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Can influenza viruses be inactivated by a "nose-mouth-nose" breathing technique?

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Seven years ago, I presented an oral communication, “Nasal breathing technique in nasal airway obstruction. Viral infections in upper respiratory tract”, in the 20th World Congress of the International Federation of Oto-Rhino-Laryngologycal Societies, IFOS, Seoul, 2013. This is a technique based on physiological concepts of breathing, to avoid the use of nasal decongestants in a cold or flu. We have to breathe the air we exhale. It is air with a high concentration of CO2, but it is not toxic. Inhaling carbon dioxide in the air we exhale through a nasal mask made by ourselves, using our hands, acts as a nasal decongestant. I think it is possible that this breathing technique can inactivate the flu virus, because the people who used it (10 patients), did not develop the flu in these years. (4) (PDF) Can influenza viruses be inactivated by a "nose-mouth-nose" breathing technique?. Available from: https://www.researchgate.net/publication/341434203_Can_influenza_viruses_be_inactivated_by_a_nose-mouth-nose_breathing_technique [accessed Apr 02 2023].
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RESEARCH ARTICLE
CAN INFLUENZA VIRUSES BE INACTIVATED BY A "NOSE-MOUTH-NOSE" BREATHING
TECHNIQUE?
*Carlos Sánchez
Galician Health Service, Primary Care, Sergas, Lugo, Spain.
ARTICLE INFO ABSTRACT
Seven years ago, I presented an oral communication “Nasal breathing technique in nasal airway
obstruction. Viral infections in upper respiratory tract”, in the 20th World Congress of the International
Federation of Oto-Rhino-Laryngologycal Societes, IFOS, Seoul, 2013. This is a technique based on
physiological concepts of breathing, to avoid the use of nasal decongestants in a cold or flu. We have
to breathe the air we exhale. It is air with a high concentration of CO2, but it is not toxic. Inhaling
carbon dioxide in the air we exhale through a nasal mask made by ourselves, using our hands, acts as
a nasal decongestant. I think it is possible that this breathing technique can inactivate the flu virus,
because the people who used it (10 patients), did not develop the flu in these years.
Copyright © 2020, Carlos Sánchez. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
INTRODUCTION
Nasal airway obstruction is one of the first symptoms of viral
infections in the upper respiratory tract. In this condition, air
goes directly into the respiratory tract without warming up in
the nostrils, and is breathed through the mouth instead of the
nose, causing oropharyngeal discomfort. In order to solve this
problem, we use topical nasal decongestants; they are very
effective and safe, when used for a short period of time.
However, we are aware of its side effects, and it is unlikely that
we will have them on hand, when the first symptoms of a cold
or flu appear. On the other hand, the effectiveness and safety of
nasal decongestants are limited (Deckx, 2016).
Aim: By using a breathing technique, we can improve the
nasal obstruction that occurs as a result of suffering a cold, and
thus avoid the use of nasal decongestants (Carlos Sánchez
Fernández de la Vega, 2013). I try to persuade my patients not
to use nasal decongestants. Moreover, by practicing this
technique, the viruses could be inactivated.
Method: We have to consider the physiological concepts of
breathing (inhalation and exhalation), to explain the nasal
decongestive effect of this technique.
The composition of the inspired air is different from that of the
exhaled air, with the following standard values for respiratory
gases (Gillian Pocock, 2013):
*Corresponding author: Carlos Sánchez,
Galician Health Service, Primary Care, Sergas, Lugo, Spain.
A/ Inspired air: O2 (21 %); CO2 (0,04 %); N2 (78, %); Argon
(0.9%); Water (0.0 %).
B/ Expired air: O2 (16 %); CO2 (4 %); N2 (78 %); Argon
(0.9%); Water (4 %).
The CO2 gas exhaled is about a 100-fold increase over the CO2
inhaled amount. So, the air we breathe out (exhaled air),
contains about 100 times more carbon dioxide concentration,
more water vapor and less oxygen. This fact is important in
explaining the hypothesis I adopted, according to which the
concentration of carbon dioxide in the exhaled air could act as
a vasoconstrictor of the nasal mucosa and inactivate influenza
viruses. On the other hand, nose breathing helps us to use our
own nitric oxide generated in the sinuses. The confirmed
function of the nitric oxide is destruction of viruses, parasitic
organisms, and malignant cells, in the airways and lungs, by
inactivating their respiratory chain enzymes (Chaves, 2010;
Jefferson, 2010). There is a very interesting article “Evidence
for cure of flu through nose breathing”, about how nitric oxide
prepared in the sinuses uses and kills the flu virus to cure us of
the flu (Sana Jamshald,2013). The physiology of the autonomic
nervous system, helps us to understand the decongestant effect
of this breathing technique: General innervation to the nose
involves the autonomic nervous system, the parasympathetic
and sympathetic nerves. The glands of the nasal mucosa, as
well as the vessels, have a direct parasympathetic innervation,
which leads to a direct parasympathetic increase in nasal
secretions via transudation and exudation (Golding-Wood,
1963).
