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. 2021 Sep;278(9):3351-3356.
doi: 10.1007/s00405-020-06602-7. Epub 2021 Feb 4.

Effects of tranexamic acid on human nasal ciliary beat frequency

W Behr  1 , F Horschke  2 , A Nastev  2 , C E Mueller  2 , J U Sommer  3 , B Folz  2 , H Li  2 , U W Geisthoff  2 , B A Stuck  2 , R Birk  2
Affiliations

Effects of tranexamic acid on human nasal ciliary beat frequency

W Behr et al. Eur Arch Otorhinolaryngol. 2021 Sep.

Abstract

Background: Patients with recurrent epistaxis, particularly due to hereditary hemorrhagic telangiectasia (HHT) are recommended to apply topical tranexamic acid (TXA) to reduce bleeding events. Those patients may suffer ciliary dysfunction due to TXA's effects on ciliary beating frequency (CBF) and their consequences.

Methodology/principal: Human nasal epithelial cells were harvested with a nasal brush in 30 healthy subjects. We investigated the CBF in RPMI medium using high-frequency video microscopy. TXA was added to the cells in various concentrations ranging from 2 to 5%, including the therapeutic concentration (2%) and a control (0%).

Results: CBF in the control condition was 6.1 ± 1.6 Hz. TXA reduces CBF in a time and concentration dependent manner, to, e.g. 4.3 ± 1.2 Hz with 2% TXA and 3.3 ± 0.9 Hz with 5% TXA after 16-20 min. The differences in CBF were statistically significant for all concentrations of TXA.

Conclusions: TXA has the potential to significantly impair nasal epithelial function. Therefore, frequent or regular topical nasal application of TXA should be done under close monitoring of nasal function, especially in patients with co-morbidities like chronic rhinosinusitis.

Keywords: CBF; Ciliary beat frequency; Ciliary dysfunction; Epistaxis; Tranexamic acid.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Boxplot of ciliary beat frequency (CBF) in concentrate with 0% (green), 2% (red) and 5% (blue) concentrate of TXA. The boxes show interquartile range (IQR) with whiskers extending up to 1.5 times the IQR. The solid line marks the median. CBF in Hz, time in min. N = 30
Fig. 2
Fig. 2
3D diagram of time- and concentration-dependent changes of ciliary beat frequency (CBF) by TXA in vitro. CBF in Hz, time in min. N = 30
See this image and copyright information in PMC

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