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Biomedical scientific research in the Netherlands has a good reputation worldwide. Quantitatively, the university medical centres (UMCs) deliver about 40 % of the total number of scientific publications of this research. Analysis of the bibliometric output data of the UMCs shows that their research is highly cited. These output-based analyses also indicate the high impact of cardiovascular scientific research in these centres, illustrating the strength of this research in the Netherlands. A set of six joint national cardiovascular research topics selected by the UMCs can be recognised. At the top are heart failure, rhythm disorder research and atherosclerosis. National collaboration of top scientists in consortia in these three areas is successful in acquiring funding of large-scale programs. Our observations suggest that funding national consortia of experts focused on a few selected research topics may increase the international competitiveness of cardiovascular research in the Netherlands.

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Normal values for the flow at a transnasal pressure of 150 Pa were established with active anterior rhinomanometry (with decongestion) in a group of 33 normal subjects. These values were used to detect abnormalities in a group of 193 patients whose septum anatomy had been evaluated with rhinoscopy. About 25% of the rhinoscopically normal patients were found to have significantly low ("abnormal") flow values on one side. The same was true for patients with a small septal deviation restricted to one anatomical area. An abnormal flow was measured in about 35% of the patients with a moderate (restricted) septal deviation. In the patients whose septal deviation was not restricted to one anatomical area, about 45% had an abnormal flow. The highest detection rate was about 80% in patients with major deviations in the region of the vestibule and the valve. Such deviations were found only in a minority of the patients with complaints of nasal obstruction, which limits the importance of rhinomanometric evaluation in clinical practice.

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Nasal hyperreactivity in nasal allergy may be due to changes of the characteristics in adrenergic receptors. Radioligand receptor-binding studies with the antagonists, 3H-prazosin (alpha 1-adrenoceptor), 3H-rauwolscine (alpha 2-adrenoceptor), and 125I-(-)-Cyanopindolol (beta-adrenoceptor) were performed in homogenates of nasal mucosa of allergic and nonallergic (NA) patients to investigate this hypothesis. The heterogeneous NA group was subdivided into control individuals and patients with chronic sinusitis and vasomotor rhinitis. No significant differences in affinities or densities of alpha 1- and alpha 2-adrenoceptors could be demonstrated in allergic patients in comparison with NA and control individuals. The beta-adrenoceptor density was significantly reduced in allergic patients in comparison with that of control individuals. Neither changes in agonist binding or in the effect of Gpp(NH)p on the agonist binding to beta-adrenoceptors could be observed in allergic patients. The subtype selective antagonist, LK203-030, demonstrated the presence of a homogeneous population of beta 2-adrenoceptors in human nasal mucosa of both NA and allergic patients. In vitro, autoradiography demonstrated specific 125I-(-)-Cyanopindolol labeling of the epithelium in NA and allergic patients. In conclusion, no changes in characteristics of alpha 1- or alpha 2-adrenoceptors in the nasal mucosa could be demonstrated in nasal allergy. However, a decreased number of beta-adrenoceptors may reflect a beta-adrenergic abnormality in nasal allergy.

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Cholinergic nasal hyperresponsiveness in nasal allergy may be due to changes of the characteristics in muscarinic cholinergic receptors. Radioligand receptor binding and in vitro autoradiographic studies of nasal mucosa in nonallergic (NA) and allergic patients were performed to investigate this hypothesis. The heterogeneous NA group was subdivided into control individuals and patients with chronic sinusitis and vasomotor rhinitis. The 3H-(-)-Quinuclidinylbenzilate binding to muscarinic receptors in human nasal mucosa membranes was saturable and of high affinity in all groups. No significant differences could be demonstrated between the subgroups of the NA patients. In allergic patients the dissociation constants and receptor densities were significantly decreased in comparison with those of NA and with those of control individuals. No differences in agonist binding or coupling of the muscarinic receptor to the effector system via the G protein could be observed in allergic patients. In vitro autoradiographic experiments demonstrated specific 3H-(-)-Quinuclidinylbenzilate labeling of the glandular acini in NA and allergic patients. No specific labeling could be observed in the epithelium, blood vessels, or connective tissue. In conclusion, the increased sensitivity and decreased muscarinic receptor number may reflect the cholinergic-induced hypersecretion in nasal allergy but are probably too small to explain the complex allergic reaction.

