Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T20:04:15.241Z Has data issue: false hasContentIssue false
  • English
  • Français

Sequential magnetic resonance imaging analysis of the maxillary sinuses: implications for a model of gene therapy in cystic fibrosis

Published online by Cambridge University Press:  29 June 2007

Scott M. Graham ,
Janice L. Launspach ,
Michael J. Welsh  and
Joseph Zabner
Scott M. Graham*
Affiliation:
Division of Head and Neck Surgery, Department of Internal Medicine, University of Iowa City, Iowa, USA.
Janice L. Launspach
Affiliation:
Department of Otolaryngology – Head and Neck Surgery and the Howard Hughes Medical Institute, Department of Internal Medicine, University of Iowa City, Iowa, USA.
Michael J. Welsh
Affiliation:
Department of Otolaryngology – Head and Neck Surgery and the Howard Hughes Medical Institute, Department of Internal Medicine, University of Iowa City, Iowa, USA.
Joseph Zabner
Affiliation:
Department of Otolaryngology – Head and Neck Surgery and the Howard Hughes Medical Institute, Department of Internal Medicine, University of Iowa City, Iowa, USA.
*
Address for correspondence: Scott M. Graham, M. D., University of Iowa Hospitals and Clinics, Department of Otolaryngology – Head and Neck Surgery, 200 Hawkins Drive / E230 GHIowa City, IA 52242. Fax: (319) 356-4547
Get access Rights & Permissions [Opens in a new window]

Abstract

Serial maxillary sinus aminoglycoside lavage is an adjunctive technique increasingly employed in a variety of areas in cystic fibrosis (CF). It may be helpful in reducing revision rates for sinus surgery, in lowering rates of bronchial pseudomonal colonization after lung transplantation and in the evolving field of gene therapy for CF. The goal of this study was to assess the utility of the maxillary sinus as a model for gene transfer in cystic fibrosis. We performed serial maxillary sinus lavage, in accordance with published protocols, using tobramycin in a randomized series of five CF subjects. Lavage was performed for up to 10 days and sequential magnetic resonance imaging (MRI) scans were taken at zero, 10, 30, 60, 120 and 180 days. The 30 MRI scans were blindly scored by two examiners on the parameters of maxillary sinus aeration, averaged over the five time intervals, was significantly improved (p<0.05) in the lavaged sinus. This study provides the first systematic image-based measure of efficacy of maxillary sinus aminoglycoside lavage, a major element of a number of clinical protocols used in the treatment of CF. The prolonged increase in aeration after lavage suggests that any further improvement potentially achievable after gene transfer would be difficult to detect, limiting the value of this system as a model of clinical efficacy of gene transfer in CF.

Keywords

Cystic fibrosisGene therapyMaxillary sinus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 4 , April 1999 , pp. 329 - 335
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This work was supported in part by a grant from the Cystic Fibrosis Foundation (10-51017-3215-12000-1-15036-02-6026-000-00000-20-7634) and by a General Clinical Research Center program for the National Center for Research Resources.

