Alteration of blood monocyte subsets in chronic rhinosinusitis with regard to anti-inflammatory 1,8-Cineol treatment

Abstract

This paper provides a brief historical background of saline nasal irrigation (SNI), main modes of SARS-COV-2 transmission and entry, and anti-infective properties of saline. It reviews the protective evidence associated with SNI and gargling against viral upper respiratory tract infection (URTI). SARS-CoV-2 presents as an URTI transmitted mainly via respiratory droplets and aerosols to the oro-nasal mucosa and indirectly after touching these entry sites from contaminated fomites. It can potentially be transmitted from the conjunctival mucosa to the nasal mucosa or from resuspension and inhalation from the facial area around the nose. SNI has antiviral, anti-inflammatory and mucociliary restorative properties. Numerous randomized controlled trials have reported that SNI, with and without gargling, prevents and treats viral URTI. Based on biological rationale and anecdotal evidence we suggest a protocol: Soap and Water to the Hands and Face-Eye Rinse Nasal Irrigation and Gargling with Saline (SWHF-ERNIGS) may limit the transmission SARS-CoV-2, and prevent and treat COVID-19 infection. Clinical considerations of the protocol are presented. The protocol is safe, straightforward and can be easily performed by healthcare workers and the general public; it uses readily available salt, water and soap. Formal studies of effectiveness and application of the protocol are warranted.

Modes of Action of 1,8-Cineol in Infections and Inflammation

“…Data revealed a decrease in classical monocytes accompanied by a significant increase in intermediate CD16 + monocytes in the peripheral blood of CRSwNP patients. Chronic rhinosinusitis patients with a severe redistribution of these monocyte subsets revealed a significant restoration in response to two-week 1,8-Cineol treatment [ 63 ]. Nitric oxide (NO) is also known to possess airway-modulating functions in patients with chronic rhinosinusitis and an increased phosphorylation in eNOS was shown in nasal polyps from CRSwNP patients, which was significantly inhibited in response to 1,8-Cineol treatment [ 64 ].…”

Deep immune profiling of chronic rhinosinusitis in allergic and non-allergic cohorts using mass cytometry

“…Though mass cytometry has recently revealed differences in nasal polyp-derived T cell subsets with a higher percentage of CD161 hi CXCR3 lo expressing T helper cells in nasal polyps as compared to control tissues 26 , we only detected a trend towards elevated Th2 cell levels in blood of CRSwNP patients and N-ERD patients, which did not reach significance. The lack of difference in Th2 cell numbers between different patient groups has also been observed using flow cytometry approaches 27 .…”

Immunomodulatory effects and mechanisms of the extracts and secondary compounds of Zingiber and Alpinia species: a review

“…T-cell subset distribution and PD-1 and PD-L1 expression were examined in chronic rhinosinusitis patients with monocyte subsets (CRSwNP and CRSsNP). Chronic rhinosinusitis caused a shift in the inflammatory phenotypes of peripheral monocyte subsets, which may be reversed by 1,8-cineol ( Polasky et al, 2021 ). 1,8-Cineol concentrations in tissue samples of nasal polyps from CRSwNP patients were significantly higher than those in the control group ( MacKenzie et al, 2023 ).…”