Smell and Taste Clinic, Department of Otorhinolaryngology, Northwestern University, Chicago, Illinois, USA.
Laryngoscope. 2011 Mar;121(3):679-82. doi: 10.1002/lary.21401. Epub 2011 Feb 1.
OBJECTIVES/HYPOTHESIS: Infection of the upper respiratory tract is one of the most common causes of olfactory loss. One of the possible underlying pathologic pathways is an increase of apoptosis of olfactory receptor neurons. Therefore, treatment with the antibiotic minocycline, which has been shown to act as an antiapoptotic agent, is thought to accelerate improvement of olfactory function. To investigate this idea, 55 patients with postinfectious olfactory dysfunction were tested for their olfactory ability.
Randomized, prospective, double-blind, placebo-controlled.
Olfactory function was examined by means of a standardized psychophysical method (Sniffin' Sticks) before and 7 months after a 3-week treatment with either minocycline (2 × 50 mg/d) or a placebo.
Statistical analyses did not reveal any influence of the treatment on the progress of olfactory function, possibly indicating that pathologic changes other than apoptosis contribute to postinfectious olfactory loss, either on a peripheral level (e.g., scarring/reorganization of the olfactory epithelium) or on a central nervous level.
In conclusion, the present results indicate that minocycline in the given dosage has little or no effect on the recovery of human olfactory function following postinfectious olfactory loss. However, spontaneous recovery is found in approximately 20% of the patients over an observation period of 7 months.
目的/假设:上呼吸道感染是嗅觉丧失的最常见原因之一。潜在的病理途径之一是嗅觉受体神经元凋亡增加。因此,使用已被证明具有抗凋亡作用的抗生素米诺环素进行治疗被认为可以加速嗅觉功能的恢复。为了验证这一观点,对 55 例感染后嗅觉功能障碍患者的嗅觉能力进行了测试。
随机、前瞻性、双盲、安慰剂对照。
使用标准化的心理物理方法(Sniffin' Sticks)在 3 周的米诺环素(2×50mg/d)或安慰剂治疗前后对嗅觉功能进行检查。
统计分析未发现治疗对嗅觉功能进展有任何影响,这可能表明除了凋亡之外,其他病理变化(如嗅觉上皮的瘢痕/重组)也可能导致感染后嗅觉丧失,无论是在周围水平还是在中枢神经系统水平。
总之,目前的结果表明,在给定剂量下,米诺环素对感染后嗅觉丧失后人类嗅觉功能的恢复几乎没有影响。然而,在 7 个月的观察期内,约有 20%的患者出现自发恢复。