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The specific binding of 125I-(-)-cyanopindolol (125I-(-)-CYP) to homogenates and cryostat sections of rat nasal mucosa was saturable, stereoselective and of high affinity (Kd = 5.0 +/- 0.4 pM. Bmax = 204 +/- 12 fmol/mg protein and Kd = 7.2 +/- 0.7 pM; Bmax = 15 +/- 1 fmol/mg protein respectively). The subtype-selective antagonists, LK203-030 and ICI118,551, inhibited specific 125I-(-)-CYP binding according to a two-binding site model, indicating the presence of 57 and 45% beta 1-adrenoceptors in homogenates and cryostat sections, respectively. Competition of isoprenaline for antagonist binding to homogenates demonstrated 30 +/- 3% high-affinity agonist binding sites. A steepening of the curve was observed in presence of guanine nucleotides. In vitro labelling of cryostat sections of rat nasal mucosa was combined with autoradiography. The autoradiographs generated after incubation with 20 pM 125I-(-)-CYP showed specific labelling of the epithelium and glandular excretory ducts. It appeared from autoradiographs generated with subtype-selective antagonists in addition to the radioligand that beta 1- and beta 2-adrenoceptors were present in both structures.

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The specific binding of [3H]rauwolscine to rat nasal mucosa membranes was saturable, stereoselective and of high affinity. The Scatchard plot pointed to a homogeneous population of binding sites (Kd = 3.6 +/- 0.6 nM; Bmax = 5.1 +/- 0.7 pmol/g). The non-specific binding appeared to be non-linear, probably due to filter binding. Inhibition of [3H]rauwolscine binding with the subtype-selective antagonist, prazosin, suggested the presence of alpha 2-adrenoceptor subclasses in rat nasal mucosa. The (-)-epinephrine inhibition curves demonstrated high- and low-affinity agonist binding sites. A monophasic (-)-epinephrine inhibition curve was obtained in the presence of guanine nucleotides.

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Cholinergic and adrenergic abnormalities have been observed in nasal allergy and may be due to changes in pharmacological characteristics of neuroreceptors. Radioligand receptor binding studies demonstrated no significant changes in affinities or densities of alpha-adrenoceptors, a decreased number of beta-adrenoceptors and a decreased affinity combined with a decreased number of muscarinic acetylcholine receptors.

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3H-Prazosin was used to demonstrate alpha 1-adrenoceptors in rat nasal mucosa. Specific binding is saturable and occurs to a homogeneous class of binding sites with high affinity (Kd = 0.07 +/- 0.01 nmol/l and with a receptor density of 0.36 +/- 0.02 pmol/g tissue or 14 +/- 1 fmol/mg protein. Kinetic experiments resulted in a Kd-value of 0.03 nmol/l. The binding is stereoselectively inhibited by epinephrine enantiomers. The antagonist prazosin inhibits 3H-Prazosin binding with high affinity, in contrast to yohimbine, classifying the binding sites as alpha 1-adrenoceptors. Inhibition experiments with WB4101 indicated the presence of alpha 1a- (31 +/- 9%) and alpha 1b-adrenoceptor subtypes in the rat nasal mucosa. The order of potencies of agonists determined in competition experiments was (-)epinephrine greater than (+)epinephrine greater than (-)phenylephrine.

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Specific 3H-1-quinuclidinylbenzilate (3H-1-QNB) binding to rat cochlea homogenates occurs to a homogeneous class of binding sites with Kd = 0.13 +/- 0.01 nM and Bmax = 0.57 +/- 0.07 fmol per cochlea. Binding is stereoselectively inhibited by benzetimide enantiomers. Dexetimide was more effective than levetimide in displacing 3H-1-QNB from its binding sites (Ki = 4 x 10(-10) M and 6.5 x 10(-6) M, respectively). Pirenzepine inhibits 3H-1-QNB binding with low affinity (Ki = 2 x 10(-6) M), classifying the binding sites as muscarinic M2 receptors.

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The distribution of beta-adrenergic receptors in rat nasal glands has been investigated with the use of an in vitro autoradiographic technique. Radioligand binding studies indicated that [125I]cyanopindolol binds specifically to beta-adrenergic receptors in cryostat sections of these glands. Autoradiograms generated after incubation with 0.02 nM [125I]cyanopindolol and dipping in nuclear K2 emulsion, showed specific labelling of the striated excretory ducts. These in vitro observations suggest a sympathetic control of the ion and water content of the glandular secretion.

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To visualize muscarinic receptors in human bronchi, the stripping film method was used which permits direct autoradiographic localization of tissue labeling. Cryostate sections of human bronchi were fixed in 0.5% glutaraldehyde in Krebs-Ringer buffer, pH 7.0 for 30 min at 0 degrees C, washed in Krebs-Ringer buffer for 20 min at 0 degrees C and incubated with (-)-[3H]Quinuclidinyl benzilate [(-)-[3H]QNB] for 90 min at 37 degrees C. Specific (-)-[3H]QNB binding to tissue sections was saturable (receptor density of 0.14 +/- 0.03 fmol/tissue section) and of high affinity (Kd of 40 +/- 9 pM). For autoradiography, labeled tissue sections were covered with stripping film and exposed for 5 months. Muscarinic receptors in human bronchi were located predominantly in submucosal glands and parasympathetic ganglia. There was less labeling in smooth muscle cells and nerve bundles. Epithelium and blood vessels located within the bronchial wall were devoid of specific labeling.

