New Massachusetts Eye and Ear research gives new meaning to the expression, “the nose knows.” The study, led by Mass. Eye and Ear sinus surgeon Benjamin Bleier, MD, sheds new light on the nasal cavity’s pivotal role in the body’s immune response—and could lead to novel drug delivery mechanisms to treat conditions through the airway.

The research is focused on the role of exosomes, tiny fluid-filled sacs, in protecting the airway from the pervasive bacteria we encounter through virtually every breath of air inhaled. Dr. Bleier’s lab had previously found that that exosomes are present in the nasal mucus of healthy patients at the same numbers as those with chronic rhinosinusitis. This led to the question-what is the purpose of these exosomes. The team’s new research found that upon inhalation of bacteria, exosomes in the nasal passage are immediately released from cells, attack the bacteria, then shuttle protective antimicrobial proteins from the front of the nose to the back along the airway, protecting other cells from the same bacteria.

"Similar to kicking a hornet’s nest, the nose releases billions of exosomes into the mucus at the first sign of bacteria, killing the bacteria and arming cells throughout the airway with a natural, potent defense," says Dr. Bleier. "It's almost like this swarm of exosomes vaccinates cells further down the airway against a microbe before they even have a chance to see it. This is also the first description in live patients of the human immune system actually reaching outside the body to attack bacteria before they have a chance to cause damage ".

The team believes that their findings, published in the Journal of Allergy and Clinical Immunology, could eventually lead to the use of exosomes as vehicles that carry inhaled packets of therapeutics to cells in the airway and lungs to treat a range of conditions.

Read more in Science Daily.

Photo credit: Massachusetts Eye and Ear

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