International Journal of Information Research and Review
Vol. 07, Issue, 07, pp.6973-6975, July, 2020
Article History:
Received 15th April, 2020
Received in revised form
19th May, 2020
Accepted 27th June, 2020
Published online 30th July, 2020
International Journal of Information Research and Review, July, 2020
Keywords:
Obstruction Nasal, Nasal Decongestants,
Virus, Upper Respiratory Tract.
Several co-transmitters were detected in the nasal respiratory
mucosa (Baraniuk,1998). Parasympathetic neurons mainly
have a vasointestinal peptide (VIP) as co-transmitter to
acetylcholine (Figueroa et al., 1998). VIP stimulates secretions
(more serious than mucous) and vasodilation in the arterial and
sinusoidal vessels (Knipping, 2004). Sympathetic neurons
contain the neuropeptide Y (NPY) as a key co-transmitter for
noradrenalin and predominantly innervate arterioles and
arteriovenous anastomoses. Release of NPY results in
prolonged vasoconstriction, along with decongestion of the
venous sinus vessels (Baraniuk,1992). Therefore, the activation
of the sympathetic nerves leads to a decrease in blood flow and
a remarkable vasoconstriction, and the activation of the
parasympathetic nerves leads to an increase in blood flow and a
remarkable vasodilation. Stimulation also occurs during each
cycle of breathing. Inhalation stimulates sympathetic activity
and exhalation stimulates parasympathetic activity. Nasal
breathing can alter metabolism and autonomic activities. This
increase in metabolism may be due to increased sympathetic
discharge in the adrenal medulla (Telles,1994). Carbon dioxide
activates the sympathetic tone, thus increasing adrenaline
levels. Stimulation of the sympathetic system decreases nasal
congestion and discharge (Fig.1). This could explain the
decongestant effect of this technique. It is suggested that both
sympathetic and parasympathetic components, play a role in
alternating symptoms of unilateral nasal obstruction This could
explain the decongestant effect of this technique. This way, it
could be explained the decongestant effect of this technique.
Both sympathetic and parasympathetic components are
suggested to play a role in alternating unilateral nasal
obstruction symptoms (Sarin, 2006).
How is this technique used?
We have to make a nasal mask with our own hands. It is very
simple. (Fig. 2).
Fig 2: The nasal breathing technique using the left hand
A/ Put your hand in an upright position, as shown in the
picture.
B/ Place the palm of your right hand under the chin, in contact.
This serves to create a cavity between the hand and the mouth.
C/ Flex your fingers and touch the tip of your nose.
D/ With your left hand, raising your elbow 90 degrees, grasp
the fingers of your right hand to bring them together.
You now have a mask! You just inhale the air you exhale
through your mouth.
Fig. 2. The nasal breathing technique using the right hand
Fig 3. We have made a nasal mask to breathe the air we exhale. It
is air with higher concentration in CO2 than normal air, and with
a decongestant effect in the nostrils.
Fig 4. A nasal mask
The activation of the alae nasi will decrease nasal and total
airway resistance during voluntary nasal flaring and during
CO2 inhalation and thus should be considered in any studies of
upper airway resistance (Strohl, 1982). I think when we get a
cold, the first symptom is often a sneeze, that no one attributes
to exposure to respiratory viruses. For this reason, I
recommend my patients do this breathing technique for 45-60
seconds, every time they sneeze. It is difficult to appreciate the
difference with the sneezes of other aetiologias. This simple
technique could inactivate respiratory viral infections. Another
significant clinical fact that we have observed, is that the cough
disappears if we use the technique for several minutes. This
can be explained by a fluidification of the mucous membranes
of the respiratory tract. Nasal congestion is relieved by the use
of this technique, if practiced for a short period of time
(between 1-1.5 minutes), 3-4 times in a row, several times a
day when the first symptoms of a cold appear. It is necessary to
6974 Carlos Sánchez, Can influenza viruses be inactivated by a "nose-mouth-nose" breathing technique?
make a brief pause between them (about 30 seconds), because
otherwise we will get tired. At first, we hardly observe any
changes in nasal obstruction, but each time that we practice the
technique, the nasal decongestant effect is greater and we
breathe better.
