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Chen J, Shen B, Zhang M, Yang Y, Wang Y, Yang Z, Su K. Real-time observation of nasal cycle during sleep with polysomnography. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08812-9. [PMID: 39172233 DOI: 10.1007/s00405-024-08812-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/25/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE To investigate the nasal cycle (NC) during sleep in healthy individuals without nasal obstruction or obstructive sleep apnoea via a flexible wearable respiratory monitoring system in a continuous and real-time manner. METHODS NC during sleep was continuously measured in 30 healthy individuals (15 women, 15 men) via long-term sleep respiratory monitoring system, while sleep stage and body position were simultaneously recorded via polysomnography (PSG). The number of NC transitions and positional changes were documented each night. Additionally, time intervals between NC transitions and their closest positional changes during sleep were meticulously recorded to investigate potential correlations between them. RESULTS A total of 86.7% of the participants displayed the classic NC, with a mean duration of 6.43 ± 2.33 h. Nightly observations revealed an average occurrence of 2.19 ± 0.40 NC transitions, predominantly occurring during REM stage (68.4%), and 9.15 ± 7.77 postural changes. Analysis of the intervals between NC transitions and positional changes revealed an average absolute value of 27.72 ± 10.85 min, with a substantial 56.4% exceeding 30 min, indicating a non-obvious sequence order among them. CONCLUSION NC can be measured in a continuous and real-time manner, the transitions occur mainly during the REM stage. However, we have not identified a clear correlation between NC transition and positional change.
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Affiliation(s)
- Jingyi Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, 600 Yishan Road, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, China
| | - Bojun Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, 600 Yishan Road, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, China
| | - Miao Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, 600 Yishan Road, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, China
| | - Yingchao Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, 600 Yishan Road, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, China
| | - Yao Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, 600 Yishan Road, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, China
| | - Zhuoqing Yang
- National Key Laboratory of Advanced Micro and Nano Manufacture Technology, Shanghai Jiao Tong University (SJTU), 800 Dongchuan RD., Minhang District, Shanghai, 200240, China.
| | - Kaiming Su
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China.
- Shanghai Key Laboratory of Sleep Disordered Breathing, 600 Yishan Road, Shanghai, China.
- Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, China.
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Di Berardino F, Zanetti D, D'Amato G. Nasal Rinsing with an Atomized Spray Improves Mucociliary Clearance and Clinical Symptoms during Peak Grass Pollen Season. Am J Rhinol Allergy 2017; 31:40-43. [DOI: 10.2500/ajra.2016.30.4383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Nasal rinsing with an atomizer spray was found to be effective in the treatment of allergic rhinitis. Two parameters express the nasal functions: (1) mucociliary clearance (MCC), and (2) the pH and its stability. MCC is the main factor that defines the time of pollen transition on the nasal mucosa and, therefore, the amount of the allergen glycoprotein elution. Objective We hypothesized that the nasal wash efficacy could be due to the reduction of contact time of the grass pollen on the nasal mucosa (improving MCC). Methods Forty patients with seasonal grass pollen oculorhinitis were randomized in two groups: 20 received three times daily nasal rinsing with hypertonic solution buffered to pH 6.1, before and during the peak pollen season in 2015 (active group), and another 20 patients were allocated to the control group and received no nasal treatment. The daily symptoms score and the use of oral antihistamines when required were evaluated during the grass pollen peak season. All the patients completed the study. Results In comparison with the control group, in the active group, a significant decrease of both nasal symptoms (p = 0.01) and consumption of antihistamines (p = 0.035) was found. Furthermore, the MCC was significantly worse (p = 0.011) only in the control group. Conclusion The nasal treatment maintained the efficiency of the MCC in the patients in the active group, who showed a significant reduction of symptoms and medication score. The MCC decreased the transit time of the pollen on the nasal mucosa, which favored an elution of the allergenic proteins.
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Affiliation(s)
- Federica Di Berardino
- Audiology Unit, Medical and Community Science Department, University of Milano, Fondazione IRCCS “Càa Granda,” H. Maggiore Policlinico, Milan, Italy
| | - Diego Zanetti
- Audiology Unit, Medical and Community Science Department, University of Milano, Fondazione IRCCS “Càa Granda,” H. Maggiore Policlinico, Milan, Italy
| | - Gennaro D'Amato
- Division of Respiratory and Allergic Diseases, High Specialty Department, “A. Cardarelli” Hospital, Naples, Italy
- Committee and Task Force on “Climate Change, Biodiversity and Allergy,”, Naples, Italy, World Allergy Organization
- Centre on “Health and Environment,” University of Naples, Naples, Italy
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Saraiva C, Ferreira L, Bernardino L. Traceable microRNA-124 loaded nanoparticles as a new promising therapeutic tool for Parkinson's disease. NEUROGENESIS 2016; 3:e1256855. [PMID: 28405588 DOI: 10.1080/23262133.2016.1256855] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/22/2016] [Accepted: 11/01/2016] [Indexed: 01/09/2023]
Abstract
Parkinson's disease (PD), a neurodegenerative disorder characterized by the selective degeneration of the nigrostriatal dopaminergic pathway, is a major socio-economic burden in modern society. While there is presently no cure for PD, enhancing the number of neural stem cells (NSCs) and/or stimulating their differentiation into new neurons are promising therapeutic strategies. Many proneurogenic factors have been implicated in controlling NSCs activity, including the microRNA (miR)-124. However, current strategies described for the intracellular delivery of miR involve mostly unspecific or inefficient platforms. In Saraiva et al. we developed miR-124 loaded nanoparticles (NPs) able to efficiently deliver miR-124 into neural stem/progenitor cells and boost neuronal differentiation and maturation in vitro. In vivo, the intracerebroventricular injection of miR-124 NPs increased the number of new neurons in the olfactory bulb of healthy and 6-hydroxidopamine (6-OHDA) lesioned mice, a model for PD. Importantly, miR-124 NPs enhanced the migration of new neurons into the 6-OHDA lesioned striatum, culminating in motor function improvement. Given the recent advent of clinical trials for miR-based therapies and the theranostic applications of our NPs, we expect to support the clinical translation of our delivery platform in the context of PD and other neurodegenerative diseases which may benefit from enhancing miR levels.
