Therapeutic diminution of Interleukin-10 with intranasal theophylline administration in hyposmic patients.

Objective: To determine changes in nasal mucus Interleukin-10 (IL-10) before and after intranasal theophylline treatment in hyposmic patients, and the relationship of these changes to orally administered theophylline treatment.

Design: IL-10 was measured in nasal mucus samples of 17 normal subjects and 39 patients with hyposmia of multiple etiologies by use of a sensitive spectrophotometric ELISA assay. Hyposmia is defined clinically by standardized evaluation of impaired olfactometry, as well as subjectively self reported by the patient.

Theophylline increases saliva sonic hedgehog and improves taste dysfunction.

Objective: To determine changes in saliva sonic hedgehog (Shh) and in taste dysfunction before and after oral theophylline treatment.

Design: Shh was measured in parotid saliva of both normal subjects and patients with taste dysfunction of multiple etiologies by use of a sensitive spectrophotometric ELISA assay. Taste dysfunction was defined clinically by both subjective inhibition of taste function (including acuity loss) and impaired gustometry.

Sonic hedgehog is present in parotid saliva and is decreased in patients with taste dysfunction.

Purpose: To demonstrate that sonic hedgehog (Shh) is present in human parotid saliva and is decreased in human taste dysfunction.

Methods: Shh was measured in parotid saliva of 27 normal subjects and 81 patients with taste dysfunction of multiple etiologies using a sensitive spectrophotometric ELISA assay. Taste dysfunction was defined clinically both by subjective decreases of taste acuity and flavor perception and by impaired gustometry.

A genetic marker of the ACKR1 gene is present in patients with Type II congenital smell loss who have type I hyposmia and hypogeusia.

Purpose: Our previous study of Type II congenital smell loss patients revealed a statistically significant lower prevalence of an FY (ACKR1, formerly DARC) haplotype compared to controls. The present study correlates this genetic feature with subgroups of patients defined by specific smell and taste functions.

Methods: Smell and taste function measurements were performed by use of olfactometry and gustometry to define degree of abnormality of smell and taste function.

Improved smell function with increased nasal mucus sonic hedgehog in hyposmic patients after treatment with oral theophylline.

Purpose: We previously demonstrated the presence of sonic hedgehog (Shh) in nasal mucus in normal subjects and in patients with smell loss (hyposmia). Nasal mucus Shh levels were found significantly diminished in untreated hyposmic patients of multiple etiologies. Since treatment with oral theophylline has been previously associated with improvement in smell function we wished to study if such treatment increased nasal mucus Shh as well as improved smell function in patients with hyposmia.

On the mechanism of smell loss in patients with Type II congenital hyposmia.

Background: Smell function has been initiated with theophylline treatment in 63% of patients with Type II congenital smell loss. Based upon a systematic evaluation of the protein components of nasal mucus we have demonstrated that interactions among four chemical moieties in nasal mucus may play significant roles in this initiation. Prior to treatment three of these moieties, cAMP, cGMP and sonic hedgehog (Shh), were significantly decreased in concentration whereas one of these moieties, TNFalpha, was increased in concentration.

Initiation of smell function in patients with congenital hyposmia.

Background: Patients with congenital smell loss (hyposmia) are born without a sense of smell. They comprise two types. Type I patients have genetic abnormalities manifested by brain, gonadal and other somatic abnormalities.

Erythrocyte membrane antigen frequencies in patients with Type II congenital smell loss.

Objective: The objective of this study was to determine whether there are genetic factors associated with Type II congenital smell loss.

Study Design: The expression frequencies of 16 erythrocyte antigens among patients with Type II congenital smell loss were determined and compared to those of a large control group.

Methods: Blood samples were obtained from 99 patients with Type II congenital smell loss.

Effects of smell loss (hyposmia) on salt usage.

Objective: Smell loss (hyposmia) inhibits flavor perception and influences food intake. To compensate for flavor loss, some patients with hyposmia appear to increase salt usage. The purpose of this study was to compare self-reported salt usage in patients with hyposmia with that in normal volunteers.

Anatomic olfactory structural abnormalities in congenital smell loss: magnetic resonance imaging evaluation of olfactory bulb, groove, sulcal, and hippocampal morphology.

