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1、Full Terms 113: 642-648 Mucosal Exudation of Fibrinogen in Coronavirus-induced Common Colds A. AKERLUND, L. GREIFF, M. ANDERSSON, M. BENDE, U. ALKNER3 and C. G. A. PERSSON4 From the Departments Of Otorhinolaryngology and 4Clinicul Pharmacology, Linitiersity Hospital, Lund, Department of Otorhinolary
2、ngology, Central Hospital, Skovde, and Department of Bioanalysis. Astru Draco, Lund, Sweden Akerlund A, Greiff L, Anderson M, Bende M, Alkner U, Persson CGA. Mucosal exudation of fibrinogen in coronaoirus- induced common colds. Acta Otolaryngol (Stockh) 1993; 113: 642-648. We studied the mucosal exu
3、dation of plasma in relation to pathophysiological events during an induced common cold. Coronavirus 229E was inoculated nasally in 20 healthy volunteers under controlled conditions. Ten volunteers developed the common cold, determined by symptom scores and serology. The bulk plasma exudate was moni
4、tored, using fibrinogen (MW 340 kD) in nasal lavage fluids as an endogenous marker. Following inoculation, anterior rhinoscopy and objective registrations of nasal mucosal temperature, nasal discharge weight, and nasal blockage index by peak expiratory air flow, were followed twice daily for 6 days.
5、 Mucosal plasma exudation, as assessed by fibrinogen in lavage fluids, increased hundredfold after virus inoculation. concomitantly with the subjective symptoms and objective physiological changes. We propose that this exudation reflects the degree of subepithelial inflammation, and suggests that pl
6、asma bulk exudate, including all potent plasma protein systems may be involved in the resolution of acute viral rhinitis-common cold. Key word*Y 1 inflammation, nasal lavage, nasal mucosal temperature, peak expiratory flow, plasma exudation, respiratory tract infection, symptom scores, virus inocula
7、tion INTRODUCTION Experimental coronavirus infections cause nasal symptoms which exhibit the general features of com- mon colds. These include increased nasal mucosal discharge and nasal blockage along with a significant increase in nasal mucosal temperature. The changes are transient and return to
8、pre-infection levels within a few days when the infection is aborted (1). Inocula- tion of coronavirus thus provides an opportunity for examining the nasal mucosal changes in the different phases of a common cold. It is well established that proteins, such as im- munoglobulins and albumin, appear at
9、 the mucosal surface during viral infections in the upper respira- tory airway (2-5). However, there is still uncer- tainty as to whether the proteins are produced lo- cally, or whether they are derived from plasma. The latter source has been considered of impor- tance when the mucosa and its microc
10、irculation have been damaged. The presence of increased amounts of the major plasma protein albumin on the mucosal surface of the airway suggests that plasma is the source of the proteins. It is not known to what extent plasma proteins larger than albumin may also traverse the mucosa along with albu
11、min. Indeed, albumin may not always be a valid plasma tracer, since it may also be secreted by the airway mucosa (6). Although increased levels of albumin have been observed during common cold infections (1, 3-9, this information may therefore not be suffi- cient to establish whether or not mucosal
12、exudation of the plasma proteins occurs during a common cold. The mechanisms of mucosal exudation of plasma induced by inflammation are finely regulated, and constitute an integral function .of the subepithelial microcirculation and the epithelial lining (7, 8). Mu- cosal exudation involves a dramat
13、ic change in per- meability because the large plasma macromolecules are also moved to the mucosal surface (9, 10). This process is not injurious because it leaves the ultra- structure of the mucosa intact and it does not com- promise the integrity of the mucosa as an absorption barrier ( 11 - 13). T
14、he mechanism of this unidirec- tional outward flux of solutes involves active, media- tor-induced separation of microvascular endothelial cells and the creation of increased subepithelial hy- drostatic pressure as well as the suggested effects of the mechanical force on the epithelial zonuh occlu- d
15、ens (8). Mucosal exudation of bulk plasma is a sensitive human airway response to inflammatory mediators (14), and a large plasma protein, such as fibrinogen, may equally, or better than albumin, reflect the mu- cosal exudation response in allergic inflammation of the airways (10, 15). The only know
16、n source of mucosal fibrinogen is plasma. Fibrinogen is a large molecule (MW 340 kDa) with a non-globular struc- ture, which explains the fact that it has a high fric- tion coefficient, 2.34. Its exudation may, therefore, represent the para-cellular movement of bulk plasma, including the circulating immunoglobulins, into the airway lumen. Downloaded by New York University at 21:41 18 March 2016 Acta Otolaryngol (Stockh) I13 Coronavirus-induced mucosal exudation of fibrinogen 643 In t
