE2 binding which was further improved at low temperature. Intriguingly, Spike-ACE2 interaction at low temperature is strongly associated with viral growth rate, as such, low temperatures could represent another parameter affecting viral transmission.
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Affiliation(s)
- Mehdi Benlarbi
- Centre de Recherche du CHUM, Montréal, Québec, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Shilei Ding
- Centre de Recherche du CHUM, Montréal, Québec, Canada
| | - Étienne Bélanger
- Centre de Recherche du CHUM, Montréal, Québec, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Alexandra Tauzin
- Centre de Recherche du CHUM, Montréal, Québec, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Raphaël Poujol
- Montreal Heart Institute, Research Center, Montreal, Quebec, Canada
| | | | - Omar El Ferri
- Department of Biochemistry, Microbiology and Immunology, Centre for Infection, Immunity and Inflammation, University of Ottawa, Ottawa, Ontario, Canada
| | - Yuxia Bo
- Department of Biochemistry, Microbiology and Immunology, Centre for Infection, Immunity and Inflammation, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Julie Hussin
- Montreal Heart Institute, Research Center, Montreal, Quebec, Canada
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Mila—Quebec AI institute, Montreal, Quebec, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Québec, Canada
| | - Marzena Pazgier
- Infectious Disease Division, Department of Medicine of Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Inès Levade
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Québec, Canada
| | - Cameron Abrams
- Department of Biochemistry and Molecular Biology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Marceline Côté
- Department of Biochemistry, Microbiology and Immunology, Centre for Infection, Immunity and Inflammation, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrés Finzi
- Centre de Recherche du CHUM, Montréal, Québec, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
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Robertson J, Abaidoo CS, Okwan DK, Tetteh J, Adjei-Antwi C, Bempah S, Ampofo M. Nasal Anthropometry: An Assessment Among the Akan and Ewe Ethnic Groups in Ghana. BIOMED RESEARCH INTERNATIONAL 2024; 2024:7508791. [PMID: 39130534 PMCID: PMC11315967 DOI: 10.1155/2024/7508791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/25/2024] [Accepted: 07/08/2024] [Indexed: 08/13/2024]
Abstract
The distribution of nasal types has been reported to be influenced by climatic adaptation as the nose is involved in conditioning inhaled air. Previous studies have reported differential nasal types and dimensions among varying populations which is very beneficial in planning for rhinoplasty and in forensic identification. However, there is inadequate data on nasal types and dimensions of the various ethnic groups in the Ghanaian population. Since it is inappropriate to apply nasal dimensions of one ethnic group to another, the current study sought to assess the nasal types and dimensions of Akans and Ewes in the Ghanaian population. Nasal height, nasal length, nasal tip protrusion, morphological nose width, and anatomical nose width were measured from 202 participants (116 Akans and 86 Ewes) aged 18-27 years belonging to the Akan and Ewe ethnic groups. Nasal index was calculated, and the frequencies of the nasal types among the two ethnic groups were determined. Ewe significantly had greater nasal length and nasal tip protrusion than the Akans. For both ethnic groups, sexual dimorphism was observed in morphological nose width and anatomical nose width, with males having greater values than females. The platyrrhine (broad nose) nasal type was predominant among the Akan and Ewe ethnic groups. The average nasal dimensions of the Akan and Ewe ethnic groups for the Ghanaian population have been reported in the present study, which will be useful in rhinoplasty intended for individuals belonging to these ethnic groups and in identification.
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Affiliation(s)
- Juliet Robertson
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Chrissie Stansie Abaidoo
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Kobina Okwan
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joshua Tetteh
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Collins Adjei-Antwi
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Bempah
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Ampofo
- Department of AnatomySchool of Medicine and DentistryKwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Sadry S, Ok U, Özdaş DÖ. Is there a relationship of nasal septum deviation with pharyngeal airway dimension and craniocervical posture? Cranio 2024; 42:461-469. [PMID: 34720059 DOI: 10.1080/08869634.2021.1995223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effects of nasal septum deviation on the pharyngeal airway and craniocervical posture measurements using cone beam computed tomography (CBCT). METHODS This retrospective study analyzed the CBCTs of 25 patients with and without nasal septum deviation. Various parameters defining the pharyngeal airway and craniocervical and facial skeletal morphology were measured and compared between the groups after confirming intra-examiner reliability. RESULTS Compared to the control group, the group with nasal septum deviation had a statistically significantly shorter nasopharyngeal length (p < 0.001), longer vertical airway length (p < 0.002), and larger cervical column curvature angle (p < 0.006). CONCLUSION Children with a nasal septum deviation of 4 mm or more on their CBCT scan are susceptible to unfavorable pharyngeal airway and craniocervical postural changes.
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Affiliation(s)
- Sanaz Sadry
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydin Universty, Istanbul, Turkey
| | - Ufuk Ok
- Department of Orthodontics, Faculty of Dentistry, Istanbul Gelişim Universty, Istanbul, Turkey
| | - Didem Öner Özdaş
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Aydin Universty, Istanbul, Turkey
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Bastir M, Sanz-Prieto D, Burgos MA, Pérez-Ramos A, Heuzé Y, Maréchal L, Evteev A, Toro-Ibacache V, Esteban-Ortega F. Beyond skeletal studies: A computational analysis of nasal airway function in climate adaptation. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 184:e24932. [PMID: 38516761 DOI: 10.1002/ajpa.24932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 03/01/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Ecogeographic variation in human nasal anatomy has historically been analyzed on skeletal morphology and interpreted in the context of climatic adaptations to respiratory air-conditioning. Only a few studies have analyzed nasal soft tissue morphology, actively involved in air-conditioning physiology. MATERIALS AND METHODS We used in vivo computer tomographic scans of (N = 146) adult individuals from Cambodia, Chile, Russia, and Spain. We conducted (N = 438) airflow simulations during inspiration using computational fluid dynamics to analyze the air-conditioning capacities of the nasal soft tissue in the inflow, functional, and outflow tract, under three different environmental conditions: cold-dry; hot-dry; and hot-humid. We performed statistical comparisons between populations and sexes. RESULTS Subjects from hot-humid regions showed significantly lower air-conditioning capacities than subjects from colder regions in all the three conditions, specifically within the isthmus region in the inflow tract, and the anterior part of the internal functional tract. Posterior to the functional tract, no differences were detected. No differences between sexes were found in any of the tracts and under any of the conditions. DISCUSSION Our statistical analyses support models of climatic adaptations of anterior nasal soft tissue morphology that fit with, and complement, previous research on dry skulls. However, our results challenge a morpho-functional model that attributes air-conditioning capacities exclusively to the functional tract located within the nasal cavity. Instead, our findings support studies that have suggested that both, the external nose and the intra-facial soft tissue airways contribute to efficiently warming and humidifying air during inspiration. This supports functional interpretations in modern midfacial variation and evolution.
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Affiliation(s)
- Markus Bastir
- Paleoanthropology Group, Department of Paleobiology, National Museum of Natural Sciences-Spanish National Research Council, Madrid, Spain
| | - Daniel Sanz-Prieto
- Paleoanthropology Group, Department of Paleobiology, National Museum of Natural Sciences-Spanish National Research Council, Madrid, Spain
- Fluid Mechanics and Thermal Engineering Group, Department of Thermal and Fluid Engineering, Polytechnic University of Cartagena, Cartagena, Spain
- Department of Biology, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
| | - Manuel A Burgos
- Fluid Mechanics and Thermal Engineering Group, Department of Thermal and Fluid Engineering, Polytechnic University of Cartagena, Cartagena, Spain
| | - Alejandro Pérez-Ramos
- Paleobiology, Paleoclimatology, and Paleogeography Group, Department of Ecology and Geology, Faculty of Science, University of Málaga, Malaga, Spain
| | - Yann Heuzé
- CNRS, Ministère de la Culture, PACEA, Université de Bordeaux, Pessac, France
| | - Laura Maréchal
- CNRS, Ministère de la Culture, PACEA, Université de Bordeaux, Pessac, France
| | - Andrej Evteev
- Anuchin Research Institute and Museum of Anthropology, Lomonosov Moscow State University, Moscow, Russia
| | - Viviana Toro-Ibacache
- Center for Quantitative Analysis in Dental Anthropology, Faculty of Dentistry, University of Chile, Santiago, Chile
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Rigaut C, Giaprakis A, Deruyver L, Goole J, Lambert P, Haut B. The air conditioning in the nose of mammals depends on their mass and on their maximal running speed. Sci Rep 2024; 14:9053. [PMID: 38643255 PMCID: PMC11032399 DOI: 10.1038/s41598-024-59768-z] [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: 10/31/2023] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
The nose of the mammals is responsible for filtering, humidifying, and heating the air before entering the lower respiratory tract. This conditioning avoids, notably, dehydration of the bronchial and alveolar mucosa. However, since this conditioning is not perfect, exercising in cold air can induce lung inflammation, both for human and non-human mammals. This work aims to compare the air conditioning in the noses of various mammals during inspiration. We build our study on computational fluid dynamics simulations of the heat exchanges in the lumen of the upper respiratory tract of these mammals. These simulations show that the efficiency of the air conditioning in the nose during inspiration does not relate only to the mass m of the mammal but also to its maximal running speed v. More precisely, the results allow establishing a scaling law relating the efficiency of air conditioning in the nose of mammals to the ratio v / log 10 ( m ) . The simulations also correlate the resistance to the flow in the nose to the efficiency of this air conditioning. The obtained scaling law allows predicting the air temperature at the top of the trachea during inspiration for nasal-breathing mammals, and thus notably for humans of various ages.
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Affiliation(s)
- Clément Rigaut
- TIPs (Transfers, Interfaces and Processes), Université libre de Bruxelles, 1050, Brussels, Belgium.
| | - Alice Giaprakis
- TIPs (Transfers, Interfaces and Processes), Université libre de Bruxelles, 1050, Brussels, Belgium
| | - Laura Deruyver
- Laboratoire de Pharmacie galénique et de Biopharmacie, Université libre de Bruxelles, 1050, Brussels, Belgium
| | - Jonathan Goole
- Laboratoire de Pharmacie galénique et de Biopharmacie, Université libre de Bruxelles, 1050, Brussels, Belgium
| | - Pierre Lambert
- TIPs (Transfers, Interfaces and Processes), Université libre de Bruxelles, 1050, Brussels, Belgium
| | - Benoît Haut
- TIPs (Transfers, Interfaces and Processes), Université libre de Bruxelles, 1050, Brussels, Belgium
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Zelasko S, Swaney MH, Sandstrom S, Davenport TC, Seroogy CM, Gern JE, Kalan LR, Currie CR. Upper respiratory microbial communities of healthy populations are shaped by niche and age. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.14.589416. [PMID: 38645133 PMCID: PMC11030450 DOI: 10.1101/2024.04.14.589416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Alterations in upper respiratory microbiomes have been implicated in shaping host health trajectories, including by limiting mucosal pathogen colonization. However, limited comparative studies of respiratory microbiome development and functioning across age groups have been performed. Herein, we perform shotgun metagenomic sequencing paired with pathogen inhibition assays to elucidate differences in nasal and oral microbiome composition and functioning across healthy 24-month-old infant (n=229) and adult (n=100) populations. Results We find that beta diversity of nasal and oral microbiomes varies with age, with nasal microbiomes showing greater population-level variation compared to oral microbiomes. Infant microbiome alpha diversity was significantly lower across nasal samples and higher in oral samples, relative to adults. Accordingly, we demonstrate significant differences in genus- and species-level composition of microbiomes between sites and age groups. Antimicrobial resistome patterns likewise varied across body sites, with oral microbiomes showing higher resistance gene abundance compared to nasal microbiomes. Biosynthetic gene clusters encoding specialized metabolite production were found in higher abundance across infant oral microbiomes, relative to adults. Investigation of pathogen inhibition revealed greater inhibition of gram-negative and gram-positive bacteria by oral commensals, while nasal isolates had higher antifungal activity. Conclusions In summary, we identify significant differences in the microbial communities inhabiting nasal and oral cavities of healthy infants relative to adults. These findings inform our understanding of the interactions impacting respiratory microbiome composition and functioning, with important implications for host health across the lifespan.
