Rhinorrhea and increased chloride secretion through the CFTR chloride channel-a systematic review
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Authors
Eisenhut, M
Issue Date
2023
Type
Published Abstract
Language
Keywords
Research Subject Categories::MEDICINE::Surgery::Otorhinolaryngology
Alternative Title
Abstract
Abstract
Purpose: Allergic and non-allergic rhinorrhea in the forms of acute or chronic rhinosinusitis can mean a watery nasal discharge that is disabling. Primary objective was to review the evidence supporting the hypothesis that rhinorrhea is due to increased chloride secretion through the CFTR chloride channel.
Methods: The structure of the evidence review followed the EQUATOR Reporting Guidelines. Databases searched from inception to February 2022 included Pubmed, EMBASE and the Cochrane library using keywords "Rhinorrhea", "chloride", "chloride channel", "CFTR" and "randomized controlled trial". Quality assessment was according to the Oxford Centre for Evidence-based Medicine.
Results: 49 articles were included. They included randomized controlled trials out of which subsets of data with the outcome of rhinorrhea on 6038 participants were analysed and in vitro and animal studies. The review revealed that drugs, which activate CFTR are associated with rhinorrhea. Viruses, which cause rhinorrhea like rhinovirus were found to activate CFTR. The chloride concentration in nasal fluid showed an increase in patients with viral upper respiratory tract infection. Increased hydrostatic tissue pressure, which is an activator of CFTR was observed in allergic upper airway inflammation. In this condition exhaled breath condensate chlorine concentration was found to be significantly increased. Drugs, which can reduce CFTR function including steroids, anti-histamines, sympathomimetic and anticholinergic drugs reduced rhinorrhea in randomized controlled trials.
Conclusions: A model of CFTR activation-mediated rhinorrhea explains the effectiveness of anticholinergic, sympathomimetic, anti-histamine and steroid drugs in reducing rhinorrhea and opens up avenues for further improvement of treatment by already known specific CFTR inhibitors.
Keywords: Chloride channel; Cystic fibrosis transmembrane conductance regulator; Hydrostatic interstitial tissue pressure; Rhinorrhea; Transudate; Vasodilatation.
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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Publication types
Systematic Review
Review
MeSH terms
Animals
Chloride Channels*
Chlorides
Cystic Fibrosis Transmembrane Conductance Regulator*
Nasal Mucosa / metabolism
Randomized Controlled Trials as Topic
Sympathomimetics
Substances
Chloride Channels
Cystic Fibrosis Transmembrane Conductance Regulator
Chlorides
Sympathomimetics
Related information
Gene
Gene (GeneRIF)
MedGen
Protein (RefSeq)
PubChem Compound (MeSH Keyword)
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Citation
Eisenhut M. Rhinorrhea and increased chloride secretion through the CFTR chloride channel-a systematic review. Eur Arch Otorhinolaryngol. 2023 Oct;280(10):4309-4318. doi: 10.1007/s00405-023-08067-w. Epub 2023 Jun 20. PMID: 37338585.