Influence of viral infection on the development of nasal hypersensitivity.

BACKGROUND: The underlying relationship between viral infections and allergic diseases of the upper respiratory tract has not been well clarified. METHODS: In order to clarify the relationship between viral infection and nasal hypersensitivity, mice were sensitized with ovalbumin (OVA) and then infected intranasally with respiratory syncytial virus (RSV), after which their nasal sensitivity to histamine or antigen was examined. RESULTS: Non-sensitized mice showed transient mild nasal hypersensitivity following nasal administration of histamine after intranasal RSV inoculation. In mice sensitized with OVA, RSV infection significantly exaggerated their nasal hypersensitivity to histamine and OVA. Treatment of these mice with a neurokinin (NK)-1/NK-2 receptor antagonist, but not with anti-IL-5 antibodies, reduced their hypersensitivity. The infiltration of nasal mucosa with eosinophils was temporarily associated with accelerated rate of RSV elimination in these animals. CONCLUSION: RSV infection induced transient nasal hypersensitivity. Several mechanisms, including impairment of nasal epithelial cells are thought to mediate this effect. In allergen-sensitized mice, RSV inoculation strongly enhanced nasal hypersensitivity.

Characteristics of immunity induced by viral antigen or conferred by antibody via different administration routes.

The characteristics of the immunity induced by viral antigens or conferred by antiviral antibody via different routes of administration were evaluated comparatively. C57BL/6 mice were immunized via intranasal, intradermal or enteric routes with a live recombinant vaccinia virus expressing the respiratory syncytial virus (RSV) F glycoprotein (F.rVV) or RSV, and then challenged intranasally with RSV. Inhibition of RSV replication was observed in the lungs of all the mice; however, only intranasal immunization hindered virus replication in the nose. Lung inflammation, characterized by infiltration of neutrophils and of mononuclear cells was strongest in the intradermally immunized mice, but was observed in all F.rVV immunized mice to various degrees. Intranasal administration of a potently neutralizing human anti-RSV antibody Fab fragment to infected mice inhibited RSV replication in the nose and, when combined with intraperitoneal administration, protected both the lung and the nose in the absence of deleterious lung pathology. These data suggest that intranasal immunization with F.rVV reduces RSV replication in the respiratory tract, but still induces pathological lung inflammation, even though this is milder than that observed following intradermal immunization. Local neutralizing antibody is indispensable for protection in the nose.

Suppressive effect of locally produced interleukin-10 on respiratory syncytial virus infection.

Interleukin (IL)-10 is known to be a multifunctional cytokine. This study was designed to evaluate the role of IL-10 during respiratory syncytial virus (RSV) infection using a C57BL/6 transgenic (TG) mouse model in which the expression of murine IL-10 cDNA was regulated by a human salivary amylase promoter (IL-10 TG mice). These mice expressed a large amount of IL-10 in the nasal mucosa and in salivary glands. Viral replication in the respiratory tract after intranasal infection with RSV was suppressed significantly in IL-10 TG mice compared to non-transgenic controls. This suppression was IL-10 specific, because it was prevented by treating mice with neutralizing anti-IL-10 antibodies. We also found that IL-10-stimulated T cells displayed cytotoxic activity against infected murine nasal epithelial cells. Previous data indicated that IL-10 induces Fas ligand (L) expression on mouse T cells. Taken together, these data suggest that Fas/Fas L mediated cytotoxicity is involved in the suppression of RSV replication observed in IL-10 TG mice after intranasal infection.

Fosfomycin nebulizer therapy to chronic sinusitis.