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Affiliation(s)
- Susan Zelasko
- Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Microbiology Doctoral Training Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mary Hannah Swaney
- Microbiology Doctoral Training Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Shelby Sandstrom
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Timothy C. Davenport
- Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Christine M. Seroogy
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Lindsay R. Kalan
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- M.G. DeGroote Institute for Infectious Disease Research, David Braley Centre for Antibiotic Discovery, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Cameron R. Currie
- Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- M.G. DeGroote Institute for Infectious Disease Research, David Braley Centre for Antibiotic Discovery, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
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Zhang Y, Hu Z, Wang Y, Lou M, Ma R, Gong M, Dong J, Zheng G, Wang B. Numerical investigation of nanoparticle deposition in the olfactory region among pediatric nasal airways with adenoid hypertrophy. Comput Biol Med 2023; 167:107587. [PMID: 37890422 DOI: 10.1016/j.compbiomed.2023.107587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/28/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
To understand inhaled nanoparticle transport and deposition characteristics in pediatric nasal airways with adenoid hypertrophy (AH), with a specific emphasis on the olfactory region, virtual nanoparticle inhalation studies were conducted on anatomically accurate child nasal airway models. The computational fluid-particle dynamics (CFPD) method was employed, and numerical simulations were performed to compare the airflow and nanoparticle deposition patterns between nasal airways with nasopharyngeal obstruction before adenoidectomy and healthy nasal airways after virtual adenoidectomy. The influence of different inhalation rates and exhalation phase on olfactory regional nanoparticle deposition features was systematically analyzed. We found that nasopharyngeal obstruction resulted in significant uneven airflow distribution in the nasal cavity. The deposited nanoparticles were concentrated in the middle meatus, septum, inferior meatus and nasal vestibule. The deposition efficiency (DE) in the olfactory region decreases with increasing nanoparticle size (1-10 nm) during inhalation. After adenoidectomy, the pediatric olfactory region DE increased significantly while nasopharynx DE dramatically decreased. When the inhalation rate decreased, the deposition pattern in the olfactory region significantly altered, exhibiting an initial rise followed by a subsequent decline, reaching peak deposition at 2 nm. During exhalation, the pediatric olfactory region DE was substantially lower than during inhalation, and the olfactory region DE in the pre-operative models were found to be significantly higher than that of the post-operative models. In conclusions, ventilation and particle deposition in the olfactory region were significantly improved in post-operative models. Inhalation rate and exhalation process can significantly affect nanoparticle deposition in the olfactory region.
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Affiliation(s)
- Ya Zhang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China
| | - Zhenzhen Hu
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; School of Engineering, RMIT University, Bundoora, VIC, 3083, Australia
| | - Yusheng Wang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China
| | - Miao Lou
- Department of Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710068, China
| | - Ruiping Ma
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China
| | - Minjie Gong
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China
| | - Jingliang Dong
- Institute for Sustainable Industries & Liveable Cities, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia; First Year College, Victoria University, Footscray Park Campus, Footscray, VIC, 3011, Australia.
| | - Guoxi Zheng
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China.
| | - Botao Wang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China.
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Na Y, Kwon KW, Jang YJ. Impact of the Location of Nasal Septal Deviation on the Nasal Airflow and Air Conditioning Characteristics. Facial Plast Surg 2023; 39:393-400. [PMID: 36564036 DOI: 10.1055/s-0042-1759764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The location of nasal septal deviation (NSD) directly impacts nasal physiology. The objective is to examine, using computational fluid dynamics (CFD), the difference in the airflow and air conditioning characteristics according to the location of NSD. Twenty patients with septal deviation were divided into two: 10 caudal septal deviation (CSD) and 10 posterior septal deviation (PSD). Physiological variables were compared and numerical models for nasal cavity were created with CT scans. Cases with CSD had distinctive features including restricted airflow partition, larger nasal resistance, and decreased surface heat flux in the more obstructed side (MOS), and lower humidity and air temperature in the lesser obstructed side (LOS). Physiological differences were observed according to the location of septal deviation, CSD cases exhibit significantly more asymmetric airflow characteristics and air conditioning capacity between LOS and MOS.
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Affiliation(s)
- Yang Na
- Department of Mechanical Engineering, Konkuk University, Seoul, Korea
| | - Kyung Won Kwon
- Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
| | - Yong Ju Jang
- Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
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Khoa ND, Phuong NL, Tani K, Inthavong K, Ito K. In-silico decongested trial effects on the impaired breathing function of a bulldog suffering from severe brachycephalic obstructive airway syndrome. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 228:107243. [PMID: 36403552 DOI: 10.1016/j.cmpb.2022.107243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Brachycephalic obstructive airway syndrome (BOAS) susceptible dogs (e.g., French bulldog), suffer health complications related to deficient breathing primarily due to anatomical airway geometry. Surgical interventions are known to provide acceptable functional and cosmetic results; however, the long-term post-surgery outcome is not well known. In silico analysis provides an objective measure to quantify the respiratory function in postoperative dogs which is critical for successful long-term outcomes. A virtual surgery to open the airway can explore the ability for improved breathing in an obstructed airway of a patient dog, thus supporting surgeons in pre-surgery planning using computational fluid dynamics. METHODS In this study five surgical interventions were generated with a gradual increment of decongested levels in a bulldog based on computed tomography images. The effects of the decongested airways on the breathing function of a patient bulldog, i.e., airflow characteristics, pressure drop, wall shear stress, and air-conditioning capacity, were quantified by benchmarking against a clinically healthy bulldog using computational fluid dynamics (CFD) method. RESULTS Our findings demonstrated a promising decrease in excessive airstream velocity, pressure drop, and wall shear stress in virtual surgical scenarios, while constantly preserving adequate air-conditioning efficiency. A linear fit curve was proposed to correlate the reduction in the pressure drop and decongested level. CONCLUSIONS The in silico analysis is a viable tool providing visual and quantitative insight into new unexplored surgical techniques.
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Affiliation(s)
- Nguyen Dang Khoa
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1, Kasuga-koen, Kasuga, Fukuoka 816-8580, Japan.
| | - Nguyen Lu Phuong
- Faculty of Environment, University of Natural Resources and Environment, Ho Chi Minh, Viet Nam
| | - Kenji Tani
- Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Yamaguchi, Japan
| | - Kiao Inthavong
- School of Engineering, Mechanical & Automotive, RMIT University, Melbourne, Australia
| | - Kazuhide Ito
- Faculty of Engineering Sciences, Kyushu University, Kasuga, Fukuoka, Japan
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11
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Sun Q, Dong J, Zhang Y, Tian L, Tu J. Numerical modelling of micron particle inhalation in a realistic nasal airway with pediatric adenoid hypertrophy: A virtual comparison between pre- and postoperative models. Front Pediatr 2023; 11:1083699. [PMID: 36911037 PMCID: PMC9996336 DOI: 10.3389/fped.2023.1083699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/26/2023] [Indexed: 02/25/2023] Open
Abstract
Adenoid hypertrophy (AH) is an obstructive condition due to enlarged adenoids, causing mouth breathing, nasal blockage, snoring and/or restless sleep. While reliable diagnostic techniques, such as lateral soft tissue x-ray imaging or flexible nasopharyngoscopy, have been widely adopted in general practice, the actual impact of airway obstruction on nasal airflow and inhalation exposure to drug aerosols remains largely unknown. In this study, the effects of adenoid hypertrophy on airflow and micron particle inhalation exposure characteristics were analysed by virtually comparing pre- and postoperative models based on a realistic 3-year-old nasal airway with AH. More specifically, detailed comparison focused on anatomical shape variations, overall airflow and olfactory ventilation, associated particle deposition in overall and local regions were conducted. Our results indicate that the enlarged adenoid tissue can significantly alter the airflow fields. By virtually removing the enlarged tissue and restoring the airway, peak velocity and wall shear stress were restored, and olfactory ventilation was considerably improved (with a 16∼63% improvement in terms of local ventilation speed). Furthermore, particle deposition results revealed that nasal airway with AH exhibits higher particle filtration tendency with densely packed deposition hot spots being observed along the floor region and enlarged adenoid tissue area. While for the postoperative model, the deposition curve was shifted to the right. The local deposition efficiency results demonstrated that more particles with larger inertia can be delivered to the targeted affected area following Adenoidectomy (Adenoid Removal). Research findings are expected to provide scientific evidence for adenoidectomy planning and aerosol therapy following Adenoidectomy, which can substantially improve present clinical treatment outcomes.
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Affiliation(s)
- Qinyuan Sun
- School of Engineering, RMIT University, Bundoora, VIC, Australia
| | - Jingliang Dong
- School of Engineering, RMIT University, Bundoora, VIC, Australia
| | - Ya Zhang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lin Tian
- School of Engineering, RMIT University, Bundoora, VIC, Australia
| | - Jiyuan Tu
- School of Engineering, RMIT University, Bundoora, VIC, Australia
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12
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Maréchal L, Dumoncel J, Santos F, Astudillo Encina W, Evteev A, Prevost A, Toro-Ibacache V, Venter RG, Heuzé Y. New insights into the variability of upper airway morphology in modern humans. J Anat 2022; 242:781-795. [PMID: 36585765 PMCID: PMC10093156 DOI: 10.1111/joa.13813] [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: 09/01/2022] [Revised: 11/29/2022] [Accepted: 12/12/2022] [Indexed: 01/01/2023] Open
Abstract
The biological adaptation of the human lineage to its environment is a recurring question in paleoanthropology. Particularly, how eco-geographic factors (e.g., environmental temperature and humidity) have shaped upper airway morphology in hominins have been subject to continuing debate. Nasal shape is the result of many intertwined factors that include, but are not limited to, genetic drift, sexual selection, or adaptation to climate. A quantification of nasal airway (NA) morphological variation in modern human populations is crucial to better understand these multiple factors. In the present research, we study 195 in vivo CT scans of adult individuals collected in five different geographic areas (Chile, France, Cambodia, Russia, and South Africa). After segmentation of the nasal airway, we reconstruct 3D meshes that are analyzed with a landmark-free geometric morphometrics method based on surface deformation. Our results highlight subtle but statistically significant morphological differences between our five samples. The two morphologically closest groups are France and Russia, whose NAs are longer and narrower, with an important protrusion of the supero-anterior part. The Cambodian sample is the most morphologically distinct and clustered sample, with a mean NA that is wider and shorter. On the contrary, the Chilean sample form the most scattered cluster with the greatest intra-population variation. The South African sample is morphologically close to the Cambodian sample, but also partially overlaps the French and Russian variation. Interestingly, we record no correlation between NA volume and geographic groups, which raises the question of climate-related metabolic demands for oxygen consumption. The other factors of variation (sex and age) have no influence on the NA shape in our samples. However, NA volume varies significantly according both to sex and age: it is higher in males than in females and tends to increase with age. In contrast, we observe no effect of temperature or humidity on NA volume. Finally, we highlight the important influence of asymmetries related to nasal septum deviations in NA shape variation.
