Correlation between cytological characteristics of the nasal epithelium and the menstrual cycle

BACKGROUND: There has been considerable controversy concerning the effect of hormones on the nasal epithelium and, in particular, their association with the female reproductive state. OBJECTIVE: To investigate the relationship between cytological characteristics of the nasal epithelium and phase of the menstrual cycle.Design and Subjects Nasal smears were obtained from 15 women during the menstrual, follicular, and luteal phases, and the abundance of different cell types at each phase was compared with the abundance of equivalent cell types in vaginal smears during the follicular and luteal phases; the nasal smears were also compared with nasal smears from 20 postmenopausal women and 20 prepubertal girls. Epithelial cell counts were conducted by an observer blind to the origin of the samples. RESULTS: A significant correlation was found between the cytological characteristics of the nasal and vaginal smears and stage of the cycle, with cornified cells predominating during the follicular phase (median, 54%; range, 24%-65%) and rounded or spindle-shaped epithelial cells predominating during the luteal phase (median, 56%; range, 34%-73%). Cornified cells predominated in the nasal smears from the postmenopausal women (median, 71%; range, 60%-77%) and the prepubertal girls (median, 77%; range, 67%-81%) at all times tested. CONCLUSION: Cell turnover in the nasal epithelium may be related to hormonal state, and investigation of the mechanisms underlying such change should help in identifying possible functional consequences and in treating nasal symptoms associated with the female reproductive cycle.     

Nasal congestion during the menstrual cycle

Oestrogens have been considered to cause nasal congestion during the menstrual cycle and during pregnancy. The aim of the present study was to evaluate the degree of nasal congestion during the menstrual cycle in healthy women. Nasal peak expiratory flow (nPEF) was measured and subjective nasal stuffiness was scored morning and evening by 27 women for 3 months and by 14 women for 6 months. During the menstrual days, when the serum oestrogen level is lowest, the morning nPEFs were significantly lower compared with the rest of the cycle (P= 0.0012). The difference was most pronounced for the second day of the cycle (P= 0.00034). The correlation between nPEFs and the subjective scores was high (R= 0.98), while the coefficient of variation within the series of three nPEF recordings was low (6.4%). It is concluded that the nasal obstruction experienced during menstruation cannot be explained by increased serum levels of oestrogen.     

Comparison of transient and distortion-product otoacoustic emissions during the luteal and follicular phases of the menstrual cycle

We conducted a study to examine cochlear activity in women with a naturally occurring menstrual cycle by measuring transient otoacoustic emissions (TOAEs) and distortion-product otoacoustic emissions (DPOAEs). Our study population was made up of 11 women aged 20 to 40 years (mean: 35.6) who were not taking a contraceptive medication or hormone therapy. Measurements of TOAEs and DPOAEs were made during both the follicular phase and the luteal phase of the menstrual cycle. We found no statistically significant difference in any of the TOAE amplitude values between the two phases. Although a sharp decrease at the 0.75 kHz frequency was seen in DPOAEs during both phases, none of the amplitude values in the tested frequencies were significantly different between the two phases. The absence of TOAE and DPOAE amplitude changes suggests that it is unnecessary to take into account the phase of the menstrual cycle when interpreting the results of otoacoustic emissions testing.     

The effect of the steroid sex hormones on the nasal airway during the normal menstrual cycle

The changes in the nasal mucosa during the menstrual cycle have been little researched and the role of oestrogens debated. The aim of this study was to measure a spectrum of physiological parameters in relation to the peak and trough of these hormonal levels. Ten women underwent measurements at the onset of menses and at the time of ovulation. On each occasion, anterior rhinoscopy, peak inspiratory nasal flow, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance time and rhinitis questionnaire score were recorded. All measurements except anterior rhinoscopy showed a difference between the two readings consistent with nasal congestion at the peri-ovulatory stage of the cycle, of which anterior rhinomanometry and mucociliary time were significant (P 相似文献   

