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The aim of this work was to study the nasal route for the delivery of vasoactive intestinal peptide (VIP) to the brain and to evaluate the toxicity of VIP nasal spray. Mice were injected intracerebroventricularly with the aggregated Abeta25-35 to mimic Alzheimer's disease. Following administration, different groups of mice were treated over one week, and their spatial learning and memory capacities were evaluated by the Morris water maze test. The toxicity of VIP nasal spray was evaluated by examining the morphology of individual rat nasal mucosa cilia and the pathology of rat nasal mucosa. Rats receiving intranasal VIP (40 microg/ml) showed good spatial memory relative to the Abeta25-35 model group, but the escape latency did not show any statistically significant difference. Intranasal administration of VIP nasal spray (200 microg/ml) improved deficits in spatial memory to the point that test animals receiving intranasal VIP showed no statistically significant differences from the normal control group in escape latency. This indicated that the nasal spray method could increase the quantity of VIP entering the brain and protect the central nervous systems of mice. Toxicity evaluation showed that the preparation could cause minor irritation, which resolved spontaneously within a week at the end of treatment. In conclusion, VIP can be delivered successfully to the brain using the intranasal route.
Exposure to the microbial growth in Water Damaged Buildings (WDB) can result in a chronic, multi-symptom, multisystem illness, which can last years, termed Chronic Inflammatory Response Syndrome (CIRS). Symptoms of CIRS include but are not limited to fatigue, respiratory problems, including cough, interstitial lung disease and asthma-like conditions; executive cognitive deficits, neurologic deficits, pain and gastrointestinal distress among others. There are published treatment options for CIRS patients but relatively little is known about the genomic basis of the illness. One of the most striking features of CIRS is the absence of the anti-inflammatory neuropeptides vasoactive intestinal peptide (VIP) and melanocyte stimulating hormone (MSH). Additionally, the master immune regulator, TGFb1 is abnormally high in most patients. This study surveyed 15 patients coming to a specialized clinic for CIRS with refractory symptoms, despite use of a published treatment protocol, who agreed to have their transcriptomes monitored while receiving off label, exogenous VIP nasal spray treatments. Several key immune regulators were found to be differentially expressed over the course of treatment with VIP, such as CD244, CD3D, CD48 and CD52, granzymes, defensins, and the Ikaros family of lymphoid transcription factors. In addition to down regulated innate immune functions, there appears to be an overall metabolic shift, with a down regulation of ribosomal and mitochondrial gene expression, possibly indicating a calming of components of immune responses. Understanding the need for accurate diagnosis of CIRS in order to effectively treat patients, this transcriptomic study sheds important light on new aspects of pathophysiology.
The U.S. Food and Drug Administration today approved Spravato (esketamine) nasal spray, in conjunction with an oral antidepressant, for the treatment of depression in adults who have tried other antidepressant medicines but have not benefited from them (treatment-resistant depression). Because of the risk of serious adverse outcomes resulting from sedation and dissociation caused by Spravato administration, and the potential for abuse and misuse of the drug, it is only available through a restricted distribution system, under a Risk Evaluation and Mitigation Strategy (REMS).
The efficacy of Spravato was evaluated in three short-term (four-week) clinical trials and one longer-term maintenance-of-effect trial. In the three short-term studies, patients were randomized to receive Spravato or a placebo nasal spray. In light of the serious nature of treatment-resistant depression and the need for patients to receive some form of treatment, all patients in these studies started a new oral antidepressant at the time of randomization and the new antidepressant was continued throughout the trials. The primary efficacy measure was the change from baseline on a scale used to assess the severity of depressive symptoms. In one of the short-term studies, Spravato nasal spray demonstrated statistically significant effect compared to placebo on the severity of depression, and some effect was seen within two days. The two other short-term trials did not meet the pre-specified statistical tests for demonstrating effectiveness. In the longer-term maintenance-of-effect trial, patients in stable remission or with stable response who continued treatment with Spravato plus an oral antidepressant experienced a statistically significantly longer time to relapse of depressive symptoms than patients on placebo nasal spray plus an oral antidepressant.
MARCONS stands for Multiple Antibiotic Resistant Coagulase Negative Staphylococcus. It colonizes the deep nasal aerobic spaces of the majority of people with CIRS. This bacteria forms biofilms and releases biotoxins that can cleave MSH (melanocyte stimulating hormone), an anti-inflammatory neuropeptide. It is diagnosed by a deep nasal swab, which is sent to DLM labs in Massachusetts. If it is present and there are at least 2 classes of antibiotic resistance, the treatment is the use of compounded BEG spray (bactroban, edta, and gentamicin) 2 sprays three times a day for 1 month. Earlier versions of the protocol involved using Rifampin, but this is no longer necessary.
If the patient remains symptomatic after following all of the above steps, then the use of VIP is needed. It is a nasal spray that is dosed at 50 mcg/mL, 1 spray 4 times a day. The first dose should be given in the office. A TGF B and C4a should be drawn before the first spray and again in 15 minutes. If the levels rise, there is a hidden mold exposure.
Early research suggested that when taken as a nose spray, insulin could possibly improve memory and help preserve cognitive function in people with early Alzheimer's disease or mild cognitive impairment.
However, study results have been mixed. Some recent trials showed negative results. A large, well-designed study investigating the impact of nasal insulin on people with mild cognitive impairment or mild Alzheimer's disease found no benefits from the drug. But others found that nasal insulin may improve some aspects of memory and daily activity.
The FDA has not approved e-cigarettes as a way to quit smoking. Doctors and the FDA recommend evidence-based methods for quitting smoking. If you have used e-cigarettes to stop smoking, do not return to smoking cigarettes instead of using e-cigarettes. Instead, turn to safe ways to deliver nicotine such as nicotine patches, gum, lozenges, and nasal spray. Learn more about ways to quit smoking and using tobacco.
The general guidelines for taking VIP (assuming the first dose is well tolerated) is to spray 50mcg in alternating nostrils 4 times daily for 30 days and then recheck blood pressure, VCS, C4a, TGF beta 1, and fasting lipase. If the labs like C4a and TGF beta 1 are improving, then start tapering down VIP over the next month to 2 doses daily. Continue taking Vasoactive Intestinal Peptide (VIP) at 2 doses daily for 1 more month and then stop. Six months after stopping VIP, recheck labs to make sure levels are stable and within range. Note: Some spray bottles deliver 50mcg in a single spray and some require two sprays.
The sprayer tubes are always longer than the bottle. Just gently press the nozzle onto the bottle and screw into place. The tube will bow inside the bottle ensuring the end is at the bottom of the bottle so you get every last drop.
Duration of treatment with VIP nasal spray varies considerably, with timeframes ranging from 30 days to indefinitely. Dosage range can also vary from 1 spray to 16 sprays per day for adults. Paediatric patients will also likely require this final step in the Shoemaker Protocol but use a reduced dosage for a shorter time.
Spravato, also known as esketamine, is a nasal spray that is approved by the FDA for the treatment of treatment-resistant depression. It works by rapidly altering brain chemistry to provide fast-acting relief from symptoms such as sadness, hopelessness, and loss of interest in activities.
Spravato is a novel nasal spray depression treatment. It contains esketamine, which works by resetting neural pathways in the brain and increasing levels of norepinephrine and serotonin, two neurotransmitters associated with depression. This can cause faster symptom relief than traditional oral antidepressants.
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