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An in vitro method was developed for the biochemical and autoradiographic demonstration of low muscarinic receptor densities in peripheral tissue. Histological criteria point clearly to the necessity for fixation to preserve tissue quality. [3H]l-Quinuclidinylbenzilate bound specifically to a homogeneous class of binding sites in 0.5% glutardialdehyde-fixed cryostat sections (10 microns) of rat nasal glands with high affinity (Kd = 0.47 +/- 0.06 nM) and with a receptor density (Bmax) of 41 +/- 1 fmol/mg protein. This binding was linearly dependent on the thickness of the sections. Kinetic experiments resulted in a Kd value of 0.19 nM. Binding was stereoselectively inhibited by benzetimide enantiomers. Autoradiograms, generated after incubation with 0.6 nM [3H]l-quinuclidinylbenzilate and dipping in nuclear K2 emulsion, showed specific labelling of the glandular acini and excretory ducts. These in vitro observations provide conclusive evidence for the presence of acetylcholine receptors in the nasal glands of the rat.

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The nasal passages play a crucial role in the protection and functioning of the lower airways. Consequently the nerve supply of the nasal mucosa is extensive, which is related to an immediate and adequate reaction upon a variety of external and internal stimuli. A brief review of the present knowledge on nasal autonomic innervation and pharmacology will be given. There is special attention to more advanced methods, such as radioligand receptor binding techniques, which might augment our insight in the significance of the nervous system in nasal (patho)physiology. Furthermore data on the secretory activity of the nasal glands in the rat and its neural regulation will be accentuated.

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We investigated autoradiographically the distribution of muscarinic receptors in bovine airways using (-)-[3H]quinuclidinyl benzilate as radioligand. The autoradiographs demonstrated the presence of muscarinic receptors in smooth muscle as well as neuronal muscarinic receptors in pulmonary nerves and ganglia. It is reasonable to believe that the neuronal muscarinic receptors participate in the regulation of neurotransmitter release at the peripheral nerve terminals innervating the bronchial smooth muscle.

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The submucosal glands in the rat nose are characterized by the presence of both neutral and acid glycoproteins, which are important constituents of nasal and tracheobronchial secretions. This study is an attempt to gain a better insight into the secretion of these two types of glycoproteins and its neural regulation. Radiobiochemical experiments show a higher sensitivity to methacholine of the nasal glandular region producing acid glycoproteins than the area secreting neutral glycoproteins. Radioligand receptor binding suggests that the binding parameters of the muscarinic receptors in these two areas are mutually different. Furthermore, rat nasal glandular muscarinic receptors appear to be different from those in smooth muscle of rat ileum.

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Radioligand receptor binding might give more detailed information on the innervation pattern of the nasal mucosa and the character of the various neuroreceptors involved. With respect to the cholinergic receptors, this technique reveals that specific binding of tritiated I-quinuclidinyl benzilate to rat nasal mucosa homogenates occurs to a homogeneous class of binding sites, with a dissociation constant of 0.06 +/- 0.02 nM and a receptor density of 8 +/- 2 pmole/g of tissue. Binding is stereoselectively inhibited by benzetimide hydrochloride enantiomers. Pirenzepine displacement (inhibition constant = 0.5 X 10(-6) M) classifies tritiated I-quinuclidinyl benzilate binding sites as M2-muscarinic receptors. Methylfurthrethonium inhibits tritiated I-quinuclidinyl benzilate binding at high concentrations, pointing to the presence of low-affinity agonist binding sites, probably admixed with a small proportion of high-affinity agonist binding sites. These data obtained in the rat open new perspectives for studying muscarinic receptors in the human nose to elucidate the supposed disturbance of autonomic nerve regulation in nasal hyperreactivity.

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The secretory behaviour of rat nasal glands, under normal conditions and after the application of cholinergic drugs, has been studied using morphological and radiobiochemical techniques. Autoradiography and electrophoresis provide evidence for the selective incorporation of 3H-arginine into the glycoprotein-containing fraction of the nasal glandular secretion. Radiobiochemical experiments show that labelled arginine is rapidly incorporated into the acinar cells of unstimulated glands, although it takes approximately 4 h before the labelled secretory proteins leave the cells. The secretion of proteins is stimulated by the parasympathetic agonist pilocarpine, whose main action is to promote discharge. Histological sections show a depletion of secretory granules after pilocarpine treatment. The cholinergic antagonist atropine inhibits the secretion; the acinar cells are completely filled with secretory granules following this treatment. The time course of the events following atropine administration suggests that there is no feed-back system controlling glycoprotein synthesis. The techniques employed here therefore appear to be useful for studying the effects of drugs that interfere with the secretory activity of the nasal glands.

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