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[Evidence and estimation of immunoglobulins in human nasal mucosa and nasal fluid--a study towards age dependence (author's transl)].

The localization of IgA, IgG and IgM in healthy human nasal mucosa in relation to age--a fluorescence-microscopic study as well as simultaneous quantitative estimation of these immunoglobulins in nasal fluid. These investigations confirm the dominant role of IgA. The IgA concentrations decreases with age. IgG concentration is nearly independent of age. IgM scarlely existing in normal human mucosa and nasal fluid.

Adolescent

Possible immediate hypersensitivity reaction of the nasal mucosa to oral contraceptives.

Nasal provocation tests with suspension of oral contraceptive drugs (OCD) as well as of their components (Estrogen, Progestin, Non-hormonal components) were performed in two groups of women, mostly suffering from perennial rhinitis or pollinosis, and all taking oral contraceptive drugs. Thirteen of the 15 patients from the first experimental group, in whom the increase of the nasal complaints was anamnestically related to the oral contraception, and three of the 34 patients from the second experimental group (without anamnestical relation to the oral contraception) demonstrated a positive nasal mucosa response after topical challenge with OCD. All OCD positively reacting patients showed also a positive nasal mucosa response after challenge with the Estrogen and one patient also after Progestin challenge. Non-hormonal components did not cause any reaction. This nasal mucosa response was interpreted as a possible allergic reaction. Type I (immedicate hypersensitivity of the nasal mucosa due to Estrogen in blood contraceptives. This response begins within 10 minutes, reaches its maximum within 30 minutes, and does not disappear completely within 60 minutes in most patients. None of the patients from control groups (atopy--without OCD; OCD takers--without atopy; male volunteers without atopy) demonstrated any positive nasal mucosa response to OCD or their components.

Contraceptives, Oral

[Scanning electron microscopic pattern on normal and pathological nasal mucosa (author's transl)].

Nasal mucosa from animals and men were investigated by scanning electron microscopy. The findings resulting from normal nasal mucosa and mucosa chronically alterated by inflammation (rhinitis chronica hyperplastica, rhinitis allergica, rhinitis chronica atrophicans, and nasal polyps) were compared. The patterns of the surface-behavior of the mucociliary apparatus and the structure of the epithelium--as well as the findings were discussed. The three-dimensional observation of mucosal surface structure completes the light and electron microscopic examination procedures allowing further insights into morphology and physiological function of the mucosa in the upper respiratory tract.

Animals

Electron microscopic study of the normal and allergic nasal mucosa.

Electron microscopic studies of the human nasal mucosa have complemented earlier histological and histochemical studies. In this paper, the fine structural details observed in different tissue components are described and discussed in relation to the function of the nasal mucosa under normal and pathological conditions. The physiological changes in the anterior part of the inferior turbinate which occur under the influence of air currents differ clearly from the electron microscopic picture of respiratory mucosa with typical ciliated epithelium. The fine structure of the allergic nasal mucosa differs according to the stage of the allergic reaction; the characteristic changes are described both after different time intervals following intranasal allergic testing with positive reaction as well as in patients with seasonal or perennial nasal allergy of longer duration.

Humans

Scanning and transmission electron microscopy of the nasal mucosa.

We attempted to study the nasal mucosa of children (both normal and diseased) under light microscopy followed by both scanning and transmission electron microscopy. Combined methods of microscopy are valuable tools in establishing the diagnosis and lead to a better understanding of disease and its management. For this reason we found it necessary to study the ultrastructural details of the cells of the nasal mucosa. Through scanning electron microscopy we studied the functional aspects and the nature of the surface of these cells. Ultrastructural details of these cells were studied with the aid of transmission electron microscopy.

Adolescent

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.

Epithelium

Effect of inflammatory mediators on nasal mucosa.

A technique used for study of permeability and vasodilation in the middle ear has been adapted to study the response of nasal mucosa to common inflammatory mediators involved in the natural production of allergic or infectious rhinitis. All of the mediators tested (histamine, prostaglandin E1, bradykinin, the C3a fraction of complement, Escherichia coli endotoxin, and lysozyme) were found to increase nasal permeability to the isotopic tracer 99mTc as the pertechnetate ion. Histamine increased the permeability of nasal mucosa to technetium-labeled plasma protein. Results indicate that the nasal mucosa is approximately ten times as permeable to the pertechnetate ion as middle ear mucosa. Nasal mucosa was also noted to be permeable to protein, even in the absence of inflammatory mediator, in contrast to prior studies of middle ear mucosa that showed little or no permeability in the absence of inflammatory mediator. In almost all cases, a corresponding change in vasodilation accompanied permeability changes.