OBJECTIVE: effects of Fosfomycin (FOM) nebulizer therapy were studied in patients with chronic sinusitis. METHODS: about 28 patients with chronic sinusitis were administered 2 ml of FOM sodium (3% w/v) by nebulizer three times per week for 4 weeks. Levels of IL-1 beta, IL-6, IL-8, and TNF-alpha in nasal lavage were also measured before and at the end of treatment. RESULTS: the overall efficacy of this treatment on the basis of both subjective and objective symptoms, was 'excellent' for 28.6%, 'good' for 10.7%, 'fair' for 39.4%, and yield 'no change' for 21.4% of the patients. Both IL-1 beta and IL-6 concentrations were significantly decreased after treatment. Although the IL-8 level did not significantly decrease, it seems to be related to the overall efficacy. TNF-alpha was not detected in all of the samples. CONCLUSION: FOM nebulization therapy is highly effective in treatment for chronic sinusitis, and efficacy may be due to an immunomodulatory mechanism, as well as its bactericidal effect.

Effect of unilateral section of cervical afferent nerve upon optokinetic response and vestibular nystagmus induced by sinusoidal rotation in guinea pigs.

An experiment was carried out in guinea pigs to clarify the effect of unilateral section of cervical afferent nerve (C1-C3) upon optokinetic nystagmus and vestibular nystagmus induced by sinusoidal rotation. To produce optokinetic nystagmus and optokinetic after-nystagmus, a random dot pattern was utilized as visual stimulation at a speed of 30 degrees/s. As for vestibular nystagmus, sinusoidal rotation at a frequency of 0.1 Hz with an amplitude of 120 degrees was used. Results showed that for about a week after the surgical section of the C1-C3 nerves, directional preponderance of the vestibular nystagmus was found toward the lesion side, whereas no significant change was obtained in optokinetic nystagmus and optokinetic after nystagmus. This asymmetric change of the vestibular nystagmus was compensated for within a week or two. Thus. unilateral section of the cervical afferent nerve produced only a temporary effect on the vestibulo-ocular reflex but it had no significant effect on the optokinetic response.

Induction of intercellular adhesion molecule-1 in human nasal epithelial cells during respiratory syncytial virus infection.

The effects of infection with respiratory syncytial virus (RSV) on expression of intercellular adhesion molecule (ICAM)-1 was determined in vitro in nasal epithelial cell cultures. Functional consequences of changes in ICAM-1 expression were assessed by measuring adhesion of a human leukaemic T-cell line to RSV-infected epithelial cells. Also, adhesion of phytohaemagglutinin-activated tonsillar lymphocytes (TL) to RSV-infected epithelial cells caused a significant increase in interleukin (IL)-4 or IL-5 production. Release of these cytokines was adhesion dependent as non-adherent TL produced significantly less IL-4 or IL-5. However, no significant difference was observed for IL-2 or interferon-gamma (IFN-gamma) production. These observations suggest that RSV-infected epithelial cells may induce T-helper type-2 (Th2)-like cytokines by mucosal lymphocytes during mucosal infection in vivo.

Carotid artery resection for head and neck cancer.

BACKGROUND: Carotid artery resection has been shown to yield a chance of cure in patients with advanced head and neck carcinoma involving the carotid artery. However, the criteria for the identification of those who are vulnerable to neurologic injury after resection have not been established. Interposition grafting may minimize the risk of neurologic morbidity, although it is technically difficult when there is involvement of the internal carotid artery close to the skull base. METHODS: We studied 24 patients with head and neck tumor involvement of the carotid artery. We performed carotid artery resection in 16 of them, including 10 in whom the carotid artery was reconstructed with interposition grafts covered with muscle flaps. When it was thought that the reconstruction would be difficult, positron emission tomography was performed during balloon test occlusion of the internal carotid artery to assess the adequacy of hemispheric collateral blood flow before carotid resection. In one patient with interposition graft, carotid rupture occurred as a result of wound infection, but none of the other patients experienced perioperative death, persistent hemiplegia, or delayed stroke. RESULTS: Twelve patients have survived longer than 8 months, and seven (43.8%) were alive without disease at 12 months after resection, whereas all four patients who could not be treated operatively died within 8 months as a result of local primary tumors. CONCLUSIONS: Carotid artery resection is the only therapy offering any potential for cure or palliation. Positron emission tomography is a rapid quantitative means of determining the cerebral blood flow, particularly when resection is planned without reconstruction.