RESULTS
It takes me a few minutes to train patients in this breathing
technique, explaining them its therapeutic benefits. Elderly
patients may find it difficult to perform, in which case, a nasal
breathing mask may be helpful (Fig 4). We have observed that,
10 patients that did use this breathing technique correctly, they
did not develop symptoms of flu viruses over the years. They
did not come to my office because of symptoms of a cold,
saving themselves by means of using this respiratory
technique. Some of them, they didn't get a flu shot. Of course, I
recommend that all my patients get a flu shot, but I also
recommend that they practice the technique for 60 seconds,
every time they sneeze. I don't know exactly why this happens,
but I think this theory might be correct. It's just another
possibility.
Conclusions
This is a safe, efficient and effective technique to reduce the
use of nasal decongestants in nasal obstruction by a cold or flu
virus. Finally, I transcribe some paragraphs from WORLD
HEALTH ORGANIZATION about: Instructions for storage
and transport of samples of human and animal cases and
suspected or confirmed isolates of influenza A (H1N1). Date
Posted: May 20, 2009 "Specimens should be collected and
transported in a suitable transport medium, on ice or in liquid
nitrogen. Specimens collected for influenza virus isolation
should not be stored or shipped in dry ice (solid carbon
dioxide) unless they are perfectly sealed in glass or sealed,
taped and double plastic-bagged. “Carbon dioxide can rapidly
inactivate influenza viruses if it gains access to the specimens
through imperfect seals”: microscopic leaks in the seal may
allow carbon dioxide gas to penetrate the primary container as
a vacuum is created during freezing”.
Other interesting documents:
“Virus and bacteria inactivation by CO2 bubbles in
solution” (Adrian Garrido Sanchis, 2019).
Possibility of Disinfection of SARS-CoV-2 (COVID-
19) in Human Respiratory Tract by Controlled
Ethanol Vapor Inhalation (Tsumoru Shintake, 1919).
Evidence for the cure of flu through nose breathing
(6).
These publications on inactivation of viruses by different gases
should make us reflect about the usefulness of this technique.
REFERENCES
Adrian Garrido Sanchis, 2019. Richard Pashley and Barry
Ninham Virus and bacteria inactivation by CO2 bubbles in
solution. npj Clean Water Pub Date: -02-01, DOI:
10.1038/s41545-018-0027-5.
Baraniuk JN, Silver PB, Kaliner MA, Barnes PJ. 1992.
Neuropeptide Y is a vasoconstrictor in human nasal mucosa.
J Appl Physiol.73:1867–1872.
Baraniuk JN. Neuropeptides. Am J Rhinol. 1998: 12:9-16. Doi
10.2500/ 105065898782103025.
Carlos Sánchez Fernández de la Vega. Nasal breathing
technique in nasal airway obstruction. Viral infections in
upper respiratory tract. Conference: 20th IFOS WORLD
CONGRESS, June 2013, Seoul, Korea.
Chaves, T C Tatiana Sim Ãμes de Andrade e Silva, Solange
Aparecida Caldeira Monteiro, Plauto Christopher Aranha
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Deckx L, De Sutter AI, Guo L, Mir NA, van Driel ML. 2016.
Nasal decongestants in monotherapy for the common cold.
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Figueroa JM, Mansilla E, Suburo AM. Innervation of nasal
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Am J Respir Crit Care Med. 1998;157:1959–1966.
Gillian Pocock, Christopher D. Richards, David A. Richards.
Human Physiology – 2013. Pag 454.
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Knipping S. Untersuchungen zur Regulation der seromukösen
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Sana Jamshald: Evidence for the cure of flu through nose
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Sarin S, Undem B, Sanico A, Togias A. 2006. The role of the
nervoussystem in rhinitis. J Allergy Clin Immunol.
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Strohl KP, O´Cain CF, Slutsky AS. 1982. Alae nasi activation
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particular nostril can alter metabolism and autonomic
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Tsumoru Shintake. 1919. Professor in Physics at OIST
Graduate University Okinawa Institute of Science and
Technology Graduate University Tancha, Onna-son,
Kunigami-gun, Okinawa, Japan 904-0495.
