The effect of nasal irrigation formulation on the antimicrobial activity of nasal secretions

Woods, Charmaine M.; Tan, Simon; Ullah, Shahid; Frauenfelder, Claire; Ooi, Eng H.; Carney, A. Simon

doi:10.1002/alr.21604

Cited by 20 publications

(25 citation statements)

References 46 publications

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“…In addition, regular IS had a negative effect on epithelial cell function . A 2015 study by Woods et al compared the effect of low‐salt solution, IS, and HS on the antimicrobial activity of nasal secretions (Table ) . The investigators determined that IS caused a greater decrease in the antimicrobial activity of nasal secretions when compared with low‐salt solution and HS .…”

Section: Nasal Saline Compositionmentioning

confidence: 99%

“…A 2015 study by Woods et al compared the effect of low‐salt solution, IS, and HS on the antimicrobial activity of nasal secretions (Table ) . The investigators determined that IS caused a greater decrease in the antimicrobial activity of nasal secretions when compared with low‐salt solution and HS . The application of these findings into clinically meaningful conclusions has yet to be determined.…”

Section: Nasal Saline Compositionmentioning

confidence: 99%

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Nasal saline irrigation: a clinical update

Succar

Turner

Chandra

2019

Int Forum Allergy Rhinol

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Background: Nasal saline irrigation (NSI) plays an important role in the treatment of chronic rhinosinusitis (CRS). It is a beneficial low-risk treatment that serves an adjunctive function in the medical and surgical management of CRS. NSI is hypothesized to function by thinning mucous, improving mucociliary clearance, decreasing edema, and reducing antigen load in the nasal and sinus cavities. Although its use in CRS is nearly universal, significant variety exists with regard to delivery volume, delivery pressure, frequency of use, duration of use, composition, and hygiene recommendations. Evidence is limited regarding the most optimal methods of NSI delivery. In addition, use of NSI has recently come under increasing scrutiny due to potential associations with cases of primary amebic meningoencephalitis. Methods:In this review we provide a clinical update summarizing use of NSI for treatment of CRS, including current recommendations for use, and data regarding overall efficacy, available delivery devices, solution composition, and hygiene.Results: Current evidence and recommendations for nasal saline delivery methods, composition, and hygiene are presented. Conclusion:The most recent consensus statements and Cochrane Review recommend the use of NSI for CRS based on a preponderance of lower level evidence. A conclusion regarding the optimal method of delivery and solution composition cannot be drawn based on the current literature. C 2019 ARS-AAOA, LLC.

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Section: Nasal Saline Compositionmentioning

confidence: 99%

Section: Nasal Saline Compositionmentioning

confidence: 99%

Nasal saline irrigation: a clinical update

Succar

Turner

Chandra

2019

Int Forum Allergy Rhinol

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“…[29][30][31] Ongoing areas of research include attempts at quantifying the effect of saline irrigation on nasal secretions and determination of the optimal composition and pH of the irrigation. 32,33 Generally speaking, the benefits, cost, and ease of irrigating the sinus allow for this treatment method to be recommended across the collective umbrella of the CRS population both as an initial adjunct and as a postoperative treatment measure.…”

Section: Nasal Saline Irrigationmentioning

confidence: 99%

Chronic rhinosinusitis: Endotypes, biomarkers, and treatment response

Gurrola

Borish

2017

Journal of Allergy and Clinical Immunology

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It is increasingly recognized that chronic rhinosinusitis (CRS) comprises a spectrum of different diseases with distinct clinical presentations and pathogenic mechanisms. Defining the distinct phenotypes and endotypes of CRS affects prognosis and, most importantly, is necessary as the basis for making therapeutic decisions. The need for individualized definitions of pathogenic mechanisms before initiating therapy extends to virtually all therapeutic considerations. This is clearly crucial with antibiotics, where, barring an influence from their off-target anti-inflammatory pharmacologic effects, an understanding of the role of the individual biome predicts likelihood of therapeutic benefit. However, this need for identifying individual phenotypes and endotypes also extends to the agent that is currently considered the mainstay of treatment of CRS, specifically glucocorticoids. As with asthma, it is recognized that a large minority of patients with CRS have a steroid-resistant phenotype, identification of which will preclude use of these agents with their potential side effects. Identification of endotypes is also becoming increasingly imperative because targeted biotherapeutic agents, such as anti-IgE and anti-cytokine antibodies, are becoming available. These agents are likely to benefit patients in whom the targeted mediator is not only expressed but demonstrably driving a central mechanism in that patient. In summary, the treatment of CRS is at an exciting crossroad. On the positive side, numerous therapeutics are in development that seem likely to have a positive effect in our patients with this condition. The challenge is that these therapies will require targeted individualized treatments based on identifying subjects with the relevant endotype.

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“…In contrast, hypertonic solutions were found to be only marginally capable of influencing microbial antigen concentrations. Furthermore, lysozyme and lactoferrin concentrations were found to be increased by approximately 30% at 24 h after NI [20]. …”

Section: Mechanisms Of Action Of Nasal Irrigation (Ni)mentioning

confidence: 99%

Nasal Irrigation: An Imprecisely Defined Medical Procedure

Principi

Esposito

2017

IJERPH

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Nasal irrigation (NI) is an old practice of upper respiratory tract care that likely originated in the Ayurvedic medical tradition. It is used alone or in association with other therapies in several conditions—including chronic rhinosinusitis and allergic rhinitis—and to treat and prevent upper respiratory tract infections, especially in children. However, despite it being largely prescribed in everyday clinical practice, NI is not included or is only briefly mentioned by experts in the guidelines for treatment of upper respiratory tract diseases. In this review, present knowledge about NI and its relevance in clinical practice is discussed to assist physicians in understanding the available evidence and the potential use of this medical intervention. Analysis of the literature showed that NI seems to be effective in the treatment of several acute and chronic sinonasal conditions. However, although in recent years several new studies have been performed, most of the studies that have evaluated NI have relevant methodologic problems. Only multicenter studies enrolling a great number of subjects can solve the problem of the real relevance of NI, and these studies are urgently needed. Methods for performing NI have to be standardized to determine which solutions, devices and durations of treatment are adequate to obtain favorable results. This seems particularly important for children that suffer a great number of sinonasal problems and might benefit significantly from an inexpensive and simple preventive and therapeutic measure such as NI.

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The effect of nasal irrigation formulation on the antimicrobial activity of nasal secretions

Abstract: The formulation of nasal irrigation solutions significantly affects the measured levels and functionality of sinonasal antimicrobial peptides.

Cited by 20 publications

References 46 publications

Nasal saline irrigation: a clinical update

Nasal saline irrigation: a clinical update

Chronic rhinosinusitis: Endotypes, biomarkers, and treatment response

Nasal Irrigation: An Imprecisely Defined Medical Procedure

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