Animals

The localization of influenza virus in the respiratory tract of ferrets: susceptible nasal mucosa cells produce and release more virus than susceptible lung cells.

Infectious virus production by ferret nasal mucosa and lung organ cultures has been monitored in both tissue pieces and medium over 24 h following inoculation with an Asian (H2N2) strain of influenza virus. Freshly prepared cultures of nasal mucosa produced approx. 10-fold more virus per cell than fresh lung cultures. Also the nasal mucosa cells liberated into the medium a greater proportion (mean 31%) of the total virus produced than did fresh lung (mean 6%). Maintenance of lung explants for 24 h prior to inoculation resulted in a 20- to 100-fold increase in the amount of virus released. However, total virus production by fresh and maintained lung was similar. Trypsin did not increase the infectivity of virus released from any of the cultures, indicating that the haemagglutinin in the virus particles was cleaved. Similar results were obtained with a Hong Kong (H3N2) virus strain. Hence, one factor operating in the lower susceptibility of the lung compared with the nasal mucosa in vivo may be a lower capacity of lung cells both to produce and release influenza virus.

Animals

Nickel concentrations in nasal mucosa, plasma, and urine in active and retired nickel workers.

The objective of the present investigation was to study the influence of the occupational nickel exposure on the concentration of nickel in nasal mucosa, plasma and urine. Plasma, urine and biopsy specimens of nasal mucosa from 318 nickel workers, 15 retired nickel workers and 57 non-exposed controls were analyzed for nickel by atomic absorption spectrometry. The results showed that nickel exposure led significantly to raised nickel concentration in nasal mucosa, plasma and urine both in active and retired nickel workers. The average nickel concentration in the nasal mucosa was highest in workers exposed to the highest atmospheric nickel concentration, inhaled as nickel subsulphide and oxide dust. Workers exposed to aerosols of nickel chloride and sulphate at a lower atmospheric nickel concentration had, on the other hand, the highest mean nickel concentration in plasma and urine. The mucosal, plasma and urine nickel concentration were significantly correlated to duration of nickel exposure. The accumulated nickel in the nasal mucosa was retained for years after termination of the nickel exposure, and slowly released with an estimated half-life of 3.5 years.

Adult

Effects of beclomethasone dipropionate aerosol on nasal mucosa.

Rhinoscopic examination and histological studies of the nasal mucosa in patients with perennial allergic rhinitis and nasal polyposis treated with beclomethasone dipropionate aerosol provided no evidence that this form of treatment, given for one year, produced any harmful effects, such as atrophic rhinitis.

Aerosols

Selective denervation of the autonomic nerve supply of the nasal mucosa.

The autonomic innervation of the nasal mucosa has been studied in normal rats and in rats in which the supplying nerves had seen selectively transected; postoperative survival times varied from 2 weeks up to 18 months. The vascular structures appeared to be innervated both by acetylcholinesterase- and noradrenalin-containing fibres. Furthermore a nerve plexus consisting of both types of fibres was observed in the subepithelial region. The nasal glands however showed only a cholinergic innervation. The pattern of the autonomic nerve supply deduced from these selective denervation experiments does not differ fundamentally from the generally accepted scheme of this system in the nose of other mammals. Denervation occurred within 2 weeks after transection of the supplying nerves, but after longer survival times reinnervation was observed.

Acetylcholinesterase

The significance of changes in the nasal mucosa in indeterminate, tuberculoid and borderline leprosy.

A study of nasal biopsies from 137 leprosy patients classified on the basis of clinical, microbiological and skin biopsy as Indeterminate, Tuberculoid, Borderline-tuberculoid and Borderline-leproma was undertaken. Changes suggestive of leprosy viz., nerve and smooth muscle inflammation with a few acid fast bacilli in a proportion of the biopsies were seen in all groups of patients examined. This suggests, that even in Indeterminate and Tuberculoid leprosy the disease becomes generalised by the time clinical manifestations appear in skin. Tuberculoid granuloma was seen in two nasal biopsies from Borderline-tuberculoid leprosy patients, one of which was located in the wall of a vein, suggesting the possibility of intravascular dissemination of the disease even in non-lepromatous leprosy. 33 of the patients were children 15 years and below and they also showed changes such as nerve and smooth muscle inflammation but bacilli were seen only in the Borderline group. These findings suggest involvement of the nasal mucosa early in the course of the disease as 70% of the children had the skin lesion for less than one year. The nasal mucosa offers favourable conditions for the growth of the organisms and is readily accessible to infection by droplets, and therefore, it could be one of the primary sites of involvement in leprosy.