The effect of the steroid sex hormones on the nasal airway during the normal menstrual cycle1

The changes in the nasal mucosa during the menstrual cycle have been little researched and the role of oestrogens debated. The aim of this study was to measure a spectrum of physiological parameters in relation to the peak and trough of these hormonal levels. Ten women underwent measurements at the onset of menses and at the time of ovulation. On each occasion, anterior rhinoscopy, peak inspiratory nasal flow, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance time and rhinitis questionnaire score were recorded. All measurements except anterior rhinoscopy showed a difference between the two readings consistent with nasal congestion at the peri‐ovulatory stage of the cycle, of which anterior rhinomanometry and mucociliary time were significant (P ≤ 0.05). Nasal congestion therefore occurs in conjunction with the rise in serum oestrogens that occur at ovulation in the normal menstrual cycle. Pharmacological antagonism of oestrogens may therefore relieve nasal congestion and is currently under further research.     

Rhinomanometric and olfactometric variations throughout the menstrual cycle

A prospective study was performed to evaluate the rhinomanometric values and the changes in the olfactory threshold that occur in women throughout the menstrual cycle. The subjects were 60 healthy volunteer premenopausal women 18 to 40 years of age. We performed rhinomanometric and olfactometric measurements during the follicular, periovular, and luteal phases of the menstrual cycle. Rhinomanometry showed a higher (not statistically significant) airflow during the periovular phase than during the follicular and luteal phases. Olfactometry showed a higher sensitivity during the follicular phase (p < .05) and the periovular phase (p < .001) than during the luteal phase. We conclude that airflow and transnasal pressure during spontaneous respiration, as well as the olfactory threshold to odors, seem to depend on the variations of the ovarian steroids that occur during the menstrual cycle.     

Auditory brain stem response throughout the menstrual cycle

A prospective study was performed to evaluate the changes in the auditory brain stem response (ABR) that occur in healthy premenopausal women throughout the menstrual cycle. Ninety-four women with ovulatory menstrual cycles underwent ABR testing by auditory evoked potentials for wave I, III, and V latencies and for interpeak I-III, I-V, and III-V intervals during the follicular, periovular, and luteal phases of the menstrual cycle. The wave latencies and the interpeak intervals showed shorter values during the periovular phase than during the luteal phase (p < .05) and shorter values during the follicular phase for wave I (p < .05) and interpeak interval I-V (p < .05). The ABR seems to be influenced by the variations of ovarian steroids that occur during the menstrual cycle.     

The nasal cycle in respiratory defence

The review describes the phenomenon of the nasal cycle, which consists of periodic congestion and decongestion of the nasal venous sinuses and an alternation of airflow from one side of the nose to the other over a period of several hours. The hypothesis is put forward that the nasal cycle may have a role in respiratory defence by; (a) alternation of the work of air conditioning between the nasal passages (b) generation of a plasma exudate which physically cleanses the epithelium and provides a source of antibodies and inflammatory mediators (c) maintaining the patency of the airway during the inflammatory response to infection.     

Scanning and transmission electron microscopic aspects of the nasal acilia syndrome

A 3-month-old boy was admitted with failure to thrive and persistent fevers. During a 4 month hospitalization for treatment of suspected sepsis, persistent purulent nasal discharge developed. Biopsies of his nasal mucosa on 3 separate occasions disclosed thinned respiratory epithelium and a complete absence of cilia when examined by electron microscopy (EM). Despite an initial granulocytopenia and a wide range in T-cell numbers, he did not show any evidence of lower respiratory tract infection. A tracheal biopsy processed for EM demonstrated normal ciliated epithelium. This patient appears to have an unrecognized syndrome of normal tracheal cilia but absent nasal cilia.     