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Affiliation(s)
- Laura Maréchal
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, Pessac, France
| | - Jean Dumoncel
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, Pessac, France
| | - Frédéric Santos
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, Pessac, France
| | | | - Andrej Evteev
- Anuchin Research Institute and Museum of Anthropology, Lomonosov Moscow State University, Moscow, Russia
| | - Alice Prevost
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - Viviana Toro-Ibacache
- Centro de Análisis Cuantitativo en Antropología Dental, Universidad de Chile, Santiago, Chile
| | - Rudolph G Venter
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Yann Heuzé
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, Pessac, France
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13
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Na Y, Kim YJ, Kim HY, Jung YG. Improvements in airflow characteristics and effect on the NOSE score after septoturbinoplasty: A computational fluid dynamics analysis. PLoS One 2022; 17:e0277712. [PMID: 36395146 PMCID: PMC9671303 DOI: 10.1371/journal.pone.0277712] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
Septoturbinoplasty is a surgical procedure that can improve nasal congestion symptoms in patients with nasal septal deviation and inferior turbinate hypertrophy. However, it is unclear which physical domains of nasal airflow after septoturbinoplasty are related to symptomatic improvement. This work employs computational fluid dynamics modeling to identify the physical variables and domains associated with symptomatic improvement. Sixteen numerical models were generated using eight patients' pre- and postoperative computed tomography scans. Changes in unilateral nasal resistance, surface heat flux, relative humidity, and air temperature and their correlations with improvement in the Nasal Obstruction Symptom Evaluation (NOSE) score were analyzed. The NOSE score significantly improved after septoturbinoplasty, from 14.4 ± 3.6 to 4.0 ± 4.2 (p < 0.001). The surgery not only increased the airflow partition on the more obstructed side (MOS) from 31.6 ± 9.6 to 41.9 ± 4.7% (p = 0.043), but also reduced the unilateral nasal resistance in the MOS from 0.200 ± 0.095 to 0.066 ± 0.055 Pa/(mL·s) (p = 0.004). Improvement in the NOSE score correlated significantly with the reduction in unilateral nasal resistance in the preoperative MOS (r = 0.81). Also, improvement in the NOSE score correlated better with the increase in surface heat flux in the preoperative MOS region from the nasal valve to the choanae (r = 0.87) than in the vestibule area (r = 0.63). Therefore, unilateral nasal resistance and mucous cooling in the preoperative MOS can explain the perceived improvement in symptoms after septoturbinoplasty. Moreover, the physical domain between the nasal valve and the choanae might be more relevant to patient-reported patency than the vestibule area.
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Affiliation(s)
- Yang Na
- Department of Mechanical Engineering, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Youn-Ji Kim
- Department of Mechanical Engineering, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Hyo Yeol Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Yong Gi Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
- * E-mail:
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14
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Huang J, Dong G, Liang M, Wu X, Xian M, An Y, Zhan J, Xu L, Xu J, Sun W, Chen S, Chen C, Liu T. Toxicity of micro(nano)plastics with different size and surface charge on human nasal epithelial cells and rats via intranasal exposure. CHEMOSPHERE 2022; 307:136093. [PMID: 36029863 DOI: 10.1016/j.chemosphere.2022.136093] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/01/2022] [Accepted: 08/15/2022] [Indexed: 02/05/2023]
Abstract
Micro (nano)plastics (MNPs) have become emerging environmental contaminants, yet their toxicity and systemic effects via intranasal exposure remain unclear. This study investigated the in vitro toxicity of thirteen polystyrene MNPs with different surface functionalization (carboxylic (C-PS), amino (A-PS), and bare (PS)) and sizes (20-2000 nm) on human nasal epithelial cells (HNEpCs) at 10-1250 μg/mL as well as their in vivo toxicity to rats via intranasal administration at 125 μg/mL. The in vitro study showed that PS20, PS50, A-PS50, PS500, and A-PS500 significantly inhibited cell viability, which was dependent on particle concentration. A-PS induced higher cytotoxicity than C-PS and PS, and most MNPs inhibited cell proliferation after 24-h. Flow cytometry analysis suggested that PS induced cell apoptosis, while A-PS caused cell necrosis. MNPs were phagocytosed by HNEpCs and entered nucleus. The in vivo study showed that MNPs inhibited dietary behaviors of rats. Histological analysis indicated that PS20, PS200, and A-PS50 thinned out nasal mucosa. Immunohistochemical analysis revealed that exposure to PS20, PS200, and A-PS50 enhanced expression of transient receptor potential cation channel subfamily M (melastatin) member 8 (TRPM8). Systemic effects including hepatocyte cytoplasmic vacuolation and renal tubule dilatation were observed. The results suggested that nasal inhalation of MNPs may disturb energy metabolism and damage upper respiratory tract, liver, and kidneys.
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Affiliation(s)
- Jiayu Huang
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; Shantou University Medical College, Shantou, Guangdong, 515063, China
| | - Guangyuan Dong
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; Shantou University Medical College, Shantou, Guangdong, 515063, China
| | - Miaoting Liang
- College of Natural Resources and Environment, Guangdong Provincial Key Laboratory of Agricultural & Rural Pollution Abatement and Environmental Safety, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Xidong Wu
- Department of Drug Safety Evaluation, Jiangxi Testing Center of Medical Device, Nanchang, Jiangxi, 330029, China
| | - Mingjian Xian
- Department of Neurology, The People's Hospital of Dianbai District, Maoming, Guangdong, 525499, China
| | - Yunsong An
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China
| | - Jiandong Zhan
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China
| | - Lingling Xu
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jindong Xu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China; Department of Anesthesiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China
| | - Weimin Sun
- Institute of Eco-environmental and Soil Sciences, Guangdong Academy of Sciences, 808 Tianyuan Road, Guangzhou, Guangdong, 510650, China
| | - Shaohua Chen
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China
| | - Chengyu Chen
- College of Natural Resources and Environment, Guangdong Provincial Key Laboratory of Agricultural & Rural Pollution Abatement and Environmental Safety, South China Agricultural University, Guangzhou, Guangdong, 510642, China.
| | - Tao Liu
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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15
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Harnessing Nasal Immunity with IgA to Prevent Respiratory Infections. IMMUNO 2022. [DOI: 10.3390/immuno2040036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The nasal cavity is a primary checkpoint for the invasion of respiratory pathogens. Numerous pathogens, including SARS-CoV-2, S. pneumoniae, S. aureus, etc., can adhere/colonize nasal lining to trigger an infection. Secretory IgA (sIgA) serves as the first line of immune defense against foreign pathogens. sIgA facilitates clearance of pathogenic microbes by intercepting their access to epithelial receptors and mucus entrapment through immune exclusion. Elevated levels of neutralizing IgA at the mucosal surfaces are associated with a high level of protection following intranasal immunizations. This review summarizes recent advances in intranasal vaccination technology and challenges in maintaining nominal IgA levels at the mucosal surface. Overall, the review emphasizes the significance of IgA-mediated nasal immunity, which holds a tremendous potential to mount protection against respiratory pathogens.
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16
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Different Methods and Formulations of Drugs and Vaccines for Nasal Administration. Pharmaceutics 2022; 14:pharmaceutics14051073. [PMID: 35631663 PMCID: PMC9144811 DOI: 10.3390/pharmaceutics14051073] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 12/11/2022] Open
Abstract
Nasal drug delivery is advantageous when compared with other routes of drug delivery as it avoids the hepatic first-pass effect, blood–brain barrier penetration, and compliance issues with parenteral administration. However, nasal administration also has some limitations, such as its low bioavailability due to metabolism on the mucosal surface, and irreversible damage to the nasal mucosa due to the ingredients added into the formula. Moreover, the method of nasal administration is not applicable to all drugs. The current review presents the nasal anatomy and mucosal environment for the nasal delivery of vaccines and drugs, as well as presents various methods for enhancing nasal absorption, and different drug carriers and delivery devices to improve nasal drug delivery. It also presents future prospects on the nasal drug delivery of vaccines and drugs.
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17
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Kader M, Hossain MA, Reddy V, Perera NKP, Rashid M. Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study. BMC Sports Sci Med Rehabil 2022; 14:60. [PMID: 35382885 PMCID: PMC8982300 DOI: 10.1186/s13102-022-00451-z] [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: 10/22/2021] [Accepted: 03/29/2022] [Indexed: 01/08/2023]
Abstract
Background Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory tract disease. The most common clinical manifestation of severe COVID-19 is acute respiratory failure. Respiratory rehabilitation can be a crucial part of treatment, but data lack for patients with COVID-19. This study investigates the effects of short-term respiratory rehabilitation (i.e., breathing exercises) on respiratory recovery among non-ICU hospitalised patients with COVID-19. Methods This was a quasi-experimental, pre-and post-test study. The study recruited 173 patients hospitalised with moderate to severe COVID-19. All the patients received standardised care for COVID-19, and 94 patients in the intervention group also received the intervention of breathing exercises, which included breathing control, followed by diaphragmatic breathing, deep breathing, or thoracic expansion exercise, and huffing (forced expiratory technique) and coughing. Data on the mean values of peripheral oxygen saturation (SpO2), need for oxygen therapy (litre/min), respiratory rate (breaths/minute), and heart rate (beats/minute) and were collected at baseline, 4 days, and 7 days after the baseline assessment. Analysis of variance on repeated measures was applied to compare the mean value of outcome measures of all the time points. Results The mean (± SD) age of the intervention (69.6% men) and control group (62.1% men) were 50.1 (10.5) and 51.5 (10.4) years, respectively. At 4-day of follow-up, SpO2 (96.6% ± 1.9 vs. 90.7% ± 1.8, P < 0.001), need for oxygen therapy (0.8 ± 2.6 vs. 2.3 ± 2.9, P < 0.001), respiratory rate (20.5 ± 2.3 vs. 22.3 ± 2.5, P < 0.001), and heart rate (81.2 ± 9.5 vs. 89.2 ± 8.9, P < 0.001) improved in the intervention group compared to the control group. At 7-day follow-up, differences remained significant concerning the oxygen saturation and the need for oxygen therapy (P < 0.001) between the groups. Conclusions Our results indicate that breathing exercise, even for a short period, effectively improves specific respiratory parameters in moderate to severe COVID-19 patients. As a non-invasive and cost-effective respiratory rehabilitation intervention, breathing exercise can be a valuable tool for a health care system overwhelmed by the COVID-19 pandemic. These results should be considered preliminary until they are replicated in larger samples in different settings.
