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The Taste and Smell Clinic

June 2004

Nasal mucus GUSTIN [carbonic anhydrase VI (CAVI)] in patients with smell loss is lower than in normal subjects 

CA VI in saliva 

We have previously demonstrated that CA VI in saliva is lower in patients with taste and smell dysfunction than in normal subjects. Measurement of CA VI has proven to be an useful diagnostic technique since patients with low levels of this enzyme (1) are found to have taste and/or smell loss and (2) can be treated with exogenous zinc which enhances activity of CA VI and can correct their taste and smell dysfunction. The molecular mechanism by which zinc functions relates to its effect as a cofactor in CA VI activation since CA VI is a zinc dependent metalloprotein. Thus, for CA VI efficacy zinc is a required cofactor and any process which would inhibit the presence or activity of zinc in this enzyme inhibits the function of this enzyme and can cause taste and/or smell dysfunction.

CA VI in nasal mucus

We have previously made measurements of CA VI in nasal mucus but not in great detail. This biological fluid is somewhat difficult to collect and has not been a fluid of great interest to physicians. However, in the few measurements we have made previously among patients with low levels of CA VI in saliva, CA VI in nasal mucus has also been low, presumably associated with the smell loss present in these patients. As with saliva, as exogenous zinc increased CA VI levels and improved taste function, exogenous zinc also increased zinc levels in nasal mucus and improved smell function.

In order to evaluate this relationship in a systematic manner we measured CA VI levels in nasal mucus in patients with smell loss and compared these results in those in normal subjects.

In normal subjects nasal mucus CA VI was 0.29±0.04 µg/ml.
In patients with hyposmia nasal mucus CA VI was 0.16±0.01 µg/ml.

These results indicate that nasal mucus CA VI is significantly lower (p<0.02) in patients with hyposmia compared to normal subjects.

This finding is important since it confirms our prior preliminary observation that CA VI in nasal mucus can be used as a diagnostic measurement to identify patients with hyposmia who exhibit this abnormality as related to their loss of smell acuity.

Thus, both saliva and nasal mucus CA VI can serve as biological markers to establish a biochemical basis for taste and smell loss, respectively.

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