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6975 International Journal of Information Research and Review, Vol. 07, Issue, 07, pp.6973-6975, July, 2020
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Background: Many treatments for the common cold exist and are sold over-the-counter. Nevertheless, evidence on the effectiveness and safety of nasal decongestants is limited. Objectives: To assess the efficacy, and short- and long-term safety, of nasal decongestants used in monotherapy to alleviate symptoms of the common cold in adults and children. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 6, June 2016), which contains the Cochrane Acute Respiratory Infections (ARI) Specialised Register, MEDLINE (1946 to July 2016), Embase (2010 to 15 July 2016), CINAHL (1981 to 15 July 2016), LILACS (1982 to July 2016), Web of Science (1955 to July 2016) and clinical trials registers. Selection criteria: Randomised controlled trials (RCTs) and cluster-RCTs investigating the effectiveness and adverse effects of nasal decongestants compared with placebo for treating the common cold in adults and children. We excluded quasi-RCTs. Data collection and analysis: Three review authors independently extracted and summarised data on subjective measures of nasal congestion, overall patient well-being score, objective measures of nasal airway resistance, adverse effects and general recovery. One review author acted as arbiter in cases of disagreement. We categorised trials as single and multi-dose and analysed data both separately and together. We also analysed studies using an oral or topical nasal decongestant separately and together. Main results: We included 15 trials with 1838 participants. Fourteen studies included adult participants only (aged 18 years and over). In six studies the intervention was a single dose and in nine studies multiple doses were used. Nine studies used pseudoephedrine and three studies used oxymetazoline. Other decongestants included phenylpropanolamine, norephedrine and xylometazoline. Phenylpropanolamine (or norephedrine) is no longer available on the market therefore we did not include the results of these studies in the meta-analyses. Eleven studies used oral decongestants; four studies used topical decongestants.Participants were included after contracting the common cold. The duration of symptoms differed among studies; in 10 studies participants had symptoms for less than three days, in three studies symptoms were present for less than five days, one study counted the number of colds over one year, and one study experimentally induced the common cold. In the single-dose studies, the effectiveness of a nasal decongestant was measured on the same day, whereas the follow-up in multi-dose studies ranged between one and 10 days.Most studies were conducted in university settings (N = eight), six at a specific university common cold centre. Three studies were conducted at a university in collaboration with a hospital and two in a hospital only setting. In two studies the setting was unclear.There were large differences in the reporting of outcomes and the reporting of methods in most studies was limited. Therefore, we judged most studies to be at low or unclear risk of bias. Pooling was possible for a limited number of studies only; measures of effect are expressed as standardised mean differences (SMDs). A positive SMD represents an improvement in congestion. There is no defined minimal clinically important difference for measures of subjective improvement in nasal congestion, therefore we used the SMDs as a guide to assess whether an effect was small (0.2 to 0.49), moderate (0.5 to 0.79) or large (≥ 0.8).Single-dose decongestant versus placebo: 10 studies compared a single dose of nasal decongestant with placebo and their effectiveness was tested between 15 minutes and 10 hours after dosing. Seven of 10 studies reported subjective symptom scores for nasal congestion; none reported overall patient well-being. However, pooling was not possible due to the large diversity in the measurement and reporting of symptoms of congestion. Two studies recorded adverse events. Both studies used an oral decongestant and each of them showed that there was no statistical difference between the number of adverse events in the treatment group versus the placebo group.Multi-dose decongestant versus placebo: nine studies compared multiple doses of nasal decongestants with placebo, but only five reported on the primary outcome, subjective symptom scores for nasal congestion. Only one study used a topical decongestant; none reported overall patient well-being. Subjective measures of congestion were significantly better for the treatment group compared with placebo approximately three hours after the last dose (SMD 0.49, 95% confidence interval (CI) 0.07 to 0.92; P = 0.02; GRADE: low-quality evidence). However, the SMD of 0.49 only indicates a small clinical effect. 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For multiple doses of nasal decongestants, the current evidence suggests that these may have a small positive effect on subjective measures of nasal congestion in adults with the common cold. However, the clinical relevance of this small effect is unknown and there is insufficient good-quality evidence to draw any firm conclusions. Due to the small number of studies that used a topical nasal decongestant, we were also unable to draw conclusions on the effectiveness of oral versus topical decongestants. Nasal decongestants do not seem to increase the risk of adverse events in adults in the short term. The effectiveness and safety of nasal decongestants in children and the clinical relevance of their small effect in adults is yet to be determined.