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Affiliation(s)
- Manzur Kader
- Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, Torsplan floor 10, 113 65, Stockholm, Sweden.
| | - Md Afzal Hossain
- Department of Physiotherapy, Zainul Haque Sikder Women's Medical College and Hospital, Dhaka, Bangladesh
| | - Vijayendar Reddy
- Department of Neurosurgery, Zainul Haque Sikder Women's Medical College and Hospital, Dhaka, Bangladesh
| | - Nirmala K Panagodage Perera
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mamunur Rashid
- Department of Public Health and Sports Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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18
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Wang J, Wusiman P, Mi C. Cone-beam computed tomography analysis of the nasal morphology among Uyghur nationality adults in Xinjiang for forensic reconstruction. TRANSLATIONAL RESEARCH IN ANATOMY 2021. [DOI: 10.1016/j.tria.2021.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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19
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Wang B, Xu M, Yin N, Wang Y, Song T. Three-Dimensional Computed Tomography Reconstruction and Measurement of Nasal End Deformity in Complete Unilateral Cleft Lip and Palate. Ann Plast Surg 2021; 87:562-568. [PMID: 33833155 DOI: 10.1097/sap.0000000000002837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The repair of nasal deformities secondary to cleft lip and palate is complex and requires reliable preoperative nasal 3-dimensional assessment. This study explored nasal end (defined as the lower third of the external nasal and vestibular parts of the nasal cavity) deformities secondary to unilateral complete cleft lip and palate. METHODS Three-dimensional nasal end morphometric measurements were obtained from 48 patients who had undergone Millard cleft lip repair and reached skeletal maturity (cleft group) and from 36 age- and ethnicity-matched normal subjects (control group). For the cleft group, paired t tests and 1-way analysis of covariance were used to evaluate the internal and external morphological characteristics of the cleft and noncleft sides of the nasal end, and correlation analysis was done to evaluate the relationship between cleft-side measurements. RESULTS In the cleft group, the cleft side showed significantly smaller nasal vestibular volume and skin area, nostril area, nasal column length, and nostril height and greater nostril base length and nasal alar length than the noncleft side (all P < 0.05). Controlling for sex, there were significant differences in the nasal vestibular volume and skin area, internal nasal valve area, long nostril diameter, nostril base length, columella length, nostril height, and nasal alar length between the cleft and control groups (all P < 0.05). On the cleft side, the area of the skin lining of the nasal vestibule positively correlated with the alar length (r = 0.67, P < 0.05). CONCLUSIONS Three-dimensional nasal end reconstruction provides a more detailed preoperative nasal end morphological evaluation than previously available techniques. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Binqing Wang
- From the Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
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20
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Feng Y, Xia W, Zhao P, Yi X, Tang A. Survey anatomy and histological observation of the nasal cavity of Tupaia belangeri chinensis (Tupaiidae, Scandentia, Mammalia). Anat Rec (Hoboken) 2021; 305:1448-1458. [PMID: 34605617 DOI: 10.1002/ar.24793] [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: 06/02/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 11/10/2022]
Abstract
This study aimed to provide researchers with an atlas of the survey anatomy, histology, and imaging of the nasal cavity of Tupaia belangeri chinensis. Seven T. b. chinensis adult males were euthanized and scanned using micro-computed tomography (CT). The nose was separated, and tissue sections were made on the coronal and axial planes to observe the survey anatomy and histological and imaging characteristics of the nose. T. b. chinensis contains one maxilloturbinal and three ethmoturbinals, one nasoturbinal, one interturbinal, two frontoturbinals, and one lamina semicircularis in the unilateral nasal cavity. Other identified structures were the ostiomeatal complex, vomeronasal organ, superior nasal vault, maxillary sinus, and frontal recess. The drainage pathways of the sinuses and nasal airflow in T. b. chinensis were confirmed. The vault epithelium consisted of the squamous epithelium, respiratory epithelium, transitional epithelium, and olfactory epithelium. Micro-CT confirmed our findings of the coronal tissue sections. The nasal cavity anatomy of T. b. chinensis is similar to that of some strepsirrhine primates. However, the airflow and olfactory function are quite different from that of humans. Our gross and histological atlas of the nasal septum, turbinals, maxillary sinus, and frontal recess provides a reference for researchers to use T. b. chinensis for nasal cavity functional research.
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Affiliation(s)
- Yiwei Feng
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Xia
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Pengcheng Zhao
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiang Yi
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Anzhou Tang
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
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21
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Computational Fluid Dynamics Modeling of Nasal Obstruction and Associations with Patient-Reported Outcomes. Plast Reconstr Surg 2021; 148:592e-600e. [PMID: 34550944 DOI: 10.1097/prs.0000000000008328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nasal obstruction is a common problem, with significant impact on quality of life. Accurate diagnosis may be challenging because of the complex and dynamic nature of the involved anatomy. Computational fluid dynamics modeling has the ability to identify specific anatomical defects, allowing for a targeted surgical approach. The goal of the current study is to better understand nasal obstruction as it pertains to disease-specific quality of life by way of a novel computational fluid dynamics model of nasal airflow. METHODS Fifty-three patients with nasal obstruction underwent computational fluid dynamics modeling based on computed tomographic imaging. Nasal resistance was compared to demographic data and baseline subjective nasal patency based on Nasal Obstructive Symptom Evaluation scores. RESULTS Mean Nasal Obstructive Symptom Evaluation score among all patients was 72.6. Nasal Obstructive Symptom Evaluation score demonstrated a significant association with nasal resistance in patients with static obstruction (p = 0.03). There was a positive correlation between Nasal Obstructive Symptom Evaluation score and nasal resistance in patients with static bilateral nasal obstruction (R2 = 0.32) and poor correlation in patients with dynamic bilateral obstruction caused by nasal valve collapse (R2 = 0.02). Patients with moderate and severe bilateral symptoms had significantly higher nasal resistance compared to those with unilateral symptoms (p = 0.048). CONCLUSIONS Nasal obstruction is a multifactorial condition in most patients. This study shows correlation between simulated nasal resistance and Nasal Obstructive Symptom Evaluation score in a select group of patients. There is currently no standardized diagnostic algorithm or gold standard objective measure of nasal airflow; however, computational fluid dynamics may better inform treatment planning and surgical techniques on an individual basis. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, V.
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22
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Prévost J, Richard J, Gasser R, Ding S, Fage C, Anand SP, Adam D, Gupta Vergara N, Tauzin A, Benlarbi M, Gong SY, Goyette G, Privé A, Moreira S, Charest H, Roger M, Mothes W, Pazgier M, Brochiero E, Boivin G, Abrams CF, Schön A, Finzi A. Impact of temperature on the affinity of SARS-CoV-2 Spike glycoprotein for host ACE2. J Biol Chem 2021; 297:101151. [PMID: 34478710 PMCID: PMC8406544 DOI: 10.1016/j.jbc.2021.101151] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 12/29/2022] Open
Abstract
The seasonal nature of outbreaks of respiratory viral infections with increased transmission during low temperatures has been well established. Accordingly, temperature has been suggested to play a role on the viability and transmissibility of SARS-CoV-2, the virus responsible for the COVID-19 pandemic. The receptor-binding domain (RBD) of the Spike glycoprotein is known to bind to its host receptor angiotensin-converting enzyme 2 (ACE2) to initiate viral fusion. Using biochemical, biophysical, and functional assays to dissect the effect of temperature on the receptor-Spike interaction, we observed a significant and stepwise increase in RBD-ACE2 affinity at low temperatures, resulting in slower dissociation kinetics. This translated into enhanced interaction of the full Spike glycoprotein with the ACE2 receptor and higher viral attachment at low temperatures. Interestingly, the RBD N501Y mutation, present in emerging variants of concern (VOCs) that are fueling the pandemic worldwide (including the B.1.1.7 (α) lineage), bypassed this requirement. This data suggests that the acquisition of N501Y reflects an adaptation to warmer climates, a hypothesis that remains to be tested.
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Affiliation(s)
- Jérémie Prévost
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada
| | - Jonathan Richard
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada
| | - Romain Gasser
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada
| | - Shilei Ding
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada
| | - Clément Fage
- Centre de Recherche du CHU de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Sai Priya Anand
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Damien Adam
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Médicine, Université de Montréal, Montréal, Quebec, Canada
| | - Natasha Gupta Vergara
- Department of Biochemistry and Molecular Biology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Alexandra Tauzin
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada
| | - Mehdi Benlarbi
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada
| | - Shang Yu Gong
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Guillaume Goyette
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada
| | - Anik Privé
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada
| | - Sandrine Moreira
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Hugues Charest
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Michel Roger
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada; Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Walther Mothes
- Department of Microbial Pathogenesis, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Marzena Pazgier
- Infectious Disease Division, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Emmanuelle Brochiero
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Médicine, Université de Montréal, Montréal, Quebec, Canada
| | - Guy Boivin
- Centre de Recherche du CHU de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Cameron F Abrams
- Department of Biochemistry and Molecular Biology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Arne Schön
- Department of Biology, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrés Finzi
- Centre de Recherche du CHUM, axe Immunopathologie, Montreal, Quebec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada; Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada.
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23
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Salati H, Khamooshi M, Vahaji S, Christo FC, Fletcher DF, Inthavong K. N95 respirator mask breathing leads to excessive carbon dioxide inhalation and reduced heat transfer in a human nasal cavity. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:081913. [PMID: 34552313 PMCID: PMC8450908 DOI: 10.1063/5.0061574] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/06/2021] [Indexed: 05/16/2023]
Abstract
Face masks and respirators are used to filter inhaled air, which may contain airborne droplets and high particulate matter (PM) concentrations. The respirators act as a barrier to the inhaled and exhaled air, which may change the nasal airflow characteristics and air-conditioning function of the nose. This study aims to investigate the nasal airflow dynamics during respiration with and without an N95 respirator driven by airflow through the nasal cavity to assess the effect of the respirator on breathing conditions during respiration. To achieve the objective of this study, transient computational fluid dynamics simulations have been utilized. The nasal geometry was reconstructed from high-resolution Computed Tomography scans of a healthy 25-year-old female subject. The species transport method was used to analyze the airflow, temperature, carbon dioxide (CO2), moisture content (H2O), and temperature distribution within the nasal cavity with and without an N95 respirator during eight consecutive respiration cycles with a tidal volume of 500 ml. The results demonstrated that a respirator caused excessive CO2 inhalation by approximately 7 × greater per breath compared with normal breathing. Furthermore, heat and mass transfer in the nasal cavity was reduced, which influences the perception of nasal patency. It is suggested that wearers of high-efficiency masks that have minimal porosity and low air exchange for CO2 regulation should consider the amount of time they wear the mask.
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Affiliation(s)
| | - Mehrdad Khamooshi
- Mechanical and Automotive Engineering, School of Engineering, RMIT University, Bundoora, Australia
| | - Sara Vahaji
- School of Engineering, Faculty of Science Engineering and Built Environment, Deakin University, Victoria, Australia
| | - Farid C. Christo
- School of Engineering, Faculty of Science Engineering and Built Environment, Deakin University, Victoria, Australia
| | - David F. Fletcher
- School of Chemical and Biomolecular Engineering, The University of Sydney, NSW 2006 Australia
| | - Kiao Inthavong
- Mechanical and Automotive Engineering, School of Engineering, RMIT University, Bundoora, Australia
- Author to whom correspondence should be addressed:
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24
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Perspective of the Relationship between the Susceptibility to Initial SARS-CoV-2 Infectivity and Optimal Nasal Conditioning of Inhaled Air. Int J Mol Sci 2021; 22:ijms22157919. [PMID: 34360686 PMCID: PMC8348706 DOI: 10.3390/ijms22157919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/20/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as with the influenza virus, has been shown to spread more rapidly during winter. Severe coronavirus disease 2019 (COVID-19), which can follow SARS-CoV-2 infection, disproportionately affects older persons and males as well as people living in temperate zone countries with a tropical ancestry. Recent evidence on the importance of adequately warming and humidifying (conditioning) inhaled air in the nasal cavity for reducing SARS-CoV-2 infectivity in the upper respiratory tract (URT) is discussed, with particular reference to: (i) the relevance of air-borne SARS-CoV-2 transmission, (ii) the nasal epithelium as the initial site of SARS-CoV-2 infection, (iii) the roles of type 1 and 3 interferons for preventing viral infection of URT epithelial cells, (iv) weaker innate immune responses to respiratory viral infections in URT epithelial cells at suboptimal temperature and humidity, and (v) early innate immune responses in the URT for limiting and eliminating SARS-CoV-2 infections. The available data are consistent with optimal nasal air conditioning reducing SARS-CoV-2 infectivity of the URT and, as a consequence, severe COVID-19. Further studies on SARS-CoV-2 infection rates and viral loads in the nasal cavity and nasopharynx in relation to inhaled air temperature, humidity, age, gender, and genetic background are needed in this context. Face masks used for reducing air-borne virus transmission can also promote better nasal air conditioning in cold weather. Masks can, thereby, minimise SARS-CoV-2 infectivity and are particularly relevant for protecting more vulnerable persons from severe COVID-19.
