It is on a par with fecal transplantation
If proponents of traditional methods of treatment recommend spitting in the patient’s eye for barley in the eye, then pundits quite rightly propose an unusual way to cure a runny nose. Spraying a healthy person's nasal mucus into the sick person's nose can help relieve congestion. This method supposedly improves the nasal microbiome.
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New research shows that just a few days of treatment with donor mucus can clear blocked nasal passages for up to three months. It is believed to improve the composition of the nasal microbiome—the community of microbes, including bacteria, that live in the fluid lining the nostrils and sinuses.
Previous studies have shown that the greater the number and variety of microbes in the nasal microbiome, the less likely that someone will suffer from chronic nasal congestion or hay fever (hay fever).
Now scientists have found that transplanting bacteria-rich mucus from healthy donors into the nostrils of people with persistent congestion clears their airways by reducing inflammation that makes it difficult for them to breathe through their nose.
Chronic sinusitis, or persistent congestion nose, develops when the nasal passages and sinus linings become inflamed and blocked, often as a result of a viral infection such as a cold or flu. This leads to difficulty breathing through the nose and pain around the eyes and nose.
In most cases, the disease goes away within a couple of weeks, but some people develop chronic sinusitis that lasts months or even years.
Research shows that pain and discomfort are far from minor symptoms. Inflammation can also lead to the formation of polyps, tiny growths in the sinuses that block airflow, which may require surgery under general anesthesia to remove. In England alone, 10 thousand people a year undergo this operation.
Recent research has shown that the type of bacteria in the nose may be a key factor in the development of chronic sinusitis. Earlier studies found that people with chronic sinusitis have fewer than 1,000 species of bacteria living in their nasal cavity, compared with more than 1,200 in people without the condition.
The idea of using someone else's mucus to solve a problem is borrowed from the equally unsavory-sounding method of faecal transplants, which are currently used in the NHS to fight a stomach infection that kills thousands of people in the UK every year.
Patients either implant a small sample of stool from a healthy donor into the intestine, or they swallow a capsule containing freeze-dried fecal fragments.
For the new approach, researchers from Lund University in Sweden recruited 22 adults with stuffy noses. They first gave each volunteer a two-week course of oral antibiotics to destroy the existing “abnormal” nasal microbiome so that it could be “rebuilt” using donated healthy mucus.
Donor mucus, taken mostly from partners or friends who did not have sinusitis, was then mixed with a few teaspoons of salt water and squirted into each nostril using a syringe. The syringe was held in place for several minutes to stop the solution from flowing out—enough time for some of the healthy donor's bacteria to settle in the sinuses. This process was repeated daily for five days.
The researchers then analyzed the volunteers' responses using a symptom checklist called the Sinonasal Outcome Test (or SNOT-22), which measures everything from nasal congestion to sneezing. to runny nose, cough and facial pain.
Tests were also done to measure levels of inflammatory chemicals (called cytokines) in nasal secretions.
The results, published at the International Forum of Allergy and Rhinology, showed that the severity of symptoms decreased by almost 40% over three months, and there was a significant increase in the number and diversity of bacteria in nasal mucus.
The researchers now hope to confirm their findings in a larger study.
Consultant ear, nose and throat surgery at the Lister Hospital in Stevenage, Adam Frosh, said mucus transplants were a potential new treatment for millions of people suffering from chronic sinusitis, but more research was needed.
«The theory is really good, but it's a small study that doesn't really prove anything,» said Adam Frosh.
Consultant rhinologist and ENT surgeon at the Royal National Throat Hospital, nose and ear surgery in London Simon Gain added: «The nasal area definitely has its own microbiome and it is a very interesting area of research — I would certainly prefer a snot transplant to a faecal transplant.»