Woods Charmaine M, Tan Sophia, Ullah Shahid, Frauenfelder Claire, Ooi Eng H, Carney A Simon
Ear, Nose, and Throat (ENT) Department, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia.
Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Bedford Park, South Australia, Australia.
Int Forum Allergy Rhinol. 2015 Dec;5(12):1104-10. doi: 10.1002/alr.21604. Epub 2015 Jul 24.
Saline-based irrigation solutions are evidence-based rhinological treatments; however, the formulation of these solutions could theoretically alter the function of innate antimicrobial peptides. The aim of this study was to determine if the antimicrobial activity of normal human nasal secretions in vivo is altered by commercially available large volume irrigation solutions.
Minimally manipulated sinonasal secretions were collected from patients with chronic rhinosinusitis (CRS; n = 10) and normal healthy volunteers (n = 20). In a subset of control patients (n = 10) secretions were collected prior to, and at 1 hour, 6 hours, and 24 hours after nasal irrigation with 4 commercial irrigation solutions. Lysozyme and lactoferrin levels were analyzed and the antimicrobial activity of secretions determined using a radial diffusion assay.
The antimicrobial activity of nasal secretions was reduced in CRS patients compared to healthy volunteers (p < 0.01), but there was no significant difference in antimicrobial peptide concentrations. Isotonic nasal irrigation reduced lysozyme and lactoferrin levels, which returned to baseline levels by 6 hours; in addition to a sustained decrease in antimicrobial activity before returning to baseline at 24 hours. Low-salt solution stimulated peptide secretion by approximately 40% at 6 hours and 24 hours, but produced a transient decrease in antimicrobial activity, returning to baseline levels by 6 hours. Hypertonic solution initially decreased lysozyme and lactoferrin levels but maintained baseline levels of antimicrobial activity and increased peptide secretion by approximately 30% at 24 hours.
The formulation of nasal irrigation solutions significantly affects the measured levels and functionality of sinonasal antimicrobial peptides.
基于盐水的冲洗液是循证医学的鼻科治疗方法；然而，这些冲洗液的配方理论上可能会改变天然抗菌肽的功能。本研究的目的是确定市售大容量冲洗液是否会改变正常人鼻分泌物在体内的抗菌活性。
从慢性鼻-鼻窦炎患者（n = 10）和正常健康志愿者（n = 20）中收集轻度处理的鼻窦分泌物。在一部分对照患者（n = 10）中，于使用4种市售冲洗液进行鼻腔冲洗前、冲洗后1小时、6小时和24小时收集分泌物。分析溶菌酶和乳铁蛋白水平，并使用径向扩散试验测定分泌物的抗菌活性。
与健康志愿者相比，慢性鼻-鼻窦炎患者鼻分泌物的抗菌活性降低（p < 0.01），但抗菌肽浓度无显著差异。等渗鼻腔冲洗降低了溶菌酶和乳铁蛋白水平，6小时后恢复至基线水平；此外，抗菌活性持续下降，24小时后恢复至基线水平。低盐溶液在6小时和24小时时刺激肽分泌约40%，但导致抗菌活性短暂下降，6小时后恢复至基线水平。高渗溶液最初降低了溶菌酶和乳铁蛋白水平，但维持了抗菌活性的基线水平，并在24小时时使肽分泌增加约30%。
鼻腔冲洗液的配方显著影响鼻窦抗菌肽的测量水平和功能。