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25
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Moakes RJA, Davies SP, Stamataki Z, Grover LM. Formulation of a Composite Nasal Spray Enabling Enhanced Surface Coverage and Prophylaxis of SARS-COV-2. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2008304. [PMID: 34060150 PMCID: PMC8212080 DOI: 10.1002/adma.202008304] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/26/2021] [Indexed: 05/18/2023]
Abstract
Airborne pathogens pose high risks in terms of both contraction and transmission within the respiratory pathways, particularly the nasal region. However, there is little in the way of adequate intervention that can protect an individual or prevent further spread. This study reports on a nasal formulation with the capacity to combat such challenges, focusing on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Formulation of a polysaccharide-based spray, known for its mucoadhesive properties, is undertaken and it is characterized for its mechanical, spray distribution, and antiviral properties. The ability to engineer key mechanical characteristics such as dynamic yield stresses and high coverage is shown, through systematic understanding of the composite mixture containing both gellan and λ-carrageenan. Furthermore, the spray systems demonstrate highly potent capacities to prevent SARS-CoV-2 infection in Vero cells, resulting in complete inhibition when either treating, the cells, or the virus, prior to challenging for infection. From this data, a mechanism for both prophylaxis and prevention is proposed; where entrapment within a polymeric coating sterically blocks virus uptake into the cells, inactivating the virus, and allowing clearance within the viscous medium. As such, a fully preventative spray is formulated, targeted at protecting the lining of the upper respiratory pathways against SARS-CoV-2.
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Affiliation(s)
- Richard J. A. Moakes
- Healthcare Technology InstituteSchool of Chemical EngineeringUniversity of BirminghamBirminghamB15 2TTUK
| | - Scott P. Davies
- Institute of Immunology and ImmunotherapySchool of Medicine and DentistryUniversity of BirminghamBirminghamB15 2GWUK
| | - Zania Stamataki
- Institute of Immunology and ImmunotherapySchool of Medicine and DentistryUniversity of BirminghamBirminghamB15 2GWUK
| | - Liam M. Grover
- Healthcare Technology InstituteSchool of Chemical EngineeringUniversity of BirminghamBirminghamB15 2TTUK
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26
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Stassen THA, Bartley J, White DE. Inhaled nasopharyngeal nitric oxide concentrations during unilateral nostril breathing - A pilot study. Respir Physiol Neurobiol 2021; 293:103734. [PMID: 34214661 DOI: 10.1016/j.resp.2021.103734] [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: 05/09/2021] [Revised: 06/17/2021] [Accepted: 06/27/2021] [Indexed: 11/24/2022]
Abstract
The yogic pranayama technique of unilateral nostril breathing (UNB) has previously demonstrated improvements in language and anxiety in stroke sufferers, as well as reduced blood pressure and increased heart rate in normal healthy adults. The nose typically passes different amounts of air through each nostril with the greater amount of air passing through the 'patent' side, and a lesser amount through the 'congested' side. Each side of the nose periodically takes turns at carrying the dominant tidal air flow in what is termed the' nasal cycle'. The nasal sinuses are a rich source of inhaled nitric oxide, a colourless and odourless gas that acts as a bronchodilator, vasodilator, and neurotransmitter. Nasal derived nitric oxide (NO) may contribute to the benefits attributed to UNB. This investigation seeks to assess the influence the nasal cycle has on inhaled nasopharyngeal NO concentrations during UNB by comparing unobstructed bilateral nostril breathing to patent-side and congested-side UNB in healthy individuals demonstrating a nasal cycle. After determining the patent and congested nasal sides in healthy adult volunteers, and sampling air at both nostrils, nasopharyngeal inhaled NO concentrations were then assessed during normal nasal at-rest tidal breathing during three different nasal breathing states: first both nostrils, then allocated in randomised order, patent side only, and congested side with only UNB. Nasopharyngeal NO concentrations were found to be consistently higher on both exhalation and inhalation during congested side UNB, when compared with either unilateral patent side UNB or breathing through both nostrils.
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Affiliation(s)
- Tim H A Stassen
- Zuyd University of Applied Sciences, Maastricht, the Netherlands
| | - Jim Bartley
- BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - David E White
- BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand.
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27
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Senanayake P, Salati H, Wong E, Bradshaw K, Shang Y, Singh N, Inthavong K. The impact of nasal adhesions on airflow and mucosal cooling - A computational fluid dynamics analysis. Respir Physiol Neurobiol 2021; 293:103719. [PMID: 34147672 DOI: 10.1016/j.resp.2021.103719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 06/01/2021] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
Nasal adhesions are a known postoperative complication following surgical procedures for nasal airway obstruction (NAO); and are a common cause of surgical failure, with patients often reporting significant NAO, despite relatively minor adhesion size. Division of such nasal adhesions often provides much greater relief than anticipated, based on the minimal reduction in cross-sectional area associated with the adhesion. The available literature regarding nasal adhesions provides little evidence examining their quantitative and qualitative effects on nasal airflow using objective measures. This study examined the impact of nasal adhesions at various anatomical sites on nasal airflow and mucosal cooling using computational fluid dynamics (CFD). A high-resolution CT scan of the paranasal sinuses of a 25-year-old, healthy female patient was segmented to create a three-dimensional nasal airway model. Virtual nasal adhesions of 2.5 mm diameter were added to various locations within the nasal cavity, representing common sites seen following NAO surgery. A series of models with single adhesions were created. CFD analysis was performed on each model and compared with a baseline no-adhesion model, comparing airflow and heat and mass transfer. The nasal adhesions resulted in no significant change in bulk airflow patterns through the nasal cavity. However, significant changes were observed in local airflow and mucosal cooling around and immediately downstream to the nasal adhesions. These were most evident with anterior nasal adhesions at the internal valve and anterior inferior turbinate. Postoperative nasal adhesions create local airflow disruption, resulting in reduced local mucosal cooling on critical surfaces, explaining the exaggerated perception of nasal obstruction. In particular, anteriorly located adhesions created greater disruption to local airflow and mucosal cooling, explaining their associated greater subjective sensation of obstruction.
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Affiliation(s)
- Praween Senanayake
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - Hana Salati
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia
| | - Eugene Wong
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia
| | - Kimberley Bradshaw
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - Yidan Shang
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia
| | - Narinder Singh
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, NSW, Australia; Faculty of Medicine & Health, The University of Sydney, NSW 2006, Australia
| | - Kiao Inthavong
- Mechanical & Automotive Engineering, School of Engineering, RMIT University, Bundoora, Victoria 3083, Australia.
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28
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Haut B, Nonclercq A, Buess A, Rabineau J, Rigaut C, Sobac B. Comprehensive Analysis of Heat and Water Exchanges in the Human Lungs. Front Physiol 2021; 12:649497. [PMID: 34168568 PMCID: PMC8217871 DOI: 10.3389/fphys.2021.649497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
This work presents a new mathematical model of the heat and water exchanges in the human lungs (newborn to adult). This model is based on a local description of the water and energy transports in both the lumen and the surrounding tissues, and is presented in a comprehensive, dimensionless framework with explicitly stated assumptions and a strong physiological background. The model is first used to analyze and quantify the key phenomena and dimensionless numbers governing these heat and water exchanges and then it is applied to an adult in various situations (varying atmospheric conditions, exercising…). The results highlight several interesting physiological elements. They show that the bronchial region of the lungs is able to condition the air in all the considered situations even if, sometimes, for instance when exercising, distal generations have to be involved. The model also shows that these distal generations are super-conditioners. Moreover, the results quantify the key role of the submucosal glands in mucus hydration. They also show that, during expiration, a significant cooling of the air and condensation of water occur along the respiratory tract as the vascularization of the tissues surrounding the airways is not able to maintain these tissues at body temperature during inspiration. Due to the interaction between several phenomena, it appears that the ratio of the amount of water returned to the mucosa during expiration to the amount extracted during inspiration is almost independent of the breathing conditions (around 33%). The results also show that, in acute situations, such as suffering from a pathology with airway dysfunction, when being intubated or when exercising above an intensity threshold, the heat and water exchanges in the lungs may be critical regarding mucus hydration. In proximal generations, the evaporation may overwhelm the ability of the submucosal glands to replenish the airway surface liquid with water. In some situations, the cooling of the mucosa may be very important; it can even become colder than the inspired air, due to evaporative cooling. Finally, the results show that breathing cold air can significantly increase the exchanges between the lungs and the environment, which can be critical regarding disease transmission.
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Affiliation(s)
- Benoit Haut
- Ecole Polytechnique de Bruxelles, Transfers, Interfaces and Processes (TIPs), Université libre de Bruxelles, Brussels, Belgium
| | - Antoine Nonclercq
- Ecole Polytechnique de Bruxelles, Bio, Electro and Mechanical Systems (BEAMS), Université libre de Bruxelles, Brussels, Belgium
| | - Alexandra Buess
- Ecole Polytechnique de Bruxelles, Transfers, Interfaces and Processes (TIPs), Université libre de Bruxelles, Brussels, Belgium
| | - Jérémy Rabineau
- Ecole Polytechnique de Bruxelles, Transfers, Interfaces and Processes (TIPs), Université libre de Bruxelles, Brussels, Belgium
| | - Clément Rigaut
- Ecole Polytechnique de Bruxelles, Transfers, Interfaces and Processes (TIPs), Université libre de Bruxelles, Brussels, Belgium
| | - Benjamin Sobac
- Ecole Polytechnique de Bruxelles, Transfers, Interfaces and Processes (TIPs), Université libre de Bruxelles, Brussels, Belgium.,Université de Pau et des Pays de l'Adour, E2S UPPA, CNRS, Total, LFCR, Anglet, France
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29
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Lim ZF, Rajendran P, Musa MY, Lee CF. Nasal airflow of patient with septal deviation and allergy rhinitis. Vis Comput Ind Biomed Art 2021; 4:14. [PMID: 34014417 PMCID: PMC8137764 DOI: 10.1186/s42492-021-00080-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/27/2021] [Indexed: 12/30/2022] Open
Abstract
A numerical simulation of a patient’s nasal airflow was developed via computational fluid dynamics. Accordingly, computerized tomography scans of a patient with septal deviation and allergic rhinitis were obtained. The three-dimensional (3D) nasal model was designed using InVesalius 3.0, which was then imported to (computer aided 3D interactive application) CATIA V5 for modification, and finally to analysis system (ANSYS) flow oriented logistics upgrade for enterprise networks (FLUENT) to obtain the numerical solution. The velocity contours of the cross-sectional area were analyzed on four main surfaces: the vestibule, nasal valve, middle turbinate, and nasopharynx. The pressure and velocity characteristics were assessed at both laminar and turbulent mass flow rates for both the standardized and the patient’s model nasal cavity. The developed model of the patient is approximately half the size of the standardized model; hence, its velocity was approximately two times more than that of the standardized model.
