Review: The Nose as a Route for Therapy. Part 2 Immunotherapy.

Area of Science:

• Immunology
• Microbiology
• Otorhinolaryngology

Background:

• The nose is a primary entry point for pathogens and environmental substances.
• It possesses robust innate and adaptive immune defenses, including epithelial barriers, mucociliary clearance, and immune cells.
• Despite these defenses, the nasal mucosa serves as a reservoir for significant pathogens like Streptococcus pneumoniae and SARS-CoV-2.

Purpose of the Study:

• To review strategies for augmenting nasal immune defense.
• To explore methods for reducing nasal inflammation and infection by modulating the nasal microbiome.
• To discuss the potential of intranasal applications for immunotherapy and vaccination.

Main Methods:

• Review of existing literature on nasal immunity and intranasal interventions.
• Analysis of the role of interferons and the nasal microbiome in immune defense.
• Examination of intranasal vaccine delivery systems and antibody-based therapies.

Main Results:

• Nasal application of interferons can enhance immune defense.
• Modifying the nasal microbiome can reduce inflammation and infection.
• Intranasal delivery, particularly with live-attenuated influenza vaccines (LAIV), is an effective vaccination strategy.
• Bispecific antibodies offer a novel topical treatment for allergic and viral rhinitis.

Conclusions:

• The nasal mucosa is a critical site for immune surveillance and intervention.
• Intranasal therapies, including immunomodulation, vaccination, and targeted antibody treatments, hold significant promise.
• Further research into optimizing these intranasal approaches can lead to improved management of respiratory diseases.