Autonomic innervation of interstitial cells in the nasal respiratory mucosa

We analyzed the microscopic innervations of the pars respiratoria of the nasal mucosa in humans, cats, and rabbits. To this end, the techniques of Jabonero, Champy-Maillet, and Koelle-Friedenwald were employed to detect specific acetylcholinesterase activity. The supremum colli ganglion was also removed from cats in order to observe any tissue changes produced. Using our histochemical techniques, we were able to demonstrate for the first time that Cajal's interstitial cells in the nasal mucosa are acetylcholinesterase-positive. These cells also appear to be totally integrated into the structure of the terminal vegetative neural formations. Additionally, the fibers surrounding these cells were found to show early degeneration after experimental cervical sympathectomies had been performed.     

Autonomic microganglia of the nasal mucosa and their relation to vasomotor rhinitis

The classical concept of the autonomic innervation of the nasal mucosa states that the postganglionic sympathetic neurones lie in the superior cervical ganglion and those of the postganglionic parasympathetic neurones are in the pterygopalatine ganglion. We have carried out a study of the fine structure of the respiratory nasal mucosa in man and in the cat using the techniques described by Jabonero, Champy Maillet and Koelle-Friedenwald. The most striking finding was the presence of microganglia deep within the mucosa of the inferior turbinate close to the glands. These microganglia were cholinergic in nature since they demonstrated a positive reaction to anticholinesterase. From this we deduce that the nasal parasympathetic pathway has its postganglionic neurones not only in the pterygopalatine ganglion but also in these microganglia of the inferior turbinate. Each of four groups of cats were submitted to different techniques, including administration of neostigmine, inferior turbinectomy and Vidian neurectomy. Resection of the microganglia by means of turbinectomy reduced the hypersecretion caused by neostigmine and this was most noticeable when a Vidian neurectomy was carried out in addition.     

Passive smoking causes an 'allergic' cell infiltrate in the nasal mucosa of non-atopic children

Environmental tobacco smoke (ETS) is one of the most common indoor pollutants to which many children are exposed. This study was set up to determine possible effects on cellular infiltrates in the nasal mucosa of children exposed to ETS. The research population consisted of a group of ten children exposed to more then 15 cigarettes/day and a control group of ten children without exposure. The groups were matched for age and gender. None of the children had an atopic constitution. Immunohistochemical staining techniques were used to determine the number of Langerhans cells, T cells, B cells, granulocytes, macrophages, mast cells and eosinophils in the nasal mucosa. IgE+ cells and eosinophils were seen in significantly higher cell numbers in the nasal mucosa of children exposed to ETS (Mann-Whitney U-test). IgE+ mast cells were not found to be more numerous in the ETS-exposed group. We can conclude that exposure to ETS causes changes in cellular infiltrates which partly resemble those seen in the nasal mucosa of allergic children. However, no sign of allergic sensitisation can be found in the nasal mucosa. Children with a genetic predisposition to allergic disease will probably suffer most from the 'unstable' nasal mucosa due to ETS.     

Fos expression in the brainstem nuclei evoked by nasal air-jet stimulation in rats

BACKGROUND: Noxious stimulation of the nasal mucosa may induce protective reflexes in the upper airway in rats. Previously, we have reported that nasal air-jet stimulation increases the activities of the laryngeal muscles in decerebrate cats; however, the neuronal mechanism of this phenomenon still is not clarified. METHODS: After the application of nasal air-jet stimulation for 2 hours, we investigated the distribution of Fos-positive cells (FPCs) throughout the medulla compared with sham-operated rats using Fos immunoreactivity. RESULTS: FPCs in the spinal trigeminal nucleus, the parvocellular reticular nucleus, and the nucleus of the solitary tract were more frequent than the sham-operated rats. CONCLUSION: These results suggest that the afferents induced by air-jet stimulation were conveyed to these FPCs and that some of these cells might participate in the augmentation of laryngeal muscle activities during nasal air-jet stimulation.     

