title: On the mechanism of smell loss in patients with Type II congenital hyposmia.
abstract: BACKGROUND
  Smell function has been initiated with theophylline treatment in 63% of patients with Type II congenital smell loss. Based upon a systematic evaluation of the protein components of nasal mucus we have demonstrated that interactions among four chemical moieties in nasal mucus may play significant roles in this initiation. Prior to treatment three of these moieties, cAMP, cGMP and sonic hedgehog (Shh), were significantly decreased in concentration whereas one of these moieties, TNFalpha, was increased in concentration. The mechanism(s) responsible for initiation of smell function in these patients, not immediately apparent, may depend upon understanding interactions among these moieties.
  
  
  METHODS
  Measurements of cAMP, cGMP, Shh and TNFalpha in nasal mucus by specific spectrophotometric immunoassays before and after treatment with theophylline.
  
  
  RESULTS
  Before theophylline treatment cAMP, cGMP and Shh in nasal mucus, which act as growth factors to support olfactory receptor function, were significantly decreased below normal levels whereas TNFalpha which acts as a "death factor" to inhibit olfactory receptor function was significantly increased above normal. After theophylline treatment cAMP, cGMP and Shh increased significantly whereas TNFalpha decreased significantly.
  
  
  CONCLUSIONS
  These results indicate that there are specific biochemical changes associated with smell loss in patients with Type II congenital smell loss and that correction of these biochemical changes are associated with initiation of smell function in these patients. Understanding these relationships play an important role in understanding receptor action in smell function.
authors.affiliation: Center for Molecular Nutrition and Sensory Disorders, The Taste and Smell Clinic, 5125 MacArthur Blvd, NW, #20, Washington, DC. Electronic address: doc@tasteandsmell.com.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Henkin
authors.affiliation: Center for Molecular Nutrition and Sensory Disorders, The Taste and Smell Clinic, 5125 MacArthur Blvd, NW, #20, Washington, DC. Electronic address: monaram@gmail.com.
authors.forename: Mona
authors.initials: M
authors.lastname: Abdelmeguid
authors.affiliation: Center for Molecular Nutrition and Sensory Disorders, The Taste and Smell Clinic, 5125 MacArthur Blvd, NW, #20, Washington, DC. Electronic address: abknoppel@gmail.com.
authors.forename: Alexandra B
authors.initials: AB
authors.lastname: Knöppel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D000242:Cyclic AMP / Q000378:metabolism; D006152:Cyclic GMP / Q000378:metabolism; D005260:Female; D053823:Hedgehog Proteins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D009297:Nasal Mucosa / Q000378:metabolism; D000857:Olfaction Disorders / Q000151:congenital* / Q000188:drug therapy / Q000378:metabolism*; D013806:Theophylline / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult
chemical_list: D001993:Bronchodilator Agents; D053823:Hedgehog Proteins; D014409:Tumor Necrosis Factor-alpha; D013806:Theophylline; D000242:Cyclic AMP; D006152:Cyclic GMP