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Affiliation(s)
- Zi Fen Lim
- School of Aerospace Engineering, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia
| | - Parvathy Rajendran
- School of Aerospace Engineering, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia. .,Faculty of Engineering & Computing, First City University College, 47800, Selangor, Malaysia.
| | - Muhamad Yusri Musa
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia
| | - Chih Fang Lee
- School of Aerospace Engineering, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia
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30
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Li H, Martin HL, Marcus JR, Frank-Ito DO. Analysis of nasal air conditioning in subjects with unilateral cleft lip nasal deformity. Respir Physiol Neurobiol 2021; 291:103694. [PMID: 34020065 DOI: 10.1016/j.resp.2021.103694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/22/2021] [Accepted: 05/16/2021] [Indexed: 11/15/2022]
Abstract
This study evaluated the impact of unilateral cleft lip nasal deformity (uCLND) on the ability of the nasal passages to warm and humidify inspired environmental air using computational fluid dynamics (CFD) modeling. Nasal air conditioning was simulated at resting inspiration in ten individuals with uCLND and seven individuals with normal anatomy. The overall heat and water transfer through nasal mucosa was significantly greater (p = 0.02 for both heat and moisture fluxes) on the non-cleft side than on the cleft side. Unilateral median and interquartile range (IQR) for heat flux (W/m2) was 190.3 (IQR 59.9) on the non-cleft side, 160.9 (IQR 105.0) on the cleft side, and 170.7 (IQR 87.8) for normal subjects. For moisture flux (mg/(s·m2), they were 357.4 (IQR 112.9), 298.7 (IQR 200.3) and 320.8 (IQR 173.0), respectively. Significant differences of SAHF50 between cleft side of uCLND and normal existed except for anterior region. Nevertheless, air conditioning ability in subjects with uCLND was generally comparable to that of normal subjects.
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Affiliation(s)
- Hang Li
- Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, NC, USA
| | | | - Jeffrey R Marcus
- Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, NC, USA
| | - Dennis O Frank-Ito
- Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, NC, USA; Computational Biology & Bioinformatics PhD Program, Duke University, Durham, NC, USA; Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University Pratt School of Engineering, Durham, NC, USA.
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31
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Chung SK, Na Y. Dynamic characteristics of heat capacity of the human nasal cavity during a respiratory cycle. Respir Physiol Neurobiol 2021; 290:103674. [PMID: 33894344 DOI: 10.1016/j.resp.2021.103674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/06/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022]
Abstract
The dynamic characteristics of air-conditioning in the human nasal cavity during a respiratory cycle were investigated using unsteady numerical simulations to assess whether inhaled air is sufficiently conditioned by the nasal cavity. Variations in the epithelial surface temperature, surface heat, and water vapor fluxes were found to vary significantly during inspiration while providing substantial air conditioning to the inhaled air, but variations and magnitudes were significantly reduced during the expiration period. Air temperature (31.3-35.3 °C) and relative humidity (85.1-100 %) in the nasopharynx exhibited significant variations during inspiration. Flow rate-weighted average values of the air temperature and relative humidity during inspiration were estimated to be 32.0 °C and 89.1 %, respectively. Inhaled air did not attain alveolar conditions before reaching the nasopharynx, and was therefore thought to be insufficiently conditioned by the nasal cavity alone. A steady flow of approximately 250 mL/s appears to be useful for evaluating the accumulated thermal state of air in the nasopharynx during inspiration.
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Affiliation(s)
- Seung-Kyu Chung
- Department of Otorhinolaryngology: Head and Neck Surgery, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Yang Na
- Department of Mechanical Engineering, Konkuk University, Seoul, Republic of Korea.
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32
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Stansfield E, Mitteroecker P, Vasilyev SY, Vasilyev S, Butaric LN. Respiratory adaptation to climate in modern humans and Upper Palaeolithic individuals from Sungir and Mladeč. Sci Rep 2021; 11:7997. [PMID: 33846400 PMCID: PMC8042039 DOI: 10.1038/s41598-021-86830-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/15/2021] [Indexed: 01/17/2023] Open
Abstract
As our human ancestors migrated into Eurasia, they faced a considerably harsher climate, but the extent to which human cranial morphology has adapted to this climate is still debated. In particular, it remains unclear when such facial adaptations arose in human populations. Here, we explore climate-associated features of face shape in a worldwide modern human sample using 3D geometric morphometrics and a novel application of reduced rank regression. Based on these data, we assess climate adaptations in two crucial Upper Palaeolithic human fossils, Sungir and Mladeč, associated with a boreal-to-temperate climate. We found several aspects of facial shape, especially the relative dimensions of the external nose, internal nose and maxillary sinuses, that are strongly associated with temperature and humidity, even after accounting for autocorrelation due to geographical proximity of populations. For these features, both fossils revealed adaptations to a dry environment, with Sungir being strongly associated with cold temperatures and Mladeč with warm-to-hot temperatures. These results suggest relatively quick adaptative rates of facial morphology in Upper Palaeolithic Europe.
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Affiliation(s)
- Ekaterina Stansfield
- Unit of Theoretical Biology, Department of Evolutionary Biology, University of Vienna, Althanstrasse 14, 1090, Vienna, Austria.
| | - Philipp Mitteroecker
- Unit of Theoretical Biology, Department of Evolutionary Biology, University of Vienna, Althanstrasse 14, 1090, Vienna, Austria
| | - Sergey Y Vasilyev
- Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | - Sergey Vasilyev
- Institute of Anthropology and Ethnography, Moscow, Russian Federation
| | - Lauren N Butaric
- Department of Anatomy, College of Osteopathic Medicine, Des Moines University, Des Moines, USA
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33
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Gallo O, Locatello LG, Mazzoni A, Novelli L, Annunziato F. The central role of the nasal microenvironment in the transmission, modulation, and clinical progression of SARS-CoV-2 infection. Mucosal Immunol 2021; 14:305-316. [PMID: 33244161 PMCID: PMC7690066 DOI: 10.1038/s41385-020-00359-2] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 02/06/2023]
Abstract
The novel coronavirus SARS-CoV-2 enters into the human body mainly through the ACE2 + TMPRSS2+ nasal epithelial cells. The initial host response to this pathogen occurs in a peculiar immune microenvironment that, starting from the Nasopharynx-Associated Lymphoid Tissue (NALT) system, is the product of a long evolutionary process that is aimed to first recognize exogenous airborne agents. In the present work, we want to critically review the latest molecular and cellular findings on the mucosal response to SARS-CoV-2 in the nasal cavity and in NALT, and to analyze its impact in the subsequent course of COVID-19. Finally, we want to explore the possibility that the regulation of the systemic inflammatory network against the virus can be modulated starting from the initial phases of the nasal and nasopharyngeal response and this may have several clinical and epidemiological implications starting from a mucosal vaccine development.
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Affiliation(s)
- Oreste Gallo
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy
| | - Luca Giovanni Locatello
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy
| | - Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Luca Novelli
- Department of Pathology, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy,Flow Cytometry and Immunotherapy Diagnostic Center, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy
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Mori F, Kaneko A, Matsuzawa T, Nishimura T. Computational fluid dynamics simulation wall model predicting air temperature of the nasal passage for nonhuman primates. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 174:839-845. [PMID: 33438763 DOI: 10.1002/ajpa.24221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/07/2020] [Accepted: 12/20/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Nasal passages adjust the temperature of inhaled air to reach the required body temperature for the lungs. The nasal regions of primates including humans are believed to have experienced anatomical modifications that are adaptive to effective conditioning of the atmospheric air in the habitat for a given species. Measurements of the nasal temperature are required to understand the air-conditioning performance for a given species. Unfortunately, repeated direct measurements within the nasal passage have been technically precluded in most nonhuman primates. MATERIALS AND METHODS Computational fluid dynamics (CFD) simulation is a potential approach for examining the temperature profile in the nasal passage without any direct measurements. The CFD simulation model mainly comprises a computational model to simulate physiological mechanisms and a wall model to simulate the nasal passage's anatomical and physical properties. We used a computational model developed for humans and examined corrections for the developed wall model based on human properties for predicting its performance in Japanese macaques. RESULTS This study confirmed that the epithelium layer thickness of the wall model affects the accuracy of the predictions for macaques. A convenient correction of the thickness based on body mass allows us to simulate the actual air temperature profile in macaques' nasal passage. DISCUSSION The CFD simulations of the wall model corrected with body mass can be applied to other nonhuman primates and mammals. This convenient corrective approach allows us to examine the functional contributions of a specific morphology to the air-conditioning performance without any direct measurements to improve our understanding of primates' functional morphology and physical adaptations to the temperature environment in their habitat.
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Affiliation(s)
- Futoshi Mori
- Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Iwate, Japan
| | - Akihisa Kaneko
- Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan
| | - Teruo Matsuzawa
- Japan Advanced Institute of Science and Technology, Nomi, Ishikawa, Japan
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Pedan H, Janosova V, Hajtman A, Calkovsky V. Non-Reflex Defense Mechanisms of Upper Airway Mucosa: Possible Clinical Application. Physiol Res 2021; 69:S55-S67. [PMID: 32228012 DOI: 10.33549/physiolres.934404] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The sinonasal mucosa has an essential role in defense mechanisms of the upper respiratory tract. The innate immune system presents the primary defense against noxious microorganisms followed by induction of the adaptive immune mechanisms as a consequence of the presence of pathogens. This well-known activation of adaptive immune system in response to presence of the antigen on mucosal surfaces is now broadly applicated in vaccinology research. Prevention of infectious diseases belongs to substantial challenges in maintaining the population health. Non-invasive, easily applicable mucosal vaccination purposes various research opportunities that could be usable in daily practice. However, the existence of multiple limitations such as rapid clearance of vaccine from nasal mucosa by means of mucociliary transport represents a great challenge in development of safe and efficient vaccines. Here we give an updated view on nasal functions with focus on nasal mucosal immunity and its potential application in vaccination in nearly future.
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Affiliation(s)
- H Pedan
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and Martin University Hospital, Martin, Slovak
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36
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Kimura S, Miura S, Sera T, Yokota H, Ono K, Doorly DJ, Schroter RC, Tanaka G. Voxel-based simulation of flow and temperature in the human nasal cavity. Comput Methods Biomech Biomed Engin 2020; 24:459-466. [PMID: 33095062 DOI: 10.1080/10255842.2020.1836166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The nasal airway is an extremely complex structure, therefore grid generation for numerical prediction of airflow in the nasal cavity is time-consuming. This paper describes the development of a voxel-based model with a Cartesian structured grid, which is characterized by robust and automatic grid generation, and the simulation of the airflow and air-conditioning in an individual human nasal airway. Computed tomography images of a healthy adult nose were used to reconstruct a virtual three-dimensional model of the nasal airway. Simulations of quiet restful inspiratory flow were then performed using a Neumann boundary condition for the energy equation to adequately resolve the flow and heat transfer. General agreements of airflow patterns, which were a high-speed jet posterior to the nasal valve and recirculating flow that occupied the anterior part of the upper cavity, and temperature distributions of the airflow and septum wall were confirmed by comparing in-vivo measurements with numerical simulation results.