Distribution of immunocompetent cells in normal nasal mucosa: comparisons among germ-free, specific pathogen-free, and conventional mice

To better understand the role of immunocompetent cells in the defense mechanism of the upper respiratory tract against microbial invasions, the distribution patterns of those cells were investigated in nasal mucosa of mice maintained in three different conditions: germ-free (GF), specific pathogen-free (SPF), and conventional (CV) conditions. Immunostaining by the indirect peroxidase method and toluidine blue staining were employed for the detection of immunocompetent cells and mast cells. For immunostaining, anti-IgG, -IgA, and -IgM polyclonal antibodies and anti-Lyt-1, -Lyt-2, and -Mac-1 monoclonal antibodies were used as primary antibodies. In nasal mucosa of CV mice, Mac-1+ cells, mast cells, and all cell types of lymphocyte subsets were present. In nasal mucosa of SPF mice, all cell types were also positive, but fewer in number than those of CV mice. In nasal mucosa of GF mice, IgG+, IgA+, and Lyt-2+ cells were rare, although IgM+ and Lyt-1+ cells were present in small numbers. An electron microscopic study revealed that follicle-like lymphocyte aggregates with high endothelial venules were present in nasal mucosa close to the mucosal epithelia. These findings suggest that lymphocytes are mobilized to nasal mucosa, responding to continuous antigenic stimuli, and play an important role in the local defense mechanism of the upper respiratory tract.     

Innate responses to Aspergillus: role of C1q and pentraxin 3 in nasal polyposis

BACKGROUND: Pentraxin 3 (PTX3) and complement component C1q are humoral factors of innate immunity, produced at sites of inflammation, and are essential in immune defense against several microbes such as Aspergillus, which is commonly implicated in nasal polyposis. METHODS: PTX3 and C1q were measured in nasal polyp tissue, normal nasal mucosa, and serum of patients and healthy subjects. Immunohistochemistry for the two proteins was done on normal nasal mucosa and nasal polyps. In addition, PTX3 and C1q production from mononuclear cells from patients and healthy subjects was assessed. RESULTS: Normal nasal mucosa was found to have 100-fold higher levels of PTX3 compared with serum. No measurable local increase of PTX3 was observed in polyps compared with normal mucosa. Immunohistochemistry revealed PTX3 expression in the lining of blood vessels both within normal mucosa and nasal polyps. PTX3 also was present in mononuclear cells infiltrating nasal polyps. C1q levels were higher in polyps than in normal nasal mucosa. CONCLUSION: High levels of PTX3 are present in normal nasal mucosa, suggesting a role in the maintenance of tissue homeostasis. Elevated C1q levels in nasal polyps might be indicative of an ongoing inflammatory response in the nasal mucosa in these patients.     

Inflammatory cells in nasal mucosa and nasal polyps

OBJECTIVE: Since some controversy exists concerning the frequency of inflammatory cells in nasal polyps, we have compared the frequency of tissue inflammatory cells (lymphocytes, neutrophils, eosinophils and plasma cells) including 11 kinds of lymphocyte subsets in the same specimens of nasal mucosa and nasal polyps. METHODS: Histopathological observations and flow cytometric analyses were performed on eight mucosal specimens of the inferior turbinates of patients with nasal polyps and on 13 polyp specimens. RESULTS: Nasal polyps contained significantly more eosinophils, neutrophils and plasma cells than nasal mucosa, and EG2+ cells (activated eosinophils) were significantly more frequent in nasal polyps than in nasal mucosa. Flow cytometric analysis showed that there were no significant differences in the frequencies of lymphocytes and lymphocyte subsets (CD1+, CD2+, CD3+, CD5+, CD7+, CD4+, CD8+, CD10+, CD19+, CD20+ and HLA-DR+ cells) including CD4/8 ratios between nasal mucosa and polyps, though, both nasal mucosa and polyps contained significantly more lymphocytes than eosinophils, neutrophils or plasma cells. The T cell lineage (CD2+, CD3+, CD5+ and CD7+ cells) was found in high frequency and B cell lineage (CD10+, CD19+ and CD20+ cells) in low frequency in both nasal mucosa and polyps. The frequency of HLA-DR+ cells (most of which were activated T cells) was not significantly different between nasal mucosa and nasal polyps. CONCLUSION: Histopathological and flow cytometric analyses were performed on the composition of inflammatory cells in nasal mucosa of the inferior turbinates and in polyps from the same patients. The elevated numbers of activated eosinophils, neutrophils and plasma cells in nasal polyps compared with nasal mucosa suggest that inflammatory processes play important roles in the pathophysiology of nasal polyps. The frequencies of lymphocytes and lymphocyte subsets were not significantly different between these two tissues.     