References

Davidson, T. M., Murphy, C., Mitchell, M.Smith, C., Light, M. (1995);Management of chronic sinusitis in cystic fibrosis. Laryngoscope 105: 354–358CrossRefGoogle ScholarPubMed
Fitzsimmons, S. C. D. (1993) The changing epidemiology of cystic fibrosis. Journal of Pediatrics 122: 19.Google Scholar
Graham, S. M., Launspach, J. L. (1997) Utility of the nasal model in gene transfer studies in cystic fibrosis. Rhinology 35: 149–153.Google ScholarPubMed
Knowles, M. R., Hohneker, K. W., Zhou, Z., Osen, J. C., Noah, T. L., Hu, P. C.Leigh, M. W., Engelhardt, J. F., Edwards, L. J., Jones, K. R., Grossman, M., Wilson, J. M.Johnson, L. G.Boucher, R. C. (1995) A controlled study of adenoviral vector-mediated gene transfer in the nasal epithelium of patients with cystic fibrosis. New England Journal of Medicine 333: 823–831.CrossRefGoogle ScholarPubMed
Lewiston, N., King, V., Umetsu, D., Starnes, V., Marshal, S., Kramer, M., Theodore, J. (1991) Cystic fibrosis patients who have undergone heart-lung transplantation benefit from maxillary sinus antrostomy and repeated sinus lavage. Transplantation Proceedings 23: 1207–1208.Google ScholarPubMed
Lloyd, G. A. (1989) Magnetic resonance imaging of the nose and paranasal sinus. Journal of the Royal Society of Medicine 82: 84–87.CrossRefGoogle Scholar
Madonna, D., Isaacson, G., Rosenfeld, R. M., Panitch, H. (1997) Effect of sinus surgery on pulmonary function in patients with cystic fibrosis. Laryngoscope 107: 328–331.CrossRefGoogle ScholarPubMed
Moore, J., Potchen, M., Waldenmaier, N.Sierra, A.Potchen, E. J. (1986) High-field magnetic resonance imaging of paranasal sinus inflammatory disease. Laryngoscope 96: 267–271.CrossRefGoogle ScholarPubMed
Moss, R. B., King, V. V. (1995)Management of sinusitis in cystic fibrosis by endoscopic surgery and serial antimicrobial lavage. Archives of Otolaryngology—Head and Neck Surgery 121: 566–572.CrossRefGoogle ScholarPubMed
Romer, T., Tausch-Treml, R., Hamm, B., Felix, R., Wold, K. J. (1988) Magnetic resonance tomography of paranasal sinus tumors using gadolinium-DTPA and multi-echo sequences. ROFO 149: 171–177.Google Scholar
Shapiro, M. D., Som, P. M., (1989) MRI of the paranasal sinus and nasal cavity. Radiological Clinics of North America 27: 447–475CrossRefGoogle Scholar
Smith, J. J., Travis, S. M., Greenberg, E. P., Welsh, M. J. (1996) Cystic fibrosis epithelia fail to kill bacteria because of abnormal airway surface fluid. Cell 85: 229–236.CrossRefGoogle ScholarPubMed
Som, P. M., Shapiro, M. D., Biller, H. F.Sasaky, C.Lawson, W. (1988) Sinonasal tumors and inflammatory tissues: differentiation with MR imaging. Radiology 167: 803–804.Google Scholar
Umetsu, D. T., Moss, R. B., King, V. V., Lewiston, N. J. (1990) Sinus disease in patients with severe cystic fibrosis: relation to pulmonary exacerbation. Lancet 335: 1077–1078.Google Scholar
Wagner, J., Moran, M. L., Messner, A. (1997) Efficient and persistent gene transfer of adeno-associated virus-cystic fibrosis transmembrane regulator gene in the cystic fibrosis maxillary sinus. Proceedings of the Cottle International Rhinology Centennial. Philadelphia, PA (abstract).Google Scholar
Welsh, M. J., Anderson, M. P., Rich, D. P., Berger, H. A.Denning, G. M.Ostedgaard, L. S., Sheppard, D. N., Cheng, S. H.Gregory, R. J., Smith, A. E. (1992) Cystic fibrosis transmembrane conductance regulator: A chloride channel with novel regulation. Neuron 8: 821–829.CrossRefGoogle ScholarPubMed
Welsh, M. J., Smith, A. E, Zabner, J.Rich, D. P., Graham, S. M.Gregory, R. J.Pratt, B. M., Moscicki, R. A. (1994) Cystic fibrosis gene therapy using an advenovirus vector: In Vivosafety and efficacy in nasal epithelia. Human Gene Therapy 5: 209–219CrossRefGoogle Scholar
Welsh, M. J.Zabner, J., Graham, S. M., Smith, A. E., Moscicki, R., Wadsworth, S. (1995) Adenovirus-mediated gene transfer for cystic fibrosis: Part A. Safety of dose and repeat administration in the nasal epithelium. Part B. Clinical efficacy in the maxillary sinus. Human Gene Therapy 6: 205–218.CrossRefGoogle Scholar
Wine, J. J., King, V. V., Lewiston, N. J. (1991) Method for rapid evaluation of topically-applied agents to cystic fibrosis airways. American Journal of Physiology 261: 218–221.Google Scholar
Zabner, J.Couture, L A., Gregory, R. J., Graham, S. M.Smith, A. E., Welsh, M. J. (1993) Adenovirus-mediated gene transfer transiently corrects the chloride transport defect in nasal epithelia of patients with cystic fibrosis. Cell 75: 207–216.CrossRefGoogle ScholarPubMed
Zabner, J., Ramsey, B. W., Meeker, D. P., Aitken, M. L., Balfour, R. P., Gibson, R. L.Launspach, J.Moscicki, R. A., Richards, S. M.Standaert, T. A.Williams-Warren, J.Wadsworth, S. C.Smith, A. E., Welsh, M. J. (1996) Repeat administration of an adenovirus vector-encoding cystic fibrosis transmembrane conductance regulator to the nasal epithelium of patients with cystic fibrosis. Journal of Clinical Investigation 6: 1504–1511.CrossRefGoogle Scholar