Estrogen influences auditory brainstem responses during the normal menstrual cycle

We evaluated the impact of the menstrual cycle on auditory brainstem response (ABR) latency in nine normally cycling women. Subjects (age 23–40 years) using no hormonal therapy were recruited and underwent ABR testing during four different phases of the same menstrual cycle: early follicular (cycle days 1 to 3); mid-cycle (cycle days 12 to 15); mid-luteal (cycle days 17 to 22), and premenstrual (cycle days 25–27). Cycles were verified by basal body temperature, and serum estrogen (E₂), progesterone (P), and gonadoropin levels. A control group of nine women (age 23–40 years) on oral contraceptives (Nordette-28) was also studied four times during a pill cycle. Results show a significant increase in the latency of wave III and wave V peak latencies and in the I-V interpeak interval associated with a high estrogen state at the mid-cycle phase. No statistically significant variations in latency were found in the birth control pill group. These data suggest the existence of brainstem auditory neural pathways that are sensitive to fluctuations in E₂ levels during the menstrual cycle.     

Effects of the ovarian and contraceptive cycles on absolute thresholds, auditory fatigue and recovery from temporary threshold shifts at 4 and 6 kHz

Absolute thresholds at 4 and 6 kHz were tested in three sessions before and after 20 min of exposure to 105 dB(A) pink noise in 12 young normal-cycling females, 11 young females on oral contraceptives and 8 young men. Women on contraceptives showed lower resting thresholds, larger temporary threshold shift (TTS) and higher recovery rates than normal-cycling females. The analysis of resting thresholds, auditory fatigue and recovery from auditory fatigue did not evidence any sex-linked difference. Significant differences linked to the phases of the menstrual cycle and of the contraceptive cycle were observed during recovery from auditory fatigue at 4 kHz and in resting thresholds at 6 kHz. Application of Kendall's coefficient of concordance confirmed these results. Absolute thresholds were highest at menstruation and lowest in the postovulatory phase in normal-cycling females and in women on oral contraceptives, during the days of pill ingestion. Oral contraception is probably a more important factor of change in hearing performance than the phases of the menstrual cycle.     

Effects of the Ovarian and Contraceptive Cycles on Absolute Thresholds,Auditory Fatigue and Recovery from Temporary Threshold Shifts at 4 and 6 kHz

Absolute thresholds at 4 and 6 kHz were tested in three sessions before and after 20 min of exposure to 105 dB(A) pink noise in 12 young normal-cycling females, 11 young females on oral contraceptives and 8 young men. Women on contraceptives showed lower resting thresholds, larger temporary threshold shift (TTS) and higher recovery rates than normal-cycling females. The analysis of resting thresholds, auditory fatigue and recovery from auditory fatigue did not evidence any sex-linked difference. Significant differences linked to the phases of the menstrual cycle and of the contraceptive cycle were observed during recovery from auditory fatigue at 4 kHz and in resting thresholds at 6 kHz. Application of Kendall's coefficient of concordance confirmed these results. Absolute thresholds were highest at menstruation and lowest in the postovulatory phase in normal-cycling females and in women on oral contraceptives, during the days of pill ingestion. Oral contraception is probably a more important factor of change in hearing performance than the phases of the menstrual cycle.     

Differences in terminal carbohydrate structures of sialomucin in the murine nasal cavity

Terminal carbohydrate structures of sialomucin in the murine nasal cavity were characterized by means of lectin histochemistry. Two kinds of biotinylated lectins (Maackia amurensis agglutinin and Sambucus nigra agglutinin), which recognize sialic acid residues, showed marked differences in their respective labeling patterns when used as epithelial probes. Maackia amurensis agglutinin labeled the epithelial goblet cells, Bowman's glands, and all cell surfaces of both olfactory and respiratory epithelium. In contrast, Sambucus nigra agglutinin labeled cell surfaces and Bowman's glands in the murine olfactory epithelium, but did not label the murine respiratory epithelium. These results indicate that sialomucin in the murine nasal cavity has two different terminal carbohydrate structures. Our data show that sialomucin in the murine respiratory epithelium has a Neu5Ac(2–3)Gal sequence, while sialomucin in the murine olfactory epithelium has both a2-3 and a2-6 binding sequences. These results suggest that different carbohydrate structures of sialomucin in the nasal cavity may reflect differences in susceptibility to bacterial colonization and viral infection between respiratory and olfactory epithelium, and influence rheological properties of nasal secretion.     