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Neuropeptide Y (NPY) is a neurotransmitter in sympathetic nerve fibers in human nasal mucosa. Like norepinephrine, NPY acts as a vasoconstrictor. An established method of nasal provocation was used to determine the effects of topically applied NPY on nasal resistance to airflow measured by anterior rhinomanometry, the protein content of nasal secretions, and the protein content of bradykinin-induced secretions. NPY (2.3 nmol) reduced the resistance to inspiratory airflow by 57 +/- 18% (P < 0.001) in 10 normal subjects and by 50 +/- 17% (P < 0.05) in 12 subjects with perennial rhinitis. In nasal provocations, NPY in doses of 0.1-10 nmol had no effect on vascular (albumin), glandular (lysozyme, glycoconjugate), or total proteins present in lavaged nasal secretions. Because the vasoconstrictor properties of NPY may only be apparent in the presence of increased vascular permeability and albumin exudation, bradykinin (BK) nasal provocation was performed. BK (500 nmol) significantly increase total protein (10- to 20-fold), albumin (10- to 30-fold), and glycoconjugate (2- to 5-fold) in lavage fluid. NPY (2.3 nmol) reduced BK-induced total protein by 59 +/- 15% (P < 0.05) and albumin by 63 +/- 17% (P < 0.02) but had no significant effect on glandular secretion. Therefore exogenous administration of NPY to the human nasal mucosa reduced nasal airflow resistance and albumin exudation without affecting submucosal gland secretion. NPY agonists may be useful for the treatment of mucosal diseases characterized by vasodilation, vascular permeability, and plasma exudation.
There is increasing interest in the fact that breathing exclusively through one nostril may alter the autonomic functions. The present study aimed at checking whether such changes actually do occur, and whether breathing is consciously regulated. 48 male subjects, with ages ranging from 25 to 48 years were randomly assigned to different groups. Each group was asked to practice one out of three pranayamas (viz. right nostril breathing, left nostril breathing or alternate nostril breathing). These practices were carried out as 27 respiratory cycles, repeated 4 times a day for one month. Parameters were assessed at the beginning and end of the month, but not during the practice. The 'right nostril pranayama' group showed a significant increase, of 37% in baseline oxygen consumption. The 'alternate nostril' pranayama group showed an 18% increase, and the left nostril pranayama group also showed an increase, of 24%. This increase in metabolism could be due to increased sympathetic discharge to the adrenal medulla. The 'left nostril Pranayama' group showed an increase in volar galvanic skin resistance, interpreted as a reduction in sympathetic nervous system activity supplying the sweat glands. These results suggest that breathing selectively through either nostril could have a marked activating effect or a relaxing effect on the sympathetic nervous system. The therapeutic implications of being able to alter metabolism by changing the breathing pattern have been mentioned.
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An immunohistochemical study of the nasal mucosa was done in pediatric patients attending an otorhinolaringology (ORL) clinic. The goal was a comparison between vascular innervation in patients with or without symptoms of chronic rhinitis. All patients had an indication for tonsillectomy prior to their inclusion in this study. Samples were obtained under general anesthesia at the time of programmed surgery and fixed in a paraformaldehyde-picric acid mixture. Cryostat sections were immunostained for the following neuronal markers: protein-gene product 9.5 (PGP), calcitonin gene- related peptide (CGRP), substance P (SP), and C-terminal peptide of neuropeptide Y (CPON). The following classes of vessels were identified: arteries, sinusoids, veins, and arteriovenous anastomoses (AVAs). As shown by immunostaining with the general neuronal marker PGP, each vessel type had a characteristic innervation pattern, differing in the amount of fibers and their distribution within the adventitial and muscle layers. Evaluation of PGP, CPON, and CGRP immunoreactivity patterns indicated that rhinitic arteries and AVAs displayed a richer innervation than did nonrhinitic blood vessels. Quantification of vascular PGP immunostaining confirmed the difference of vascular innervation between nonrhinitic and rhinitic patients. Fibers immunostained by CPON partially accounted for the rhinitic arterial hyperinnervation.
  • J N Baraniuk
Baraniuk JN. Neuropeptides. Am J Rhinol. 1998: 12:9-16. Doi 10.2500/ 105065898782103025.
Nasal breathing technique in nasal airway obstruction
  • Carlos Sánchez Fernández De La Vega
Carlos Sánchez Fernández de la Vega. Nasal breathing technique in nasal airway obstruction. Viral infections in upper respiratory tract. Conference: 20th IFOS WORLD CONGRESS, June 2013, Seoul, Korea.