RESUMO
Olfactory disorders are common and have consequences for the quality of life of patients. The main causes are post viral upper respiratory tract infections, head trauma and sinonasal disease. However, there are many more less frequent causes which we illustrate by showing three different rare cases. A distinguishment between qualitative and quantitative olfactory disorders is made which is mainly based on the patient's history and olfactory testing. It is important to diagnose the cause of an olfactory disorder because treatment options are dependent on it and it can be a symptom of a progressive disease. Olfactory training is a proven treatment for many perceptive olfactory disorders and is easily performed by most patients.
Assuntos
Transtornos do Olfato , Qualidade de Vida , Humanos , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/etiologia , Transtornos do Olfato/terapia , OlfatoRESUMO
Innate mononuclear phagocytic system (MPS) cells preserve mucosal immune homeostasis. We investigated their role at nasal mucosa following allergen challenge with house dust mite. We combined single-cell proteome and transcriptome profiling on nasal immune cells from nasal biopsies cells from 30 allergic rhinitis and 27 non-allergic subjects before and after repeated nasal allergen challenge. Biopsies of patients showed infiltrating inflammatory HLA-DRhi/CD14+ and CD16+ monocytes and proallergic transcriptional changes in resident CD1C+/CD1A+ conventional dendritic cells (cDC)2 following challenge. In contrast, non-allergic individuals displayed distinct innate MPS responses to allergen challenge: predominant infiltration of myeloid-derived suppressor cells (MDSC: HLA-DRlow/CD14+ monocytes) and cDC2 expressing inhibitory/tolerogenic transcripts. These divergent patterns were confirmed in ex vivo stimulated MPS nasal biopsy cells. Thus, we identified not only MPS cell clusters involved in airway allergic inflammation but also highlight novel roles for non-inflammatory innate MPS responses by MDSC to allergens in non-allergic individuals. Future therapies should address MDSC activity as treatment for inflammatory airway diseases.