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Expert Opinion on Pharmacotherapy Jun 2024Olfactory disorders significantly affect individuals, diminishing their capacity to detect dangers, appreciate flavors, and engage socially. Despite their considerable... (Review)
Review
INTRODUCTION
Olfactory disorders significantly affect individuals, diminishing their capacity to detect dangers, appreciate flavors, and engage socially. Despite their considerable impact on quality of life, these disorders often receive less attention compared to other sensory impairments. This review emphasizes the importance of olfactory function and explores both traditional and innovative diagnostic and therapeutic approaches.
AREAS COVERED
This review comprehensively covers the pathophysiology, diagnostic challenges, and treatment options for olfactory disorders. It delves into the nuances of different disorders, such as anosmia and parosmia, and discusses the array of diagnostic tools from traditional sniff tests to advanced imaging techniques. The review also evaluates therapeutic strategies, from pharmacological treatments to emerging therapies like electrical stimulation and regenerative medicine, highlighting recent advances in the field.
EXPERT OPINION
Current insights suggest a growing recognition of the significance of olfactory disorders, driven by recent pandemics and advances in diagnostic and therapeutic technologies. Future perspectives indicate a promising direction toward more personalized medicine approaches and enhanced regenerative therapies. Continuous research and improved clinical awareness are critical for evolving the management strategies of olfactory impairments, potentially leading to better patient outcomes and quality of life enhancements.
Topics: Humans; Olfaction Disorders; Quality of Life; Precision Medicine; Regenerative Medicine; Animals
PubMed: 38935483
DOI: 10.1080/14656566.2024.2368243 -
International Forum of Allergy &... Jun 2024Intralesional cidofovir injections in combination with surgery is an effective treatment for recurrent multifocal sinonasal exophytic papilloma. No malignant...
Intralesional cidofovir injections in combination with surgery is an effective treatment for recurrent multifocal sinonasal exophytic papilloma. No malignant transformation has been observed in our experience. Anosmia is a potential side effect that patients should be aware of.
PubMed: 38934682
DOI: 10.1002/alr.23399 -
Pharmaceutics Jun 2024Following recovery from the acute infection stage of the SARS-CoV-2 virus (COVID-19), survivors can experience a wide range of persistent Post-Acute Sequelae of COVID-19...
UNLABELLED
Following recovery from the acute infection stage of the SARS-CoV-2 virus (COVID-19), survivors can experience a wide range of persistent Post-Acute Sequelae of COVID-19 (PASC), also referred to as long COVID. According to the US National Research Action Plan on Long COVID 2022, up to 23.7 million Americans suffer from long COVID, and approximately one million workers may be out of the workforce each day due to these symptoms, leading to a USD 50 billion annual loss of salary. Neurological symptoms associated with long COVID result from persistent infection with SARS-CoV-2 in the nasal neuroepithelial cells, leading to inflammation in the central nervous system (CNS). As of today, there is no evidence that vaccines or medications can clear the persistent viral infection in olfactory mucosa. Recently published clinical data demonstrate that only 5% of long COVID anosmia patients have fully recovered during the past 2 years, and 10.4% of COVID patients are still symptomatic 18 months post-infection. Our group demonstrated that epigallocatechin-3-gallate-monopalmitate (EC16m) nanoformulations possess strong antiviral activity against human coronavirus, suggesting that this green-tea-derived compound in nanoparticle formulations could be developed as an intranasally delivered new drug targeting the persistent SARS-CoV-2 infection, as well as inflammation and oxidative stress in the CNS, leading to restoration of neurologic functions. The objective of the current study was to evaluate the mucociliary safety of the EC16m nasal nanoformulations and their efficacy against human coronavirus.
METHODS
Nanoparticle size and Zeta potential were measured using the ZetaView Nanoparticle Tracking Analysis system; mucociliary safety was determined using the MucilAir human nasal model; contact antiviral activity and post-infection inhibition against the OC43 viral strain were assessed by the TCID50 assay for cytopathic effect on MRC-5 cells.