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Affiliation(s)
- Shinya Kimura
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | - Shuta Miura
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | - Toshihiro Sera
- Department of Mechanical Engineering, Kyushu University, Fukuoka, Japan
| | - Hideo Yokota
- Image Processing Research Team, Center for Advanced Photonics, RIKEN, Wako, Japan
| | - Kenji Ono
- Interdisciplinary Computational Science Section, Research Institute for Information Technology, Kyushu University, Fukuoka, Japan
| | - Denis J Doorly
- Department of Aeronautics, Imperial College London, London, UK
| | | | - Gaku Tanaka
- Graduate School of Engineering, Chiba University, Chiba, Japan
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Jung JY, Park CA, Lee YB, Kang CK. Investigation of Functional Connectivity Differences between Voluntary Respirations via Mouth and Nose Using Resting State fMRI. Brain Sci 2020; 10:brainsci10100704. [PMID: 33022977 PMCID: PMC7599777 DOI: 10.3390/brainsci10100704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/26/2020] [Accepted: 09/30/2020] [Indexed: 12/03/2022] Open
Abstract
The problems of mouth breathing have been well-studied, but the neural correlates of functional connectivity (FC) still remain unclear. We examined the difference in FC between the two types of breathing. For our study, 21 healthy subjects performed voluntary mouth and nasal breathing conditions during a resting state functional magnetic resonance imaging (fMRI). The region of interest (ROI) analysis of FC in fMRI was conducted using a MATLAB-based imaging software. The resulting analysis showed that mouth breathing had widespread connections and more left lateralization. Left inferior temporal gyrus had the most left lateralized connections in mouth breathing condition. Furthermore, the central opercular cortex FC showed a significant relationship with mouth breathing. For nasal breathing, the sensorimotor area had symmetry FC pattern. These findings suggest that various FCs difference appeared between two breathing conditions. The impacts of these differences need to be more investigated to find out potential link with cognitive decline in mouth breathing syndrome.
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Affiliation(s)
- Ju-Yeon Jung
- Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea;
| | - Chan-A Park
- Biomedical Engineering Research Center, Gachon University, Incheon 21936, Korea;
| | - Yeong-Bae Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea;
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea
| | - Chang-Ki Kang
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea
- Department of Radiological Science, College of Health Science, Gachon University, Incheon 21936, Korea
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4110
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38
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Na Y, Chung SK, Byun S. Numerical study on the heat-recovery capacity of the human nasal cavity during expiration. Comput Biol Med 2020; 126:103992. [PMID: 32987204 DOI: 10.1016/j.compbiomed.2020.103992] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/29/2020] [Accepted: 09/13/2020] [Indexed: 12/31/2022]
Abstract
The characteristics of the thermal field in the human nasal cavity during the expiration period were investigated using computational fluid dynamics. Heat and water-vapor recovery features were quantitatively investigated under realistic distributions of the epithelial surface and air temperature. A constant expiratory flow rate of 250 mL/s was assumed. The epithelial surface temperature was approximately 34.3-34.4 °C in the nasopharynx and 33.5-33.6 °C in the vestibule region, and these values are in good agreement with the measurement data in the literature. We observed that heat-recovery from the exhaled air mostly occurred in the posterior turbinate region, and the amount of heat recovered is estimated to be approximately 1/3 of the heat supply during inspiration. Because of this heat transfer from the exhaled air to the epithelial surface, the temperature of the epithelial surface increased in this region, and the exhaled air temperature dropped through the turbinate airway. Water-vapor recovery primarily occurs in the posterior segments of the turbinates; however, the amount of water-vapor transfer was approximately 1/5 of that in inspiration. Accordingly, the relative humidity of the exhaled air remained constant throughout the airway.
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Affiliation(s)
- Yang Na
- Department of Mechanical Engineering, Konkuk University, Seoul 05029, Republic of Korea.
| | - Seung-Kyu Chung
- Department of Otorhinolaryngology: Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Seongsu Byun
- Department of Mechanical Engineering, Konkuk University, Seoul 05029, Republic of Korea
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39
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Bastir M, Megía I, Torres-Tamayo N, García-Martínez D, Piqueras FM, Burgos M. Three-dimensional analysis of sexual dimorphism in the soft tissue morphology of the upper airways in a human population. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 171:65-75. [PMID: 31837016 DOI: 10.1002/ajpa.23944] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/17/2019] [Accepted: 09/24/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Several studies have analyzed the sexual dimorphism of the skeletal cranial airways. This study aimed to quantify the three-dimensional (3D) morphology of the soft tissues of the upper airways in a human population. We addressed hypotheses about morphological features related to respiratory and energetic aspects of nasal sexual dimorphism. METHODS We reconstructed 3D models of 41 male and female soft tissue nasal airways from computed tomography data. We measured 280 landmarks and semilandmarks for 3D-geometric morphometric analyses to test for differences in size and 3D morphology of different functional compartments of the soft tissue airways. RESULTS We found statistical evidence for sexual dimorphism: Males were larger than females. 3D features indicated taller and wider inflow tracts, taller outflow tracts and slightly taller internal airways in males. These characteristics are compatible with greater airflow in males. DISCUSSION The differences in 3D nasal airway morphology are compatible with the respiratory-energetics hypothesis according to which males differ from females because of greater energetic demands. Accordingly, structures related to inflow and outflow of air show stronger signals than structures relevant for air-conditioning.
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Affiliation(s)
- Markus Bastir
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales (CSIC), Madrid, Spain
| | - Irene Megía
- Departamento de Prehistoria y Arqueología, Campus de Cantoblanco, Universidad Autónoma de Madrid, Madrid, Spain
| | - Nicole Torres-Tamayo
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales (CSIC), Madrid, Spain
| | | | - Francisco M Piqueras
- Servicio de Otorrinolaringología, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Manuel Burgos
- Universidad Politécnica de Cartagena, Departamento de Ingeniería Térmica y de Fluidos, Cartagena, Spain
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40
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The anthropological analysis of the nasal morphology of Dayak Kenyah population in Indonesia as a basic data for forensic identification. TRANSLATIONAL RESEARCH IN ANATOMY 2020. [DOI: 10.1016/j.tria.2020.100064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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41
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Araújo BCL, de Magalhães Simões S, de Gois-Santos VT, Martins-Filho PRS. Association Between Mouth Breathing and Asthma: a Systematic Review and Meta-analysis. Curr Allergy Asthma Rep 2020; 20:24. [PMID: 32430704 DOI: 10.1007/s11882-020-00921-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW This systematic review and meta-analysis evaluated the association between asthma and mouth breathing. We performed a systematic search in the PubMed, SCOPUS, Lilacs, Web of Science, Google Scholar and OpenThesis databases. RECENT FINDINGS Asthma is defined as a heterogeneous disease characterized by variable symptoms of wheezing, shortness of breath, chest oppression and/or cough, and limitation of expiratory airflow. Although several studies have examined the association between asthma and mouth breathing, there are no systematic reviews or meta-analyses that synthesize the available bodies of evidence. We used the odds ratio as a measure of the association between asthma and mouth breathing. Summary estimates were calculated using random-effects models, and the risk of bias was estimated using the Newcastle-Ottawa Scale for case-control studies and the National Institutes of Health tool for cross-sectional studies. Nine studies were included in the present systematic review. Data from 12,147 subjects were analyzed, of which 2083 were children and adolescents and 10,064 were adults. We found an association between mouth breathing and asthma in children and adolescents (OR 2.46, 95% CI 1.78-3.39) and in adults (OR 4.60, 95% CI 1.49-14.20). However, limitations were found in the methodological description of the included studies, as well as high heterogeneity among studies evaluating adult populations. This meta-analysis showed an association between mouth breathing and asthma in children, adolescents and adults, but the results should be interpreted with caution. Further studies with standardized criteria for the investigation of mouth breathing are needed.
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Affiliation(s)
- Brenda Carla Lima Araújo
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Brazil. .,Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil. .,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil.
| | - Silvia de Magalhães Simões
- Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.,Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Vanessa Tavares de Gois-Santos
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil.,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Paulo Ricardo Saquete Martins-Filho
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil.,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil
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42
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Keustermans W, Huysmans T, Schmelzer B, Sijbers J, Dirckx JJ. The effect of nasal shape on the thermal conditioning of inhaled air: Using clinical tomographic data to build a large-scale statistical shape model. Comput Biol Med 2020; 117:103600. [PMID: 32072966 DOI: 10.1016/j.compbiomed.2020.103600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/16/2019] [Accepted: 01/01/2020] [Indexed: 11/19/2022]
Abstract
In this paper, we investigate the heating function of the nasal cavity qualitatively, using a high-quality, large-scale statistical shape model. This model consists of a symmetrical and an asymmetrical part and provides a new and unique way of examining changes in nasal heating function resulting from natural variations in nasal shape (as obtained from 100 clinical CT scans). Data collected from patients suffering from different nasal or sinus-related complaints are included. Parameterized models allow us to investigate the effect of continuous deviations in shape from the mean nasal cavity. This approach also enables us to avoid many of the compounded effects on flow and heat exchange, which one would encounter when comparing different patient-specific models. The effects of global size, size-related features, and turbinate size are investigated using the symmetrical shape model. The asymmetrical model is used to investigate different types of septal deviation using Mladina's classification. The qualitative results are discussed and compared with findings from the existing literature.
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Affiliation(s)
- William Keustermans
- Physics Department, University of Antwerp, Laboratory of Biophysics and Biomedical Physics, Groenenborgerlaan 171, 2020, Antwerp, Belgium.
| | - Toon Huysmans
- Section on Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628, CE Delft, Netherlands
| | - Bert Schmelzer
- ENT Department, ZNA Middelheim Hospital, Lindendreef 1, 2020, Antwerp, Belgium
| | - Jan Sijbers
- Physics Department, University of Antwerp, Imec-Vision Lab, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Joris Jj Dirckx
- Physics Department, University of Antwerp, Laboratory of Biophysics and Biomedical Physics, Groenenborgerlaan 171, 2020, Antwerp, Belgium
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Inthavong K, Das P, Singh N, Sznitman J. In silico approaches to respiratory nasal flows: A review. J Biomech 2019; 97:109434. [PMID: 31711609 DOI: 10.1016/j.jbiomech.2019.109434] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/15/2019] [Accepted: 10/17/2019] [Indexed: 12/20/2022]
Abstract
The engineering discipline of in silico fluid dynamics delivers quantitative information on airflow behaviour in the nasal regions with unprecedented detail, often beyond the reach of traditional experiments. The ability to provide visualisation and analysis of flow properties such as velocity and pressure fields, as well as wall shear stress, dynamically during the respiratory cycle may give significant insight to clinicians. Yet, there remains ongoing challenges to advance the state-of-the-art further, including for example the lack of comprehensive CFD modelling on varied cohorts of patients. The present article embodies a review of previous and current in silico approaches to simulating nasal airflows. The review discusses specific modelling techniques required to accommodate physiologically- and clinically-relevant findings. It also provides a critical summary of the reported results in the literature followed by an outlook on the challenges and topics anticipated to drive research into the future.
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Affiliation(s)
| | - Prashant Das
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
| | - Narinder Singh
- Dept of Otolaryngology, Head & Neck Surgery, Westmead Hospital Clinical School, Faculty of Medicine, University of Sydney, Australia
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
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44
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Nishimura T, Kaneko A. Temperature profile of the nasal cavity in Japanese macaques. Primates 2019; 60:431-435. [PMID: 31428951 DOI: 10.1007/s10329-019-00741-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
The nasal cavity conditions respiratory air. The distribution of temperature within the nasal cavity has been examined in humans using various direct measurements. Macaques are a nonhuman primate species that are used as a model for understanding human physiology. They are widely distributed geographically in varied climate environments and they are expected to exhibit evolutionary anatomical and physiological adaptations in the air-conditioning. To provide basic data for developing an animal model in air-conditioning, we measured the distribution of temperature within the nasal cavity in Japanese macaques, Macaca fuscata. Inhaled air was well conditioned in the vestibular cavity and was almost fully conditioned before reaching the nasopharynx. This conditioning performance is better than that in humans. The anatomical and histological features of the nasal cavity are expected to explain this difference in physiological performance between the two species. These data will be helpful in establishing an animal model to understand and model airway air-conditioning performance in macaques and humans.
