Chem Senses. Patients were blinded to the side of sodium citrate application, and side of treatment was randomized between patients. Epub 2020 Jun 25. Chem Senses 22(1):39–52, Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the ‘Sniffin’’ Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: An upgrade based on a group of more than 3,000 subjects’.  |  Previous work has demonstrated that clinical improvement can be assumed where threshold score increases by ≥ 2.5, discrimination or identification scores increase by three points or composite TDI increases by ≥ 5.5 [20]. Show abstract. Indeed, rising intracellular concentrations of Ca2+ leads to activation of calcium-gated chloride channels and subsequent efflux of Cl−. In: Menini A (ed) The neurobiology of olfaction. 2017; 42(3):557-563 (ISSN: 1749-4486) Whitcroft KL; Ezzat M; Cuevas M; Andrews P; Hummel T. OBJECTIVES: Free calcium plays an integral role in peripheral olfactory processing, including feedback inhibition. In patients 61 years or over (again, irrespective of quantitative function), 7 reported parosmia and 8 phantosmia at baseline. We aimed to determine whether treatment with a 2-week course of intranasal sodium citrate improves quantitative olfactory function in patients with post-infectious impairment. Patients continued treatment in this way two times per day for a period of 2 weeks. Again using the best of two monorhinal scores, 37 participants were hyposmic and 23 anosmic at baseline. Intranasal sodium citrate solution improves olfaction in post-viral hyposmia. However, this was limited to the subgroup of patients with PIOD (7 patients, mean improvement 2.29 ± 1.89, p = 0.02) [16]. The effect of intranasal sodium citrate on olfaction in post-infectious loss: results from a prospective, placebo-controlled trial in 49 patients Published in: Clinical Otolaryngology & Allied Sciences, December 2016 DOI: 10.1111/coa.12789: Pubmed ID: 27860366. Includes ingredients, method of preparation, discussion, and references for the compounding pharmacist. doi: 10.12968/hmed.2015.76.3.C41. This site needs JavaScript to work properly. Laryngoscope 114(4):733–737, Croy I, Nordin S, Hummel T (2014) Olfactory disorders and quality of life-an updated review. 2010 May-Jun;31(3):185-9. doi: 10.2500/aap.2010.31.3357. Again, this improvement reached statistical, but not clinical significance. To determine whether age related factors might have confounded potential treatment effect, we performed a further subgroup analysis according to age. It has therefore been suggested that reduction of intranasal free calcium with buffer solutions such as sodium citrate may improve olfactory function in patients with smell impairment. Clipboard, Search History, and several other advanced features are temporarily unavailable. Furthermore, Ca2+ forms a significant proportion of the cation influx through CNG channels following olfactory receptor activation, and is therefore again involved in cell depolarisation [26]. Box and whisker plot showing TDI scores before and after treatment with intranasal sodium citrate. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. We aimed to determine whether treatment with a 2-week course of intranasal sodium citrate improves quantitative olfactory function in patients with post-infectious impairment. Within the anosmic subgroup, 5 reported parosmia and 5 phantosmia at baseline. Error bars 5–95% interval. Across all patients, there was a significant improvement in TDI score after treatment (comparing best pre- with best post-treatment TDI of right and left monorhinal scores; improvement of 2.08 ± 3.82 points, p < 0.0001, see Fig. Whitcroft, K.L., Gunder, N., Cuevas, M. et al. Written, informed consent was obtained from all participants. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. Citrate- and Succinate-Modified Carbonate Apatite Nanoparticles with Loaded Doxorubicin Exhibit Potent Anticancer Activity against Breast Cancer Cells. However, rising intracellular calcium concentration also initiates downstream pathways involved in receptor feedback inhibition. Background: Accordingly, we found no significant difference between treated and untreated sides with respect to TDI, T, D and I (Fig. This concentration was shown to be effective in our previous studies. In both of these studies, treatment-related improvements in olfactory test scores reached statistical, but not clinical significance. Conclusions and Relevance This multifactorial assessment and patient olfactory training may improve the accuracy and reliability with which olfactory dysfunction is diagnosed and monitored. Classement du médicament en matière de délivrance : Médicament à usage vétérinaire. Part of Springer Nature. J Biol Chem 271(39):24231–24235, Wei J et al (1998) Phosphorylation and inhibition of olfactory adenylyl cyclase by CaM kinase II in neurons: A mechanism for attenuation of olfactory signals. HHS Monorhinal olfactory function was assessed using the “Sniffin’ Sticks” composite ‘TDI’ score, before and after treatment. Ten to fifteen drops were used in total. Optical observation of insulin (e) at pH 4.4, 4.8, 5.2, and 5.6 and (f) at pH 4.4, 6.4, and 7.6 with PTD1 or PTD4. To determine whether sodium citrate treatment led to significant improvement in quantitative olfactory function, we compared the change in olfactory test score [ΔTDI/T/D/I score = (TDI/T/D/I score after treatment)−(TDI/T/D/I score before treatment)] between right (treated) and left (untreated) sides. © 2021 Springer Nature Switzerland AG. --Description ; Informations nutritionnelles; Conseils d'util Within the hyposmic subgroup, the reduction in proportion of patients reporting parosmia after treatment did not reach statistical significance (18 before and 10 after treatment, p = 0.055). Br J Hosp Med (Lond). C'est le composé le plus important du soluté de réhydratation orale préconisé par l'OMS et UNICEF. It may, however, be beneficial in treating phantosmia, which should be further addressed in future work. It is possible that reducing intranasal free calcium over a prolonged period may result in equivalent results due to counterbalanced effects on depolarisation and inhibition. The aim of the present study