RESULTS
The saline-based EC16 mucoadhesive nanoformulations containing 0.005 to 0.02% / EC16m have no significant difference compared to saline (0.9% NaCl) with respect to tissue integrity, cytotoxicity, and cilia beat frequency. A 5 min contact resulted in 99.9% inactivation of β-coronavirus OC43. OC43 viral replication was inhibited by >90% after infected MRC-5 cells were treated with the formulations.
CONCLUSION
The saline-based novel EC16m mucoadhesive nasal nanoformulations rapidly inactivated human coronavirus with mucociliary safety properties comparable to saline, a solution widely used for nasal applications.
PubMed: 38931912
DOI: 10.3390/pharmaceutics16060791 -
Foods (Basel, Switzerland) Jun 2024Smell loss affects around 15-20% of the population, with a major effect on the quality of life. The most common complaint is the impairment of the eating experience,...
Smell loss affects around 15-20% of the population, with a major effect on the quality of life. The most common complaint is the impairment of the eating experience, with around 90% of patients reporting this issue. A study conducted at a specialised Taste and Smell Clinic investigated if food and cooking can positively affect the enjoyment of food, subjective cooking skills, and quality of life in patients with smell loss. The 49 participants in the study received a 5-week cooking school course that focused on emphasizing the other senses to regain the enjoyment of food. Participants gained more confidence in cooking, and their quality of life improved significantly. Positively evaluated recipes were adjusted based on feedback and published as free e-books in Danish, German, and English. Eating and cooking are multisensory experiences, and the perception of food depends on the complex interaction of senses and surroundings. If the olfactory input is reduced or absent, both the enjoyment and cooking experience can be negatively affected. Therefore, focusing on food and cooking can have a positive impact on patients with smell loss.
PubMed: 38928763
DOI: 10.3390/foods13121821 -
Biomedicines May 2024The SARS-CoV-2 virus has spread rapidly despite implementing strategies to reduce its transmission. The disease caused by this virus has been associated with a diverse... (Review)
Review
The SARS-CoV-2 virus has spread rapidly despite implementing strategies to reduce its transmission. The disease caused by this virus has been associated with a diverse range of symptoms, including common neurological manifestations such as dysgeusia, anosmia, and myalgias. Additionally, numerous cases of severe neurological complications associated with this disease have been reported, including encephalitis, stroke, seizures, and Guillain-Barré syndrome, among others. Given the high prevalence of neurological manifestations in this disease, the objective of this review is to analyze the mechanisms by which this virus can affect the nervous system, from its direct invasion to aberrant activation of the immune system and other mechanisms involved in the symptoms, including neuropsychiatric manifestations, to gain a better understanding of the disease and thus facilitate the search for effective therapeutic strategies.
PubMed: 38927354
DOI: 10.3390/biomedicines12061147 -
Journal of Renal Nutrition : the... Jun 2024Chronic kidney disease (CKD) represents a significant global public health challenge. Among the various clinical complications associated with CKD, olfactory dysfunction... (Review)
Review
BACKGROUND
Chronic kidney disease (CKD) represents a significant global public health challenge. Among the various clinical complications associated with CKD, olfactory dysfunction has been identified as a factor that substantially affects the quality of life of patients. This study aims to systematically explore the prevalence, implications, and therapeutic avenues of anosmia in CKD patients.
METHODS
This scoping review utilized the Arksey and O'Malley framework, incorporating the Joanna Briggs Institute methodology, and followed PRISMA-ScR guidelines. The research question, formulated using the PIO framework, guided a thorough search of databases (PubMed/Medline, Embase, CINAHL, Cochrane Library) and grey literature sources. Eligibility criteria focused on studies involving CKD patients with olfactory dysfunctions.