鼻内镜术中光和热对鼻黏膜的损伤

目的：探讨鼻内镜术中光和热对鼻黏膜的损伤。方法：应用透射电镜技术，观察正常和光照不同时间后的兔鼻中隔黏膜及其改变。结果：发现光照后纤毛分布不均，有粘连及脱落；随照射时间的延长，出现上皮细胞间距增大，纤毛分布稀疏、粗细不等，胞内线粒体肿胀、嵴消失，基质空泡化，上皮细胞核曲边，染色质呈块状分布、边集，细胞核接近细胞表面，且可见杯状细胞脱落。结论：鼻内镜术中光和热对鼻黏膜及黏液纤毛有损伤作用，鼻内镜手术应尽量缩短手术时间，尤其是连续照射时间。     

阿奇霉素对慢性鼻-鼻窦炎患者术腔黏膜中NF-kBp65IL-8表达的影响

目的 观察阿奇霉素对慢性鼻-鼻窦炎患者术腔黏膜中NF-kBp65、IL-8表达的影响,探讨阿奇霉素治疗术腔慢性炎症的机制。方法 将45例慢性鼻-鼻窦炎术后2周的患者随机分成阿奇霉素组、头孢菌素组和对照组进行随访治疗,所有患者均应用布地奈德喷鼻、生理盐水冲洗术腔,阿奇霉素组加用阿奇霉素500mg口服,每日1次;头孢菌素组加用头孢菌素500mg口服,每日1次;对照组继续同前治疗,连续3周后,取术腔病变黏膜作为实验标本,应用免疫组织化学PV-6000二步法检测各组治疗前后及三组间术腔黏膜上皮细胞、炎性细胞中NF-kBp65和IL-8表达的情况,计数阳性细胞数。结果 慢性鼻-鼻窦炎患者术腔黏膜呈慢性炎症表现,NF-kBp65主要表达在术腔黏膜的黏膜上皮细胞、炎性细胞的胞浆和部分胞核。IL-8主要表达在黏膜的上皮细胞、炎性细胞的胞浆。三组治疗后NF-kBp65和IL-8在上皮细胞和炎性细胞中的表达均较治疗前减少(P<0.05);阿奇霉素组治疗后术腔黏膜上皮细胞和炎性细胞中NF-kBp65、IL-8的表达均较头孢菌素组、对照组明显减少(P<0.05);头孢菌素组与对照组治疗后上皮细胞和炎性细胞中NF-kBp65、IL-8的表达无明显差别(P>0.05)。结论 阿奇霉素联合应用布地奈德抑制慢性鼻-鼻窦炎患者术腔黏膜上皮细胞、炎性细胞中NF-kBp65、IL-8的表达,较单独应用布地奈德明显,可能是阿奇霉素治疗慢性炎症的机制之一,对慢性鼻-鼻窦炎患者术腔黏膜慢性炎症的转归具有促进作用。     

Tenascin在鼻息肉组织中的表达及其临床意义

目的：探讨Tenascin(TN)在鼻息肉组织中的表达和分布特征及其在鼻息肉发生中的可能作用。方法：采用免疫组化链霉菌抗生物素蛋白—过氧化物酶(SP)法检测24例鼻息肉标本(鼻息肉组)和15例慢性肥厚性鼻炎下鼻甲标本(下鼻甲组)中TN的表达，并以5例健康者(对照组)下鼻甲黏膜作对照。结果：鼻息肉组和下鼻甲组黏膜上皮细胞及腺上皮细胞均表达TN；鼻息肉组TN的黏膜上皮阳性细胞表达的吸光度值显著高于下鼻甲组(P＜0．01)；鼻息肉组TN的腺上皮阳性细胞表达的吸光度值显著高于下鼻甲组(P＜0．01)；对照组下鼻甲组织中黏膜上皮及腺体几乎检测不到TN的表达；鼻息肉组腺体TN阳性率明显高于下鼻甲组(P＜0．05)。结论：TN在鼻息肉组织中的高表达与鼻息肉的发生、发展相关；TN在鼻腔内的表达细胞是黏膜上皮细胞和浆液性腺上皮细胞。     

Diagnostic procedure in primary ciliary dyskinesia]

BACKGROUND: Primary ciliary dyskinesia (PCD) is usually diagnosed by ultrastructural investigations of nasal or bronchial mucosa. Less invasive techniques for quick and cost-effective diagnosis of PCD should be evaluated. METHODS: In 32 patients with suspected PCD, saccharin transport time, ciliary beating of nasal respiratory epithelium, and ultrastructure of nasal mucosa biopsies were investigated. RESULTS: In 13 patients, PCD was excluded by a normal saccharin transport time (< 20 min). In 19 patients, respiratory cells were obtained by nasal brushing. Frequency, coordination, and amplitude of ciliary beating were examined using interference contrast microscopy and scored. PCD was excluded in 10 of 19 patients, who revealed normal ciliary activity. In the remaining 9 patients, nasal mucosa specimens for ultrastructural investigation were obtained. Ultrastructural alterations indicating PCD were found 4 of 9 specimens, in 2 specimens no cilia were found and in 3 specimens alterations indicating secondary inflammatory alterations were found. CONCLUSIONS: PCD may be efficiently excluded in several cases using cost-effective diagnostic techniques. The definite diagnosis in the remaining cases requires ultrastructural investigations which should be performed in specialized centers. In the present study, PCD in a carefully preselected group had a surprisingly high prevalence.     

