Effect of budesonide aerosol inhalation on postoperative complications and foreign body sensation in the throat of goiter resection patients

Purpose: To study the effect of budesonide aerosol inhalation on postoperative complications and foreign-body sensation in the throat of patients who underwent goiter resection.Methods: One hundred and twenty patients who underwent goiter resection at The Affiliated Hospital of Putian University (Fujian, China) from January 2019 to January 2020 were included in the study, and then equally and randomly assigned to groups A and B. During the perioperative period, group A patients were given budesonide aerosol inhalation, while group B patients received aerosol inhalation of equivalent volume of normal salineectively. Postoperative complication rate (CR), complication pain scores, scores on mucosal response in the throat, and scores on foreign body sensation in the throat were determined for both groups.Results: Postoperative complications in patients were hoarseness, sore throat and cough. Group A had significantly lower postoperative CR, lower complication pain scores, lower scores on mucosal response in the throat, and lower scores on foreign body sensation in the throat, when compared to group B (p < 0.001).Conclusion: Budesonide aerosol inhalation in patients who underwent goiter resection is effective in relieving throat injury from general anesthesia, minimizing likelihood of postoperative complications, and easing foreign-body sensation in the throat. Thus, this strategy may be suitable for the management of postoperative complications.

The Effects of Human Milk Oligosaccharides on Gut Microbiota, Metabolite Profiles and Host Mucosal Response in Patients with Irritable Bowel Syndrome

Background: Human milk oligosaccharide supplementation safely modulates fecal bifidobacteria abundance and holds the potential to manage symptoms in irritable bowel syndrome (IBS). Here, we aimed to determine the role of a 4:1 mix of 2′-O-fucosyllactose and lacto-N-neotetraose (2′FL/LNnT) on the modulation of the gut microbiota composition and host mucosal response, as well as the link between the bifidobacteria abundance and metabolite modulation, in IBS patients. Methods: Biological samples were collected from IBS patients (n = 58) at baseline and week 4 post-supplementation with placebo, 5 g or 10 g doses of 2′FL/LNnT. The gut microbiota composition, metabolite profiles and expression of genes related to host mucosal response were determined. Results: Moderate changes in fecal, but not mucosal, microbial composition (β-diversity) was observed during the intervention with higher dissimilarity observed within individuals receiving 10g 2′FL/LNnT compared to placebo. Both fecal and mucosal Bifidobacterium spp. increased after 2′FL/LNnT intake, with increased proportions of Bifidobacterium adolescentis and Bifidobacterium longum. Moreover, the intervention modulated the fecal and plasma metabolite profiles, but not the urine metabolite profile or the host mucosal response. Changes in the metabolite profiles were associated to changes in bifidobacteria abundance. Conclusion: Supplementation with 2′FL/LNnT modulated the gut microbiota, fecal and plasma metabolite profiles, but not the host mucosal response in IBS. Furthermore, the bifidogenic effect was associated with metabolite modulation. Overall, these findings support the assertion that 2′FL/LNnT supplementation modulate the intestinal microenvironment of patients with IBS, potentially related to health.

A thermostable oral SARS-CoV-2 vaccine induces mucosal and protective immunity

An ideal protective vaccine against SARS-CoV-2 should not only be effective in preventing disease, but also in preventing virus transmission. It should also be well accepted by the population and have a simple logistic chain. To fulfill these criteria, we developed a thermostable, orally administered vaccine that can induce a robust mucosal neutralizing immune response. We used our platform based on retrovirus-derived enveloped virus-like particles (e-VLPs) harnessed with variable surface proteins (VSPs) from the intestinal parasite Giardia lamblia, affording them resistance to degradation and the triggering of robust mucosal cellular and antibody immune responses after oral administration. We made e-VLPs expressing various forms of the SARS-CoV-2 Spike protein (S), with or without membrane protein (M) expression. We found that prime-boost administration of VSP-decorated e-VLPs expressing a pre-fusion stabilized form of S and M triggers robust mucosal responses against SARS-CoV-2 in mice and hamsters, which translate into complete protection from a viral challenge. Moreover, they dramatically boosted the IgA mucosal response of intramuscularly injected vaccines. We conclude that our thermostable orally administered e-VLP vaccine could be a valuable addition to the current arsenal against SARS-CoV-2, in a stand-alone prime-boost vaccination strategy or as a boost for existing vaccines.

Mucosal immune responses in COVID19 - a living review

COVID-19 was initially characterized as a disease primarily of the lungs, but it is becoming increasingly clear that the SARS-CoV2 virus is able to infect many organs and cause a broad pathological response. The primary infection site is likely to be a mucosal surface, mainly the lungs or the intestine, where epithelial cells can be infected with virus. Although it is clear that virus within the lungs can cause severe pathology, driven by an exaggerated immune response, infection within the intestine generally seems to cause minor or no symptoms. In this review, we compare the disease processes between the lungs and gastrointestinal tract, and what might drive these different responses. As the microbiome is a key part of mucosal barrier sites, we also consider the effect that microbial species may play on infection and the subsequent immune responses. Because of difficulties obtaining tissue samples, there are currently few studies focused on the local mucosal response rather than the systemic response, but understanding the local immune response will become increasingly important for understanding the mechanisms of disease in order to develop better treatments.