RESULTS
From an initial pool of 832 articles, 17 studies met the criteria, providing insights into olfactory alterations in 4,025 CKD patients. The data that have been reported, define that 55,34% of the sample experienced olfactory changes and the 8.5% experienced anosmia. This review revealed a complex interplay of factors contributing to olfactory alterations, including uremic toxins, dialysis procedures, electrolyte imbalances, and malnutrition. Findings suggested the potential recovery of olfactory function following kidney transplantation. Various assessment tools were utilized, with the University of Pennsylvania Smell Identification Test and Sniffin' Sticks emerging as the primary instruments.
CONCLUSIONS
The observed variability in findings highlights the need for continued research to understand the mechanisms, enhance therapies, and improve quality of life for CKD patients with olfactory dysfunctions. Future studies should employ standardized methods, explore new assessment tools, and prioritize longitudinal assessments to advance our understanding and management of olfactory dysfunctions in this population.
PubMed: 38925323
DOI: 10.1053/j.jrn.2024.06.007 -
Allergy, Asthma & Immunology Research May 2024This study investigated the impact of aeroallergens on the development and progression of chronic rhinosinusitis (CRS), with a focus on the specific associations between...
PURPOSE
This study investigated the impact of aeroallergens on the development and progression of chronic rhinosinusitis (CRS), with a focus on the specific associations between aeroallergens and CRS according to allergen type, number, and extent of sensitization.
METHODS
The medical records of 256 CRS patients were retrospectively analyzed. All were divided into nonallergic, house dust mite (HDM)-allergic, pollen-allergic, and double allergic groups via specific immunoglobulin E (IgE) testing. Clinical characteristics, computed tomography (CT) scores, olfactory functions, and demographic data were compared. Correlation analysis was performed to explore the relationships between the extent of allergen sensitization and CRS severity. Binary logistic regression analysis was used to identify risk factors for hyposmia and anosmia.
RESULTS
The allergic group exhibited higher total CT scores than the nonallergic group ( = 0.001). Sensitivity to HDM or pollen allergens alone was not significantly associated with increased CRS severity. No significant differences were observed between the effects of HDM and pollen allergens on CRS severity. However, the double allergic group exhibited significantly higher CT scores ( < 0.001, < 0.001, and 0.003) than the other groups. Although the prevalence rates of anosmia and hyposmia were notably higher in the double allergic group, the difference was not statistically significant. The maximum specific IgE levels to HDM and pollen allergens positively correlated with the CT scores ( = 0.001 and 0.001, respectively).
CONCLUSIONS
Allergen sensitization, particularly to multiple common allergens, contributed to CRS severity. CRS patients sensitized to both HDM and pollen allergens tended to experience the diminished olfactory function. These findings underscore the importance of considering the allergen sensitization pattern when assessing CRS severity and its potential progression.
PubMed: 38910285
DOI: 10.4168/aair.2024.16.3.279 -
BioRxiv : the Preprint Server For... Jun 2024Post-Acute Sequelae of COVID-19 (PASC) encompasses persistent neurological symptoms, including olfactory and autonomic dysfunction. Here, we report chronic neurological...
Post-Acute Sequelae of COVID-19 (PASC) encompasses persistent neurological symptoms, including olfactory and autonomic dysfunction. Here, we report chronic neurological dysfunction in mice infected with a virulent mouse-adapted SARS-CoV-2 that does not infect the brain. Long after recovery from nasal infection, we observed loss of tyrosine hydroxylase (TH) expression in olfactory bulb glomeruli and neurotransmitter levels in the substantia nigra (SN) persisted. Vulnerability of dopaminergic neurons in these brain areas was accompanied by increased levels of proinflammatory cytokines and neurobehavioral changes. RNAseq analysis unveiled persistent microglia activation, as found in human neurodegenerative diseases. Early treatment with antivirals (nirmatrelvir and molnupiravir) reduced virus titers and lung inflammation but failed to prevent neurological abnormalities, as observed in patients. Together these results show that chronic deficiencies in neuronal function in SARS-CoV-2-infected mice are not directly linked to ongoing olfactory epithelium dysfunction. Rather, they bear similarity with neurodegenerative disease, the vulnerability of which is exacerbated by chronic inflammation.