Adolescent

Influence of the vaccine Polyvaccinum mite on the nasal mucosa.

The necessity of prolonged administration of the vaccine Polyvaccinum prompted this study on the effect of the preserving agent on the nasal mucosa. Buffered physiologic saline solution containing 0.1--0.4% phenol, and the vaccine containing 0.1--0.4% phenol or 0.01% merthiolate were applied for 12 weeks on the nasal mucosa of rabbits. The nasal mucosa, parenchymal organs and adrenals were studied macroscopically and histologically, and immunologic studies were made. On the basis of the results, preservation of Polyvaccinum mite with 0.4% phenol is suggested.

Administration, Intranasal

Relationship between the vegetative innervation and the sensibility of the nasal mucosa.

Experimentally and clinically, we observed that the parasympathicomimetic reaction of the nasal mucosa was congruent with higher sensitivity of the nasal mucosa. The opposite is true of the sympathicomimetic reaction. The reason for this difference in reaction is connected with the transmitting agent of the vegetative system. This is shown in the provocation of intradermal reaction of different allergens by these transmitting agents.

Acetylcholine

Scanning electron microscopy of a bacterial infection of the human nasal mucosa.

Scanning electron micrographs of a bacterial infection of the human nasal mucosa indicate that the surface attachment of bacteria to epithelial cells is of significance for their pathogeneity in the airways. It is suggested that further scanning electron microscopic studies of natural and experimental infected human nasal mucosa can give valuable information about the initial interaction between micro-organisms and host cell and add to our understanding of airways infections.

Adult

Topochemistry of trace metals in nasal mucosa. Potentialities of some histochemical methods and energy dispersive X-ray microanalysis.

Histochemical methods and energy dispersive X-ray micro-analysis (EDX-analysis) were evaluated in model experiments and on tissue sections for their usefulness in detecting traces of metals in biological tissue. The goal for this study was to establish a method for localization of nickel deposits in the nasal mucosa, where it has been found in concentrations between 1 and 40 microgram/g in nickel exposed individuals. The histochemical methods tested were staining with dimethylglyoxime, rubeanic acid and dithizone, the Turnbull and Prussian blue methods and TIMM'S sulphide silver procedure. In model experiments nickel-, cobalt-, copper-, zinc- and ironsalts were applied to thin-layer chromatography sheets (TLC-sheets) and stained by the histochemical methods. Spots containing 500 and 50 ng of these metals represented the smallest amounts that could consistently be detected in these experiments, except for the sulphide silver method which seemed a little more sensitive. With the latter method, moreover, zinc was detected in 40 micrometer thick cryostat sections of gelatine made up with 1 microgram/g of the metal. For nickel the corresponding figure was 10 to 50 microgram/g. On specimens of nasal mucosa from nickel-exposed workers, a faint colour was obtained in 40 micron thick cryostat sections from specimens that had been immersed in dithizone, but the colour was too weak for histological analysis. None of the other coloured chelating agents caused noticeable staining when applied to blocks or to cryostat sections. TIMM'S sulphide silver method caused strong staining of the basal layers of the surface epithelium and of fibroblast-like cells in the underlying connective tissue. This staining pattern is described in more detail in a separate report. Rat liver tissue was analyzed by atomic absorption before and after araldite embedding. Blocks of gelatine made up with nickel, copper, zinc and iron were embedded in epoxy resin and analyzed by atomic absorption. Large changes in the metal concentrations, usually an increase, were found after embedding. Ultrathin sections from this material were used to test the sensitivity of the EDX-equipment. Referring to the concentrations determined by atomic absorption in the embedded material, iron was detected at 1215 microgram/g and 362 microgram/g (gelatine standards) but not at 167 microgram/g (rat liver). Similar values could not be determined for nickel, copper or zinc, because of background radiation resulting from the presence of these metals in the instrument. We did not succeed in establishing a procedure for detecting nickel deposits in nasal mucosa with any of the methods which were tested. The most sensitive but least specific of the tested methods for visualizing heavy metals in the nasal mucosa, was TIMM'S sulphide silver procedure. The preparation of tissue for this method is discussed.

Animals