The Effect of Passive Smoking on Mucociliary Clearance and Inferior Concha Reactivity

Introduction The aim of this study is to investigate the effect of cigarette smoke on turbinate reactivity and mucociliary clearance (MCC) in passive smokers. Methods 60 adult patients (30 passive smokers and 30 healthy subjects as the control group) were recruited for this study. Following a questionnaire on passive smoke exposure, MCC measurement using the saccharin test was carried out to all participants. The baseline and after decongestant acoustic rhinometry values (MCA1, MCA2, VOL1, VOL2) were measured and the percentage changes between the two test values (ie; response to nasal decongestants = concha reactivity) were recorded. Results All 60 patients, including 37 women (61.7%) and 23 men (38.3%) were between 18–57 years of age . MCC’s average measurements were 11.13 minutes in the passive smokers group, 7.87 minutes in the control group, which was statistically significantly different (p < 0.05). There was a statistically significant difference between the passive smokers and control group for acoustic rhinometric measurement of the ratio of MCA2 and VOL2 values before and after decongestant application (p < 0.05). Discussion Passive smoking can damage the nasal mucosa at least as active smoking. The number of studies on this subject is limited. There are no studies in the literature showing the effect of cigarette smoke on the inferior turbinate mucosal response. In our study, the inferior turbinate decongestant capacity was found to be significantly decreased in the passive smokers compared to the control group. Conclusion As a result of cigarette exposure, the erectile function of the lower turbines may be impaired. The task of the ENT physicians is to warn the passive smokers in this regard.

Secretory Proteins in the Skin Mucus of Nile Tilapia (Oreochromis niloticus) are Modulated Temporally by Photoperiod and Bacterial Endotoxin Cues

Although it is well known that the biological and physical characteristics of skin mucus in fishes are strongly affected by changes in environmental conditions, the influence of photoperiod and time-dependent bacterial endotoxin stimulation is not well documented. In the present study, we determined the diel variations in the basal activities of secretory proteins with known defense functions in the skin mucus of Nile tilapia (Oreochromis niloticus) maintained under two photic environments: equal length of day and night (12L:12D, LD) or total darkness (0L:24D, DD). A second experiment was conducted to determine how time-dependent (i.e., day versus night) lipopolysaccharide (LPS) challenge could influence these skin mucosal defenses. The results revealed that LD signal differentially modulated the activities of mucosal immune molecules. Fish subjected to LD regime showed significantly higher levels of skin mucus lysozyme and protease at nighttime than at daytime. This distinct feature was not observed in fish under DD. There was no general mucosal response patterns to time-dependent LPS challenge. Nonetheless, protease and lysozyme, which were identified to be at elevated levels at night, were significantly modulated when the endotoxin was administered at nighttime. Ceruloplasmin was the only molecule that responded to LPS challenge at daytime, where its activity significantly increased at 8 h post-stimulation. Collectively, the results revealed that photoperiod cues influenced the activities of mucosal defenses and this may play, at least in part, in the temporal sensitivity to bacterial endotoxin.

Evaluation of gall bladder mucosal changes in patients undergoing laparoscopic cholecystectomy

Background: Histopathological changes induced by gall stone disease or cholelithiasis are diverse including acute inflammation, chronic inflammation, glandular hyperplasia, granulomatous inflammation, cholesterosis, dysplasia and carcinoma. Hence, this study was planned to assess gallbladder mucosal changes in patients undergoing laparoscopic cholecystectomy (LC) and it’s correlation with number and types of stone.Methods: A total of 50 patients with symptomatic cholelithiasis scheduled to undergo laproscopic cholecystectomy (LC) after written and informed consent from October 2015 to October 2018 at Teerthanker Mahaveer Medical College and Research Centre, Moradabad were followed prospectively. Preoperative biochemical profile and ultrasonography of whole abdomen of all the patients was obtained. LC was done under the hands of the skilled and experienced surgeons. Morphologic profile of gallstones was recorded and analysed. Gallbladder mucosal tissues were sent to general pathology department for analysis. Histopathological typing of all the gallbladder mucosal specimens was done and was correlated with the number and type of gallstones.Results: In majority (76%) cases, cholecystitis was found. Hyperplasia was seen in 10% patients. Cholecystitis with metaplasia in 10 percent of the cases and carcinoma in 2 percent of the cases. While correlating the gallbladder mucosal response with the number and type of stones, non-significant results were obtained.Conclusions: There might be some association between gall bladder mucosal changes and gall stone. We cannot say an etiologic and effective correlation from the results of this study; possible mechanism may be gall stone erodes gall bladder wall constantly over a period of time which may constitute a risk. While correlating gallbladder mucosal response with the number and type of stones, non-significant results were obtained.