鼻息肉中一氧化氮合酶表达及其意义

目的 :了解鼻息肉 (NP)中一氧化氮合酶 (NOS)的分布特点和活性及其在NP发病中的作用。方法 :用免疫组织化学法检测 30例NP(NP组 )及 2 0例正常鼻黏膜 (正常鼻黏膜组 )中NOS的表达 ,并用分光光度计法检测其活性。结果 :NP组NOS活性为 (4.0 79± 0 .6 5 5 )U/mg蛋白 ,正常鼻黏膜组为 (1.5 2 6± 0 .310 )U/mg蛋白 ,二者间差异有统计学意义 (P <0 .0 1) ;NP组iNOS有大量细胞表达 ,分布在黏膜上皮、腺体和血管内皮细胞以及炎症细胞中 ,与正常鼻黏膜组比较 ,差异有统计学意义 (P <0 .0 1) ;而eNOS也有表达 ,但与正常鼻黏膜组比较 ,差异无统计学意义 ;NP组i NOS表达明显高于eNOS表达 ,其差异有统计学意义 (P <0 .0 1)。结论 :NP主要表达iNOS ,分布在黏膜上皮、腺体和血管内皮细胞以及炎症细胞中 ,其产生的大量一氧化氮在NP的发病过程中可能起着重要的作用     

干燥性鼻炎与萎缩性鼻炎鼻粘膜超微结构观察

目的通过透射电镜观察比较干燥性鼻炎与萎缩性鼻炎鼻粘膜的超微结构。方法取干燥性鼻炎和萎缩性鼻炎鼻粘膜各5例,并取正常鼻粘膜3例作对照,在透射电镜下观察。结果干燥性鼻炎与萎缩性鼻炎鼻粘膜超微结构改变有类似之处,但萎缩性鼻炎比干燥性鼻炎病变严重,上皮层细胞已鳞状上皮化生,杯状细胞消失,腺腔闭锁,部分腺细胞溶解、坏死,血管腔已被阻塞。而干燥性鼻炎的病理改变较轻,是可逆的。结论治疗干燥性鼻炎建议从扩血管、滋养恢复鼻粘膜细胞着手,促进鼻粘膜细胞新陈代谢,使受损的鼻粘膜尽快恢复正常结构和生理功能。     

Ultrastructural findings of the nasal mucosa of "ozaena" in atrophic rhinitis

Alterations in the nasal mucous layer of atrophic rhinitis "Ozaena" patients have been investigated. The vast majority (99%) of these patients were women. Morphological findings in healthy nasal mucosa demonstrated the different functional stages of the glandular tissue cells with the healthy epithelium. On the other hand, nasal mucosal material taken from the patients displayed prominent epithelial deterioration, decrease in and loss of cilia, increase in goblet cells with squamous epithelial metaplasia. A decrease in secretory granules and membrane deterioration in the apical region of the secretory cells was also clearly visible. It is possible to postulate that the ultrastructural changes seen in the secretory and storage cycles of glandular tissue of the nasal mucosa from patients seem to arise as a reaction to the superficial epithelial deterioration of the nasal mucosa together with the resulting deterioration of physiological conditions.     

He-Ne激光加复方丹参联合治疗萎缩性鼻炎的病理学观察

目的观察中西医结合疗法对萎缩性鼻炎鼻黏膜组织病理学的影响.方法综合应用复方碘薄荷液棉片黏膜表面湿敷、复方丹参液鼻甲组织内注射,He-Ne激光鼻甲前端照射进行治疗,共2个疗程.结果疗程结束后,鼻黏膜纤毛柱状上皮细胞、杯状细胞和腺体从治疗前平均每视野22、1和2个(100×)增加到43、5和3个;血管计数从1～2个增加至5个;鼻黏膜厚度增加.结论He-Ne激光加复方丹参联合治疗能促进萎缩性鼻炎鼻黏膜恢复.