Sienkiewicz-Oleszkiewicz B, Oleszkiewicz A, Bock M A, Hummel T
Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical University, Poland and Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany and Institute of Psychology, University of Wroclaw, Wroclaw, Poland.
Rhinology. 2023 Oct 1;61(5):404-411. doi: 10.4193/Rhin23.036.
Intranasal insulin (IN) administration is a promising way to deliver the peptide to the central nervous system (CNS), bypassing the blood-brain-barrier and gastrointestinal absorption inhibition. IN receptors are localized in the olfactory mucosa and the brain, mainly in the olfactory bulb, hypothalamus, hippocampus, amygdala, cerebral cortex, and cerebellum. The pleiotropic mechanism of insulin action is characterized by its anti-inflammatory properties, antithrombotic, vasodilatory, and antiapoptotic effects. It prevents energy failure and has regenerative properties, affects neuro-regeneration and counteracts insulin resistance. Hence, insulin has been suggested for various pathological states including neurocognitive disorders, obesity, and as a therapeutic option for smell loss. A sharply increased prevalence of olfactory dysfunction was observed due to the COVID-19 pandemic. The pandemic also emphasized the lack of therapeutic options for smell loss. Intranasal insulin administration has therefore been suggested to serve as potential treatment, influencing the regenerative capacities of the olfactory mucosa. This narrative review summarizes current knowledge on possible effects of intranasal insulin on the sense of smell.
经鼻给予胰岛素（IN）是一种将该肽输送到中枢神经系统（CNS）的有前景的方式，它可绕过血脑屏障并避免胃肠道吸收抑制。IN受体定位于嗅觉黏膜和大脑，主要在嗅球、下丘脑、海马体、杏仁核、大脑皮层和小脑中。胰岛素作用的多效机制具有抗炎特性、抗血栓形成、血管舒张和抗凋亡作用。它可预防能量衰竭并具有再生特性，影响神经再生并对抗胰岛素抵抗。因此，胰岛素已被建议用于包括神经认知障碍、肥胖症等各种病理状态，以及作为嗅觉丧失的一种治疗选择。由于新冠疫情，嗅觉功能障碍的患病率急剧上升。该疫情还凸显了嗅觉丧失缺乏治疗选择的问题。因此，经鼻给予胰岛素已被建议作为一种潜在治疗方法，影响嗅觉黏膜的再生能力。本叙述性综述总结了关于经鼻胰岛素对嗅觉可能影响的当前知识。