PubMed: 38895239
DOI: 10.1101/2024.06.02.596989 -
Chemical Senses Jan 2024SCENTinel, a rapid smell test designed to screen for olfactory disorders, including anosmia (no ability to smell an odor) and parosmia (distorted sense of smell),...
SCENTinel, a rapid smell test designed to screen for olfactory disorders, including anosmia (no ability to smell an odor) and parosmia (distorted sense of smell), measures 4 components of olfactory function: detection, intensity, identification, and pleasantness. Each test card contains one of 9 odorant mixtures. Some people born with genetic insensitivities to specific odorants (i.e. specific anosmia) may fail the test if they cannot smell an odorant but otherwise have a normal sense of smell. However, using odorant mixtures has largely been found to prevent this from happening. To better understand whether genetic differences affect SCENTinel test results, we asked genetically informative adult participants (twins or triplets, N = 630; singletons, N = 370) to complete the SCENTinel test. A subset of twins (n = 304) also provided a saliva sample for genotyping. We examined data for differences between the 9 possible SCENTinel odors; effects of age, sex, and race on SCENTinel performance, test-retest variability; and heritability using both structured equation modeling and SNP-based statistical methods. None of these strategies provided evidence for specific anosmia for any of the odors, but ratings of pleasantness were, in part, genetically determined (h2 = 0.40) and were nominally associated with alleles of odorant receptors (e.g. OR2T33 and OR1G1; P < 0.001). These results provide evidence that using odorant mixtures protected against effects of specific anosmia for ratings of intensity but that ratings of pleasantness showed effects of inheritance, possibly informed by olfactory receptor genotypes.
Topics: Humans; Female; Male; Adult; Odorants; Smell; Middle Aged; Olfaction Disorders; Young Adult; Olfactory Perception; Aged; Genotype; Anosmia
PubMed: 38877790
DOI: 10.1093/chemse/bjae025 -
Annals of Neurology Jun 2024To explore the clinical progression of the brain-/body-first categories within Lewy body disease (LBD): Parkinson's disease (PD), dementia with Lewy bodies (DLB), and PD...
OBJECTIVE
To explore the clinical progression of the brain-/body-first categories within Lewy body disease (LBD): Parkinson's disease (PD), dementia with Lewy bodies (DLB), and PD dementia.
METHODS
We used of the Rochester Epidemiology Project to establish a population-based cohort of clinically diagnosed LBD. We used two definitions for differentiating between brain- and body-first LBD: a previously hypothesized body-first presentation in patients with rapid eye movement sleep behavior onset before motor symptoms onset; and an expanded definition of body-first LBD when a patient had at least 2 premotor symptoms between constipation, erectile dysfunction, rapid eye movement sleep behavior, anosmia, or neurogenic bladder.
RESULTS
Brain-first patients were more likely to be diagnosed with PD (RR = 1.43, p = 0.003), whereas body-first patients were more likely to be diagnosed with DLB (RR = 3.15, p < 0.001). Under the expanded definition, there was no difference in LBD diagnosis between brain-first and body-first patients (PD: RR = 1.03, p = 0.10; DLB: RR = 0.88, p = 0.58) There were no patterns between brain- or body-first presentation, PD dementia under either definition (original: p = 0.09, expanded: p = 0.97), and no significant difference in motor symptoms between brain-first and body-first.
INTERPRETATION
Our findings do not support the dichotomous classification of body-first and brain-first LBD with the currently proposed definition. Biological exposures resulting in PD and DLB are unlikely to converge on a binary classification of top-down or bottom-up synuclein pathology. ANN NEUROL 2024.
PubMed: 38860478
DOI: 10.1002/ana.27006