Background And Purpose: There are 2 groups of patients with congenital smell loss: group 1 (12% of the total), in which patients exhibit a familial smell loss in conjunction with severe anatomical, somatic, neurological, and metabolic abnormalities such as hypogonadotropic hypogonadism; and a larger group, group 2 (88% of the total), in which patients possess a similar degree of smell loss but without somatic, neurological, or anatomical abnormalities or hypogonadism. Both groups are characterized by similar olfactory dysfunction, and both have been reported to have absent or decreased olfactory bulbs and grooves, which indicates some overlap in olfactory pathophysiology and anatomy. The purpose of this study was to evaluate patients with congenital smell loss, primarily among group 2 patients, comparing brain magnetic resonance imaging (MRI) results in patients with types of hyposmia.

Interleukin 6 in hyposmia.

Importance: Olfaction is a complex sensory process that has not been fully studied. Elevated plasma levels of interleukin 6 (IL-6) have been found in patients with several acute and chronic diseases but have not been reported in patients with smell loss (hyposmia).

Objective: To determine IL-6 levels in patients with hyposmia.

Taste and smell function in chronic disease: a review of clinical and biochemical evaluations of taste and smell dysfunction in over 5000 patients at The Taste and Smell Clinic in Washington, DC.

Purpose: To describe systematic methods developed over 40 years among over 5000 patients at The Taste and Smell Clinic in Washington, DC to evaluate taste and smell dysfunction.

Materials And Methods: A tripartite methodology was developed. First, methods to determine clinical pathology underlying the multiple disease processes responsible for taste and smell dysfunction were developed.

Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia.

Olfactory hallucinations without subsequent myoclonic activity have not been well characterized or understood. Herein we describe, in a retrospective study, two major forms of olfactory hallucinations labeled phantosmias: one, unirhinal, the other, birhinal. To describe these disorders we performed several procedures to elucidate similarities and differences between these processes.

Intranasal theophylline treatment of hyposmia and hypogeusia: a pilot study.

Objective: To determine whether intranasal theophylline methylpropyl paraben can correct hyposmia and hypogeusia.

Design: We performed an open-label pilot study in patients with hyposmia and hypogeusia under the following 3 conditions: (1) before treatment, (2) after oral theophylline anhydrous treatment, and (3) after intranasal theophylline treatment. Under each condition, we performed subjective evaluations of taste and smell functions, quantitative measurements of taste (gustometry) and smell (olfactometry), and measurements of serum theophylline level and body weight.

Morphological changes of olfactory bulbs and grooves: initial report of supernumerary olfactory bulbs.

Background: Observations and measurements of olfactory structures in humans have been difficult and not of common neuroradiological interest. Because of our interest in olfaction, we have studied the presence, size, and function of these structures in normal subjects and in patients with smell loss.

Methods: Magnetic resonance imaging studies of brain were performed in 220 consecutive patients in our medical center for a variety of clinical neurological investigations.

A randomized, placebo controlled trial of oral zinc for chemotherapy-related taste and smell disorders.

Abnormalities in taste and smell are commonly reported in patients receiving chemotherapy and may hinder appetite, dietary intake, nutritional well-being, and quality of life. Oral zinc has been used to treat taste and smell abnormalities in several altered physiologic states, including renal failure, liver disease, head trauma, and pregnancy, with varying results. The authors conducted a double-blinded, placebo-controlled randomized clinic trial over 3 months.

Comparative monitoring of oral theophylline treatment in blood serum, saliva, and nasal mucus.

Background: Theophylline, used in the treatment for various pulmonary pathologies, is usually given orally with drug levels measured primarily in blood serum and occasionally in saliva. Although theophylline treatment is now not commonly used it has been effective to correct smell loss (hyposmia). This is important because 21 million people in the United States exhibit hyposmia and oral theophylline has corrected hyposmia in about 50% of these patients.

Aetiological relationships of nasal mucus cyclic nucleotides in patients with taste and smell dysfunction.

Aims: The authors previously demonstrated that nasal mucus cyclic adenosine 3', 5'-monophosphate (cAMP) and cyclic 3', 5'-guanosine monophosphate (cGMP) were lower in patients with smell and taste dysfunction than in normal individuals. To learn more about these differences this study related levels of nasal mucus cAMP and cGMP in patients with smell and taste dysfunction to the aetiology of their sensory loss and compared these results with those in normal individuals.

Methods: Nasal mucus cAMP and cGMP levels in patients with smell loss (hyposmia) were calculated after assembling data into aetiological groups.