was to determine whether prolonged use of intranasal sodium citrate improves quantitative and qualitative olfactory function in patients with PIOD. Patients applied intranasal sodium citrate solution to the right nasal cavity for 2 weeks. After treatment, 12 reported parosmia, 1 phantosmia. Sodium citrate is known to ‘bind’ with calcium molecules, and stop them from acting in this way. https://doi.org/10.4193/Rhino16.248, Article  Treatment with sodium citrate did not significantly improve quantitative olfactory function, compared to control. Free intranasal calcium is implicated in olfactory signalling through its role in the downstream signalling cascade of the olfactory receptor. Google Scholar, Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G, Hummel T (1997) ‘Sniffin’ sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. USA.gov. 2017 Feb;274(2):803-808. doi: 10.1007/s00405-016-4277-x. Box and whisker plots showing change in TDI score before and after treatment with intranasal sodium citrate (right) or no treatment (left), in patients under 61 years (left) or 61 years and over (right). This was true across all patients, as well as in subgroup analysis of hyposmic and anosmic patients. In the study, a group of people with anosmia or hyposmia were treated with a sodium citrate nasal spray, alongside a control group whose spray contained water. Clin Otolaryngol 42(3):1–7, Frasnelli J, Livermore A, Soiffer A, Hummel T (2002) Comparison of lateralized and binasal olfactory thresholds. This study was approved by the Ethics Committee at the University Clinic of the TU Dresden, Dresden, Germany, and performed in accordance with the Declaration of Helsinki. 2018 Mar 11;10(1):32. doi: 10.3390/pharmaceutics10010032. Rhinology 54(4):368–374, CAS  We performed a prospective, controlled study. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. Request PDF | Intranasal sodium citrate solution improves olfaction in post-viral hyposmia | Background: Calcium plays an integral role in olfactory signal transduction, including feedback inhibition. All patients were treated with sodium citrate to the right nasal cavity (1 ml, 3.5 g/140 ml, pH 7.4, 298 mOsmol/L). In turn, sodium and calcium ion influx into the cell causes depolarisation and action potential generation [7]. We aimed to investigate the utility of intranasal sodium citrate in improving the olfactory function of hyposmic patients, by performing this prospective placebo controlled, single-blinded trial. However, there was a significant reduction in the proportion of patients reporting phantosmia, at the end of the study period. Medication side effects were as follows: sneezing (n = 12), nasal irritation (n = 11), pharyngeal irritation (n = 5), nasal obstruction (n = 1), increased nasal patency (n = 13). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Article  Treatment of post-viral olfactory dysfunction: an evidence-based review with recommendations. https://doi.org/10.1007/s00405-020-06567-7, DOI: https://doi.org/10.1007/s00405-020-06567-7, Over 10 million scientific documents at your fingertips, Not logged in Of these, 38 were female, 22 male and mean age was 61 years (range 25–85 years). Any potential side effects of the medication were recorded. Open Access funding enabled and organized by Projekt DEAL. 3). The reduction in number of patients reporting phantosmia, however, was statistically significant (9 before, 1 after, p = 0.013). The mean duration of olfactory dysfunction was 244 ± 238 days and mean time between testing was 23 ± 13 days. Neuron 21(3):495–504, Pifferi S, Menini A, Kurahashi T (2010) Signal transduction in vertebrate olfactory cilia. Rhinology 43(2):130–134, PubMed  Rhinol Suppl. Number of times cited according to CrossRef: 6. However, this study design incorporated frequent testing with the 12-item screening version of the SS identification test—which was performed every 15 min after instillation of the medication. Author(s): Allen Loyd V Jr. Issue: Jan/Feb 2018 - Volume 22, Number 1 View All Articles in Issue. Rhinology 54:1–6, Hummel T et al (2017) Position paper on olfactory dysfunction. No significant change in olfactory function occurred for either identification or threshold in any other aetiological subgroup. olfactory acuity was measured before and after the administration of a sodium citrate buffer solution in the nasal cleft. There was a trend towards greater increase in TDI (using best of two monorhinal scores) after treatment in younger patients compared with older patients, however, this did not reach statistical significance (mean increase in TDI score 4.89 ± 11.75 in patients under 61 and 3.24 ± 10.75 in patients aged 61 and over, p > 0.05). This efflux modulates the excitatory response of the olfactory receptor, and potentiates cell depolarisation [25]. J Exp Biol 203:253–262, Frings S, Seifert R, Godde M, Kaupp U (1995) Profoundly different calcium permeation and blockage determine the specific function of distinct cyclic nucleotide-gated channels.  |  The results of this prospective controlled trial demonstrate that treatment with intranasal sodium citrate for a period of 2 weeks does not significantly improve quantitative olfactory function but does lead to a significant reduction in the proportion of patients reporting phantosmia. After treatment, 11 reported parosmia and 1 phantosmia. For each of the individual subcomponents of the SnSt, as well as the composite score, higher values indicate better olfactory function. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Results: Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients The combination of citric acid and sodium citrate is used to prevent gout or kidney stones, or metabolic acidosis in people with kidney problems. Sodium chloride solution was applied to the contralateral olfactory cleft, which therefore acted as placebo control. Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients, http://creativecommons.org/licenses/by/4.0/, https://doi.org/10.1007/s00405-020-06567-7. For detailed description of olfactory testing using the SnSt, please see ref [16]. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. 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