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Affiliation(s)
- Takeshi Nishimura
- Primate Research Institute, Kyoto University, 41-2 Kanrin, Inuyama, Aichi, 484-8506, Japan.
| | - Akihisa Kaneko
- Primate Research Institute, Kyoto University, 41-2 Kanrin, Inuyama, Aichi, 484-8506, Japan
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45
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Newsome H, L. Lin E, Poetker DM, Garcia GJM. Clinical Importance of Nasal Air Conditioning: A Review of the Literature. Am J Rhinol Allergy 2019; 33:763-769. [DOI: 10.1177/1945892419863033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Nasal air conditioning (ie, heating and humidification of inspired air) is an important function of the nasal cavity. This function may be reduced in cases of aggressive nasal surgery. Future virtual surgery planning tools may be used to design surgical approaches that preserve the nasal air conditioning capacity while decreasing airflow resistance. However, it is unclear whether there is a threshold below which impaired nasal air conditioning is associated with negative health consequences. Objective This study aims to review the literature on the clinical impact of reduced nasal air conditioning and its implications for nasal surgery outcomes. Methods A literature search was performed on PubMed and Scopus databases for articles that investigated the effect of air temperature and humidity on mucociliary clearance, respiratory epithelial structure, and the prevalence and severity of respiratory diseases. Results Inspiration of cold, dry air has direct effects on the respiratory epithelium, such as reduced mucociliary clearance and loss of cilia. Nasal surgeries do inflict some changes to the nasal mucosa and geometry that may result in decreased heating and humidification, but it is unclear how long these effects last. Laryngectomy patients serve as a human model for the absence of nasal air conditioning. The heat and moisture exchangers that many laryngectomy patients wear have been shown to improve lung function and reduce pulmonary symptoms associated with breathing unconditioned air, such as increased coughing and thickened mucus. Conclusion Nasal air conditioning is an important mechanism to maintain mucociliary clearance and prevent infection by inhaled pathogens. Preservation of nasal air conditioning capacity should be considered in the implementation of future virtual surgery planning tools. However, a threshold for the onset of negative health consequences due to impaired nasal air conditioning is not yet available.
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Affiliation(s)
- Hillary Newsome
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Biomedical Engineering, Marquette University & The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Emily L. Lin
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Biomedical Engineering, Marquette University & The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - David M. Poetker
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Guilherme J. M. Garcia
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Biomedical Engineering, Marquette University & The Medical College of Wisconsin, Milwaukee, Wisconsin
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46
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Air-conditioning characteristics in nasal cavity models exhibiting nasal cycle states. J Therm Biol 2019; 83:60-68. [PMID: 31331526 DOI: 10.1016/j.jtherbio.2019.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/06/2019] [Accepted: 05/10/2019] [Indexed: 11/23/2022]
Abstract
The air-conditioning characteristics in nasal cavity models obtained from two subjects exhibiting different degrees of the nasal cycle states in terms of the airflow partition were investigated using computational fluid dynamics. A constant inspiratory flow rate of approximately 250 mL/s was considered, and the air temperature and relative humidity at the inlet were assumed to be 25 °C and 35%, respectively. The air-conditioning capacities of the congested and decongested sides were assessed by the amounts of epithelial heat and water vapor transferred to the inhaled air through the airway from the nostrils to the end of the septum. The results revealed that the air temperature and relative humidity near the end of the septum, respectively, reached approximately 31.4-32.5 °C and 81.4-88.0% in the decongested sides and 34.0-35.9 °C and 95.3-100% in the congested sides. The differences seen in the air temperatures and relative humidity between the congested and decongested sides were found to be larger in the cavity model that showed a larger degree of reciprocal change in the airflow rate. From a fluid mechanics perspective, while the congested side is in a rest period during the nasal cycle such that a lower amount of airflow is transported through it, this side, in effect, works to provide assistive air-conditioning capacity to the nasal cavity and aids when insufficiently conditioned airflow passes through the decongested side so that the inhaled air merging after the septum can approach the alveolar condition favorably through the nasopharynx.
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Kimura S, Sakamoto T, Sera T, Yokota H, Ono K, Doorly DJ, Schroter RC, Tanaka G. Voxel-based modeling of airflow in the human nasal cavity. Comput Methods Biomech Biomed Engin 2019; 22:331-339. [PMID: 30773052 DOI: 10.1080/10255842.2018.1555584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This paper describes the simulation of airflow in human nasal airways using voxel-based modeling characterized by robust, automatic, and objective grid generation. Computed tomography scans of a healthy adult nose are used to reconstruct 3D virtual models of the nasal airways. Voxel-based simulations of restful inspiratory flow are then performed using various mesh sizes to determine the level of granularity required to adequately resolve the airflow. For meshes with close voxel spacings, the model successfully reconstructs the nasal structure and predicts the overall pressure drop through the nasal cavity.
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Affiliation(s)
- Shinya Kimura
- a Graduate School of Engineering , Chiba University , Chiba , Japan
| | - Takashi Sakamoto
- a Graduate School of Engineering , Chiba University , Chiba , Japan
| | - Toshihiro Sera
- b Department of Mechanical Engineering , Kyushu University , Fukuoka , Japan
| | - Hideo Yokota
- c Image Processing Research Team, RIKEN Center for Advanced Photonics , Saitama , Japan
| | - Kenji Ono
- d Interdisciplinary Computational Science Section , Research Institute for Information Technology, Kyushu University , Fukuoka , Japan
| | - Denis J Doorly
- e Department of Aeronautics , Imperial College London , London , UK
| | - Robert C Schroter
- f Department of Bioengineering , Imperial College London , London , UK
| | - Gaku Tanaka
- a Graduate School of Engineering , Chiba University , Chiba , Japan
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48
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Bastir M. Big Choanae, Larger Face: Scaling Patterns Between Cranial Airways in Modern Humans and African Apes and Their Significance in Middle and Late Pleistocene Hominin Facial Evolution. ACTA ACUST UNITED AC 2019. [DOI: 10.3166/bmsap-2019-0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to understand the ontogenetic and allometric relationships in scaling between the anterior and posterior openings of the cranial airways and facial size, in order to shed light on the mechanisms that might underlie the evolution of a large face and large airways in Middle Pleistocene hominins and Neandertals. Sizes were calculated from 3D landmarks measured on the facial skeleton and airway structures of 403 skulls from two ontogenetic series of H. sapiens and P. troglodytes, an adult sample of gorillas and 11 Middle Pleistocene hominins and Neandertals. RMA regression models were used to compare the patterns in scaling between the anterior and posterior airways in relation to overall facial size. Our results show that the size of the anterior airways correlates more positively with facial size than the size of the posterior airways. This ontogenetic mechanism could explain the large faces and noses in the Neandertal lineage despite the adverse effects of such a phenotype for respiratory air-conditioning in cold climates. A large facial size could be a developmentally constrained consequence of generating airways large enough to provide the necessary oxygen for high energy demand in this large-brained and heavy-bodied hominin lineage.
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Fallacara A, Busato L, Pozzoli M, Ghadiri M, Ong HX, Young PM, Manfredini S, Traini D. In vitro characterization of physico-chemical properties, cytotoxicity, bioactivity of urea-crosslinked hyaluronic acid and sodium ascorbyl phosphate nasal powder formulation. Int J Pharm 2019; 558:341-350. [PMID: 30659923 DOI: 10.1016/j.ijpharm.2019.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 11/16/2022]
Abstract
An innovative lyophilized dry powder formulation consisting of urea-crosslinked hyaluronic acid (HA-CL) and sodium ascorbyl phosphate (SAP) - LYO HA-CL - SAP- was prepared and characterized in vitro for physico-chemical and biological properties. The aim was to understand if LYO HA-CL - SAP could be used as adjuvant treatment for nasal inflammatory diseases. LYO HA-CL - SAP was suitable for nasal delivery and showed to be not toxic on human nasal septum carcinoma-derived cells (RPMI 2650 cells) at the investigated concentrations. It displayed porous, polygonal particles with unimodal, narrow size distribution, mean geometric diameter of 328.3 ± 27.5 µm, that is appropriate for nasal deposition with no respirable fraction and 88.7% of particles with aerodynamic diameter >14.1 µm. Additionally, the formulation showed wound healing ability on RPMI 2650 cells, and reduced interleukin-8 (IL-8) level in primary nasal epithelial cells pre-induced with lipopolysaccharide (LPS). Transport study across RPMI 2650 cells showed that HA-CL could act not only as carrier for SAP and active ingredient itself, but potentially also as mucoadhesive agent. In conclusion, these results suggest that HA-CL and SAP had anti-inflammatory activity and acted in combination to accelerate wound healing. Therefore, LYO HA-CL - SAP could be a potential adjuvant in nasal anti-inflammatory formulations.
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Affiliation(s)
- Arianna Fallacara
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia; Department of Life Sciences and Biotechnology, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy.
| | - Laura Busato
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia; Department of Life Sciences and Biotechnology, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
| | - Michele Pozzoli
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia
| | - Maliheh Ghadiri
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia
| | - Hui Xin Ong
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia
| | - Paul M Young
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia
| | - Stefano Manfredini
- Department of Life Sciences and Biotechnology, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
| | - Daniela Traini
- Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, 431 Glebe Point Road, Glebe, NSW 2037, Australia.
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Cherobin GB, Voegels RL, Gebrim EMMS, Garcia GJM. Sensitivity of nasal airflow variables computed via computational fluid dynamics to the computed tomography segmentation threshold. PLoS One 2018; 13:e0207178. [PMID: 30444909 PMCID: PMC6239298 DOI: 10.1371/journal.pone.0207178] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 10/26/2018] [Indexed: 01/31/2023] Open
Abstract
Computational fluid dynamics (CFD) allows quantitative assessment of transport phenomena in the human nasal cavity, including heat exchange, moisture transport, odorant uptake in the olfactory cleft, and regional delivery of pharmaceutical aerosols. The first step when applying CFD to investigate nasal airflow is to create a 3-dimensional reconstruction of the nasal anatomy from computed tomography (CT) scans or magnetic resonance images (MRI). However, a method to identify the exact location of the air-tissue boundary from CT scans or MRI is currently lacking. This introduces some uncertainty in the nasal cavity geometry. The radiodensity threshold for segmentation of the nasal airways has received little attention in the CFD literature. The goal of this study is to quantify how uncertainty in the segmentation threshold impacts CFD simulations of transport phenomena in the human nasal cavity. Three patients with nasal airway obstruction were included in the analysis. Pre-surgery CT scans were obtained after mucosal decongestion with oxymetazoline. For each patient, the nasal anatomy was reconstructed using three different thresholds in Hounsfield units (-800HU, -550HU, and -300HU). Our results demonstrate that some CFD variables (pressure drop, flowrate, airflow resistance) and anatomic variables (airspace cross-sectional area and volume) are strongly dependent on the segmentation threshold, while other CFD variables (intranasal flow distribution, surface area) are less sensitive to the segmentation threshold. These findings suggest that identification of an optimal threshold for segmentation of the nasal airway from CT scans will be important for good agreement between in vivo measurements and patient-specific CFD simulations of transport phenomena in the nasal cavity, particularly for processes sensitive to the transnasal pressure drop. We recommend that future CFD studies should always report the segmentation threshold used to reconstruct the nasal anatomy.
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Affiliation(s)
- Giancarlo B. Cherobin
- Department of Ophtalmology and Otorhinolaryngology, Universidade de São Paulo, São Paulo, Brazil
| | - Richard L. Voegels
- Department of Ophtalmology and Otorhinolaryngology, Universidade de São Paulo, São Paulo, Brazil
| | - Eloisa M. M. S. Gebrim
- Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme J. M. Garcia
- Department of Biomedical Engineering, Marquette University & The Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- * E-mail:
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