Electron microscopy findings in the nasal mucosa of a patient with stenosis of the nasal vestibule

The nasal mucosa humidifies, warms and filters inspired air before it passes to the lower respiratory tract. In order to maintain the physiological activity of the respiratory epithelium, a certain amount of airflow is required. This report describes electron microscopy findings in the nasal mucosa of a patient who had decreased airflow through the nose due to stenosis of the nasal vestibule. Electron microscopic examination of the nasal mucosa revealed stratified squamous epithelium composed of markedly degenerated cells. The findings of abnormal mucosal structure highlight another negative consequence of nasal obstruction in addition to abnormal physiological function of the nose. The negative impact of diminished airflow on the nasal mucosa should be considered in any case where the patient has a condition that can lead to partial or total loss of airflow through the nose.     

Growth of human respiratory epithelium on collagen foil

BACKGROUND: Clinical application of bioartificial tracheal prosthesis must still be regarded as an experimental concept because restoration of a functional respiratory epithelium outlining the prosthesis is still not possible. Tissue engineering as a relatively new biotechnological discipline may offer new methods in expanding differentiated respiratory epithelium in vitro. In this study we compare two different cell and tissue culture procedures for growing human nasal mucosa on commercially available collagen foil. MATERIAL AND METHODS: Harvested specimens of human nasal mucosa (n = 6, 4 x 4 cm) were placed on collagen foil and incubated as tissue cultures for 4, 6 and 8 weeks. A suspension of enzymatically dispersed nasal epithelium seeded on collagen foil (5 x 10(5) cells) served as control. Cell growth and ciliary beat were monitored through an inverted microscope with Hoffman's modulation contrast and video set-up. Histological examination was performed after 4, 6 and 8 weeks. RESULTS: In the tissue cultures, the collagen foil was initially covered with fibroblasts growing from the mucosa specimen before epithelial cells spread out. The epithelial layer showed mostly ciliated cells which developed metachronous ciliary beat after 4 weeks in vitro. Ciliary activity was observed until the end of the experiments in 8 weeks. New cells on the suspension cultures were mesenchymal and did not exhibit any ciliary activity. CONCLUSIONS: Mucosa specimens seem to be more appropriate for tissue engineering of respiratory epithelium than cell suspensions from nasal epithelium. Collagen foil as tissue scaffold initiates epithelial-mesenchymal interaction and may play an important role in epithelial differentiation of new respiratory epithelium.     

Immunohistochemical Localization of Nitric Oxide Synthase Activity in Upper Respiratory Epithelium

Nitric oxide (NO) production in the respiratory epithelium of the upper airways has recently been described. To better delineate the role of epithelial NO, the authors of this study attempted to identify the cell type responsible for the production of NO in rat tracheal epithelium and human nasal epithelium. They localized the activity of NO through immunohistochemical analysis with an antibody to L-citrulline, a marker for activity of the L-arginine-dependent nitric oxide synthase (NOS) pathway. Using anti-inducible NOS (iNOS) and anti-constitutive NOS (cNOS) antibodies, they also attempted to identify the specific NO isotypes that were present. The tracheal and nasal epithelium demonstrated strong immunoreactivity to citrulline in ciliated cells. The ciliated cells of the nasal turbinates demonstrated strong iNOS positivity, but no significant cNOS immunoreactivity. The study findings that iNOS activity is present in ciliated epithelial cells of rat and human upper respiratory epithelium suggest that NO may play a role in epithelial homeostasis and could potentially play a role in the pathogenesis of mucociliary dysfunction.     

