A shot of carbon dioxide to the nose may bring some quick, though short-lived, relief to people with nasal allergies, a preliminary study suggests. So-called intranasal carbon dioxide (CO2) is not yet an approved treatment for nasal allergies.
The new study is one of a number of clinical trials being funded by Capnia, Inc, a Palo Alto, California-based company that is developing a hand-held device that - if approved - would allow people to administer the CO2 therapy to themselves.
In the new study, researchers recruited 348 adults with year-round nasal allergies - to irritants like dust, mold or pet dander. They randomly assigned participants to have either one dose of CO2, delivered via a nosepiece attached to a CO2 cylinder, or a placebo "treatment" where nothing was delivered through the nosepiece.
Those receiving the real treatment were further divided into four groups, receiving either a lower or higher CO2 dose for either 10 seconds or 30 seconds.
About 30 minutes later, one of the CO2 groups - the one getting the higher dose for 10 seconds - reported bigger improvements in nasal congestion, itching, sneezing and watery eyes than those getting the placebo. The advantage lasted about four hours, according to findings published in the Annals of Allergy, Asthma & Immunology.
The degree of symptom improvement was similar to what's typically seen with standard treatments like antihistamine nasal sprays, according to lead researcher Dr Thomas B. Casale, a professor of medicine at Creighton University in Omaha, Nebraska.
If approved, intranasal CO2 could offer an alternative to people with seasonal or year-round nasal allergies, Casale told Reuters Health. Prescription nasal sprays with anti-inflammatory corticosteroids, taken regularly, are the most effective treatment out there, Casale said. But some people - including parents of young children with nasal allergies - are reluctant to use steroids, even though the low doses in allergy nasal sprays are generally considered safe.
"There are still a lot of people who don't like to take medication," Casale said, "and might view this as a 'natural' treatment."
Because the treatment is still experimental, it is not clear how much it would cost if it makes it to the market. An allergy expert not involved in the study was unimpressed with the results.
Even if the symptom reduction is around what's seen with antihistamine nasal sprays, the latter have longer-lasting effects, according to Dr Harold Nelson, an allergist at National Jewish Health, a Denver hospital that specializes in respiratory diseases. One dose is good for 24 hours, Nelson said in an interview with Reuters Health, whereas the benefits of intranasal CO2 wore off after 4 to 6 hours in this study.
On top of that, he added, intranasal CO2 "seems uncomfortable." Of all CO2 patients in the study, upwards of 80 percent said they had nasal discomfort during the treatment - versus just about eight percent in the placebo group. Around one-quarter became teary-eyed, and 14 percent to 20 percent developed headaches.
"I must say, it's not a very attractive treatment," Nelson said. He also pointed to what he saw as a weakness in the study: the placebo. Instead of comparing CO2 against some other gas, the researchers only gave placebo patients a nosepiece to insert.
That makes it unclear, Nelson said, if CO2 has some distinct effect, or if it was simply the intranasal pressure that somehow brought some people relief.
But Casale said that in an earlier study - this one of people with seasonal allergies - the researchers did use air in the placebo group, and the CO2-treated patients had greater symptom improvement.
Casale also pointed out that an advantage CO2 may have over antihistamines (both nasal spray and pill) and corticosteroids is that it works quickly. So the therapy might best fit into the nasal-allergy armament as an occasional, "as-needed" fix.
But that's still under study, Casale said. It also remains unclear why intranasal CO2 would be helpful against allergy symptoms, if that turns out to be the case.
Besides nasal steroids and antihistamines, some other nasal allergy treatments include nasal washes, which remove allergens from the nostrils, and allergy shots - which may be recommended for specific allergies that do not improve with medication.
BRIEF RECORDINGS
Language barrier needs to go: Umar Saif
REVIEW: The big question for researchers is "how do you pick research problems that have immediate benefits to the society and how do you turn that into a commercially viable entity," according to Dr Umar Saif associate professor at Lahore University of Management Sciences.
In an exclusive interview with BR Research, the renowned scientist insisted that the need of the hour is conducting research in areas that are relevant to the people of Pakistan and that help improve standards of living for the masses.
