0349_GF_OnDrugDelivery Pulmonary Nasal November 2010.indd
نویسنده
چکیده
Copyright © 2010 Frederick Furness Publishing 20 Chronic sinusitis is one of the most commonly diagnosed chronic illnesses, and approximately 10-15% of the European and US population suffer from chronic rhinosinusitis. Inflammation of the nasal mucosa (i.e. rhinitis), due to bacterial, fungal or viral infections, allergies, or exposure to inhaled irritants, leads to acute sinusitis and CRS. Chronic inflammation of the nasal mucosa results in trigger of defense reactions, mucosal swelling (including polyposis), increased mucus secretion, loss of cilia, airway obstruction and blocked sinus drainage. Under these conditions, bacteria and viruses may proliferate and cannot be removed from the nasal cavity and sinuses by normal ciliary function and clearance mechanisms. In addition, impaired mucociliary clearance in patients with primary ciliary dyskinesia (PCD) or cystic fibrosis (CF) also causes chronic sinusitis, and other chronic respiratory diseases, such as asthma and COPD, are linked to CRS. Due to the limited therapeutic success of both oral and of topical treatment regimes, functional endonasal sinus surgery (FESS) has been the primary approach for treating CRS. An effective topical therapy is an unmet need and may allow new therapeutic options treating upper respiratory diseases prior to or post surgery. The sinuses are poorly-ventilated hollow organs, making topical aerosol based treatments complex and difficult since nebulised drugs do not penetrate into these areas. However, gas and aerosol transport into non-actively ventilated areas can be achieved by diffusion and flow induction caused by pressure differences, and pulsating air-flows are generating such pressure gradients.
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