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Affiliation(s)
- Cláudia Saraiva
- Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior , Covilhã, Portugal
| | - Lino Ferreira
- CNC-Center for Neuroscience and Cell Biology, Coimbra, Portugal; Biocant - Center of Innovation in Biotechnology, Cantanhede, Portugal; Institute for Interdisciplinary Research, University of Coimbra (IIIUC), Coimbra, Portugal
| | - Liliana Bernardino
- Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior , Covilhã, Portugal
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Kahana-Zweig R, Geva-Sagiv M, Weissbrod A, Secundo L, Soroker N, Sobel N. Measuring and Characterizing the Human Nasal Cycle. PLoS One 2016; 11:e0162918. [PMID: 27711189 PMCID: PMC5053491 DOI: 10.1371/journal.pone.0162918] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/30/2016] [Indexed: 11/18/2022] Open
Abstract
Nasal airflow is greater in one nostril than in the other because of transient asymmetric nasal passage obstruction by erectile tissue. The extent of obstruction alternates across nostrils with periodicity referred to as the nasal cycle. The nasal cycle is related to autonomic arousal and is indicative of asymmetry in brain function. Moreover, alterations in nasal cycle periodicity have been linked to various diseases. There is therefore need for a tool allowing continuous accurate measurement and recording of airflow in each nostril separately. Here we provide detailed instructions for constructing such a tool at minimal cost and effort. We demonstrate application of the tool in 33 right-handed healthy subjects, and derive several statistical measures for nasal cycle characterization. Using these measures applied to 24-hour recordings we observed that: 1: subjects spent slightly longer in left over right nostril dominance (left = 2.63 ± 0.89 hours, right = 2.17 ± 0.89 hours, t(32) = 2.07, p < 0.05), 2: cycle duration was shorter in wake than in sleep (wake = 2.02 ± 1.7 hours, sleep = 4.5 ± 1.7 hours, (t(30) = 5.73, p < 0.0001). 3: slower breathing was associated with a more powerful cycle (the extent of difference across nostrils) (r = 0.4, p < 0.0001), and 4: the cycle was influenced by body posture such that lying on one side was associated with greater flow in the contralateral nostril (p < 0.002). Finally, we provide evidence for an airflow cycle in each nostril alone. These results provide characterization of an easily obtained measure that may have diagnostic implications for neurological disease and cognitive state.
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Affiliation(s)
- Roni Kahana-Zweig
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Maya Geva-Sagiv
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Aharon Weissbrod
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Lavi Secundo
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Nachum Soroker
- Loewenstein Rehabilitation Hospital, Ra’anana, 43100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Israel
| | - Noam Sobel
- Department of Neurobiology, The Weizmann Institute of Science, Rehovot, 76100, Israel
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Djupesland PG, Messina JC, Mahmoud RA. Breath powered nasal delivery: a new route to rapid headache relief. Headache 2014; 53 Suppl 2:72-84. [PMID: 24024605 PMCID: PMC3786533 DOI: 10.1111/head.12186] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2013] [Indexed: 12/02/2022]
Abstract
The nose offers an attractive noninvasive alternative for drug delivery. Nasal anatomy, with a large mucosal surface area and high vascularity, allows for rapid systemic absorption and other potential benefits. However, the complex nasal geometry, including the narrow anterior valve, poses a serious challenge to efficient drug delivery. This barrier, plus the inherent limitations of traditional nasal delivery mechanisms, has precluded achievement of the full potential of nasal delivery. Breath Powered bi-directional delivery, a simple but novel nasal delivery mechanism, overcomes these barriers. This innovative mechanism has now been applied to the delivery of sumatriptan. Multiple studies of drug deposition, including comparisons of traditional nasal sprays to Breath Powered delivery, demonstrate significantly improved deposition to superior and posterior intranasal target sites beyond the nasal valve. Pharmacokinetic studies in both healthy subjects and migraineurs suggest that improved deposition of sumatriptan translates into improved absorption and pharmacokinetics. Importantly, the absorption profile is shifted toward a more pronounced early peak, representing nasal absorption, with a reduced late peak, representing predominantly gastrointestinal (GI) absorption. The flattening and “spreading out” of the GI peak appears more pronounced in migraine sufferers than healthy volunteers, likely reflecting impaired GI absorption described in migraineurs. In replicated clinical trials, Breath Powered delivery of low-dose sumatriptan was well accepted and well tolerated by patients, and onset of pain relief was faster than generally reported in previous trials with noninjectable triptans. Interestingly, Breath Powered delivery also allows for the potential of headache-targeted medications to be better delivered to the trigeminal nerve and the sphenopalatine ganglion, potentially improving treatment of various types of headache. In brief, Breath Powered bi-directional intranasal delivery offers a new and more efficient mechanism for nasal drug delivery, providing an attractive option for improved treatment of headaches by enabling or enhancing the benefits of current and future headache therapies.
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