Phase variation in nasal airways resistance assessed by active anterior rhinomanometry

Measurements of nasal airways resistance in normal subjects have shown a significant difference between values obtained in the two respiratory phases. Higher overall values are found during expiration in both the unprepared and decongested nose but these differences fail to maintain statistical significance after application of a decongestant. This indicates that the phase of respiration in which measurement is made must be routinely recorded especially when measurement is made without decongestant, and comparisons of data made only with recordings from equivalent parts of the nasal cycle.     

Localisation of heme oxygenase isoforms in allergic human nasal mucosa

Carbon monoxide (CO) is an endogenously produced gas mediator produced by heme oxygenase (HO). Like nitric oxide (NO), CO is produced in the nasal mucosa. Given that induced NO synthase (iNOS) expression in nasal mucosa has been found to be up-regulated in allergic rhinitis, the current study investigated the expression of HO isoforms in allergic human nasal mucosa. Immunohistochemical staining for type 1 and 2 HO isoforms were carried out in nasal inferior turbinate mucosa from six patients with persistent allergic rhinitis, and compared with six control patients without nasal allergy. Focal and weak expression of HO-1 was observed in seromucous glands, with no difference between allergic and control specimens. Vascular endothelium, erythrocytes, smooth muscle and inflammatory cells (except macrophages) in the allergic group exhibited stronger HO-1 immunoreactivity compared to the control. Minimal expression was found in the respiratory epithelium in either group. Intravascular HO-1 expression was found in the allergic mucosa only. Intense HO-2 immunoreactivity was observed in the respiratory epithelium, vascular endothelium and seromucous glands in both allergic and control groups with no differences in intensity. In conclusion, unlike iNOS, HO-1 is minimally expressed in the nasal respiratory epithelium of either group. However, our findings suggest that it may be involved in the inflammatory process of allergic rhinitis at the submucosal level.     

Human olfactory biopsy. The influence of age and receptor distribution.

Thirty-six mucosal specimens were obtained with a biopsy instrument from the upper nasal septum of 12 human autopsy cases before the en bloc removal of the entire olfactory area. Examination of these 36 specimens with transmission electron microscopy demonstrated olfactory epithelium in only 17. A significant negative correlation (r = -.728) was noted between the age of the subject and the probability of obtaining olfactory epithelium, supporting the idea that the olfactory mucosa is gradually replaced by respiratory epithelium with aging. Using the en bloc specimens, the distribution of olfactory epithelium was reconstructed from light microscopic examination of silver-stained sections. Multiple patches of respiratory epithelium were observed over the upper portion of the nasal septum and superior turbinates, ie, the presumptive olfactory area. On transmission electron microscopic examination, frequent respiratory metaplasia was also suggested. Within the area of respiratory metaplasia, supporting cell-like and microvillar cell-like structures often were found; these structures may be remnants of olfactory epithelium. The sampling of olfactory tissue with a biopsy procedure is hampered by the irregular and patchy distribution of olfactory epithelium. The invasion of respiratory epithelial patches into the olfactory mucosa seems to be characteristic of the human olfactory epithelium and may increase as a function of age. Thus, conclusions about the structure of the olfactory mucosa in an individual patient must be based on several tissue samples.     

The relationship between the nasal cycle and mucociliary clearance.

Nasal airway resistances were measured bilaterally on subjects at 30-minute intervals over 6 hours using anterior rhinomanometry. The first 10 subjects found to exhibit alternating congestion and decongestion of the nasal mucosa (i.e., the nasal cycle) were included in the study. Using the saccharin method, nasal mucociliary clearance was determined for each subject in both the congested and decongested phases of the cycle. The results were statistically significant at the P less than .09 level, highly suggestive of a difference in nasal mucociliary clearance between the two phases of the cycle, with the congested phase having the more rapid clearance. However, when compared to the mucociliary clearance times in disease states, the difference in transport times between the two phases is probably not clinically significant.