10 research outputs found
The Circadian Response of Intrinsically Photosensitive Retinal Ganglion Cells
Intrinsically photosensitive retinal ganglion cells (ipRGC) signal environmental
light level to the central circadian clock and contribute to the pupil light
reflex. It is unknown if ipRGC activity is subject to extrinsic (central) or
intrinsic (retinal) network-mediated circadian modulation during light
entrainment and phase shifting. Eleven younger persons (18â30 years) with
no ophthalmological, medical or sleep disorders participated. The activity of
the inner (ipRGC) and outer retina (cone photoreceptors) was assessed hourly
using the pupil light reflex during a 24 h period of constant environmental
illumination (10 lux). Exogenous circadian cues of activity, sleep, posture,
caffeine, ambient temperature, caloric intake and ambient illumination were
controlled. Dim-light melatonin onset (DLMO) was determined from salivary
melatonin assay at hourly intervals, and participant melatonin onset values were
set to 14 h to adjust clock time to circadian time. Here we demonstrate in
humans that the ipRGC controlled post-illumination pupil response has a
circadian rhythm independent of external light cues. This circadian variation
precedes melatonin onset and the minimum ipRGC driven pupil response occurs post
melatonin onset. Outer retinal photoreceptor contributions to the inner retinal
ipRGC driven post-illumination pupil response also show circadian variation
whereas direct outer retinal cone inputs to the pupil light reflex do not,
indicating that intrinsically photosensitive (melanopsin) retinal ganglion cells
mediate this circadian variation
International Consensus Statement on Rhinology and Allergy: Rhinosinusitis
Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICARâRS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICARâRSâ2021 as well as updates to the original 140 topics. This executive summary consolidates the evidenceâbased findings of the document. Methods: ICARâRS presents over 180 topics in the forms of evidenceâbased reviews with recommendations (EBRRs), evidenceâbased reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICARâRSâ2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidenceâbased management algorithm is provided. Conclusion: This ICARâRSâ2021 executive summary provides a compilation of the evidenceâbased recommendations for medical and surgical treatment of the most common forms of RS
Superantigens and nasal polyps
Nasal polyps represent an often severe T-cell-orchestrated eosinophilic upper airway disease with currently unknown pathogenesis, often associated with lower airway disease, such as asthma. Superantigens, predominantly derived from Staphylococcus aureus, are potent activators of T cells, induce the synthesis of IgE in B cells, and have direct effects on pro-inflammatory cells, such as eosinophils. IgE antibodies to S. aureus enterotoxins have been described in polyp tissue, linked to a local polyclonal IgE production and an aggravation of eosinophilic inflammation. Furthermore, such IgE antibodies have also been described in the sera of patients with asthma, and linked to severity of disease and steroid insensitivity. This review summarizes our current understanding of the possible role of S. aureus enterotoxins in chronic severe airway disease, such as nasal polyposis