Saif has received his academic training from LUMS, Cambridge and MIT. His work has been published in popular media including the New York Times, CNN, BBC, New Scientist and MIT Technology Review. He recently received the distinction of being named among the world's top young innovators for the year 2011.
Saif feels that there are very few academics in the country who are working towards such "relevant and viable research objectives," and hopes that his success will encourage more such endeavours.
During his stint at MIT and other western institutes, Saif worked on the development of SAX-40 also known as the "silent aircraft" as well as "Project Oxygen" that worked towards enhancing connectivity. However, upon his return to Pakistan, he turned his focus to research for the developing world.
BREAKING THE LANGUAGE BARRIER
"It is ironic that all governmental communications in the country take place in English when only about two to three percent of the population can actually read the language," points out Saif. He highlights that due to this "language barrier", a vast majority of the population is denied effective inclusion into the system.
"What is an uneducated person supposed to do when all medical records, legal forms and other important documents are written in a language that he cannot comprehend?," he questions.
But Saif has developed an answer to this debacle as well! Using existing technology his team has developed a service that allows users to send photographs of any document, via MMS; that they need translated from English into Urdu. "So if a person sends an MMS of a medical record or a legal notice on the system's telephone number, they will receive a phone call within seconds that would relate the contents of that document to the user in Urdu," he reveals.
BROADBAND FOR THE POOR
He highlights that there are two hubs of the internet in the world; Europe and the United States. He explains that to connect to these hubs, Pakistan has a network of underwater cables that connect to these hubs. Since maintenance of this infrastructure is very costly, consequently the cost of logging on is higher in the country. Besides this the bandwidth available to local consumers is necessarily limited by the capacity of this infrastructure, regardless of the speed of the dongle they may install here.
Recognising this problem, Saif has developed a system a peer-to-peer system that would download data using telephone lines, effectively doing away with the need to connect to the western hubs.
"In the developed world, peer-to-peer traffic constitutes between 50 and 70 percent of total internet traffic while in the developing world this stands at just about 10 percent," says Saif. He explains that since the bandwidth available to users in the developing world is low, peer-to-peer systems choke their traffic. BitMate, developed by Umar Saif, allows the users from such low-bandwidth networks to share data with each other.
MOBILIZING THE MASSES
Along with some colleagues, Saif developed SeeNreport.com; a website that allows citizen journalists to share reports including pictures and videos of significant occurrences, with a mass audience. The scientist explains that the inspiration for this service came at the time when news channels were shut down under the Musharraf regime. "We had pictures from the lawyers' movement that were being picked up by BBC and other news agencies," he exclaims.
Aaj Reporter, a citizen journalism initiative of Aaj News is also powered by the same technology. SeeNReport also brings news headlines, bulletins and even talk shows to cellular phones and is compatible with most phones. "After TV and newspapers, this platform is fast emerging as a key pillar for dissemination of news," says Saif.
He is also working on technology to replace direct satellite news gathering (DSNG) vans with a battery-powered device capable of transmitting high-definition video footage. He claims that this device can be manufactured at a fraction of the cost of DSNG vans; and that besides news agencies; various medical service providers and NGOs have shown interest in this device.
Another indigenously developed service titled SMSall allows users to send SMSs en-masse to relevant groups. Initially this system was used to communicate with students. "Over the past two years we have sent more than four billion SMSs and the service has been used by about 2.5 to 3 million people," according to him.
INFORMATION AGE: PAKISTAN
Saif believes that the market for IT-based solutions is maturing and that in the coming years "you will find many new tech start-ups propping up". He reveals that many students still face resistance from their families when they undertake research projects but he expresses hope that as the fruits of these researches materialise and turn into commercially viable products and services; the younger generation will be encouraged to join research fields.
Among plans that Saif and his colleagues are currently developing, a mentionable service is a mobile-phone based personalised educational course. This would basically entail sending questions to students via MMS which would incorporate lessons as well as assessments. The program is being developed with the help of USAID and hopes to reach prospective students in far flung areas.
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