Effects of Benzalkonium Chloride on Innate Immunity Physiology of the Human Nasal Mucosa In Vivo

Abstract

Objective: Benzalkonium chloride (BC) is a preservative commonly used in nasal decongestant sprays. It has been suggested that BC may be harmful to the nasal mucosa. The present study, involving healthy volunteers, examines effects of BC on nasal mucosal end-organ functions. Methods: Isotonic saline and BC (0.1 mg/mL) were administered acutely to the nasal mucosa using a nasal pool device. Nasal symptoms were determined. Nasal lavage fluid levels of ␣ 2 -macroglobulin and fucose were measured as indices of plasma exudation and glandular secretion, respectively. In addition, BC (0.1 mg/mL) was given as single actuations of 100 L per nasal cavity three times daily for 10 days. The ability of histamine (0.4 mg/mL) to evoke nasal symptoms and plasma exudation responses was determined before and after the repeated BC administration series. Results: BC produced immediate nasal smart or pain (P < .05), but tolerance to this response developed by repeated administrations. BC increased nasal mucosal output of fucose (P < .05), whereas nasal lavage fluid levels of ␣ 2 -macroglobulin were unaffected. Histamine produced significant symptoms and mucosal exudation of ␣ 2 -macroglobulin (P values < .01), equally before and after the 10 days of BC exposure. Conclusions: BC in dosages commonly used as preservative in nasal decongestant sprays produced short-term glandular secretion and nasal smart or pain. However, 10 days' frequent exposure to BC was not associated with untoward symptomatic effects, nor was a sensitive mucosal variable such as histamine-induced exudative responsiveness affected by this repeated exposure to BC.

Challenge‐induced plasma exudation and mucinous secretion in human airways

“…All the presently employed challenge agents evoked mucosal output of fucose. The observations with the cholinergic agonist methacholine and the sensory nerve irritant capsaicin in this study are in agreement with previously demonstrated effects of a cholinergic agonist (acetylcholine) on guinea‐pig tracheal airways (Yeadon et al ., 1995) and of sensory nerve irritants (nicotine and benzalkonium‐chloride) on human nasal airways (Greiff et al ., 1993; Storaas et al ., 2000). Methacholine may exert its effect by direct action on mucosal glands, whereas capsaicin likely acts on sensory nerves to produce a reflexogenically mediated secretion (Jeffery & Li, 1997; Stjärne et al ., 1989).…”

Objective monitoring of nasal airway inflammation in rhinitis

“…67,71 Similarly, many irritant provocations, including exposures to capsaicin, nicotine, and benzalkonium chloride, evoke secretory effects without inducing plasma exudation. 67,72 High doses of capsaicin, with as yet unknown neural or nonneural actions, seem to be needed to produce an exudative response in the human nose, and only then in patients with underlying rhinitis. Taken together, these data indicate that the special kind of neurogenic (exudative) inflammation so readily produced in select rodent species 67 is not applicable to human airways.…”

Influence of Preservatives and Topical Steroids on Ciliary Beat Frequency In Vitro

“…A nonsignificant mean reduction of mucociliary transport time was found. Storaas et al 18 investigated the effect of benzalkonium chloride on glandular secretion and nasal symptoms of healthy volunteers. During 10 days of repeated exposure to commonly used dosages of benzalkonium chloride, short-term glandular secretion or nasal pain occurred, but no exudative hyperresponsiveness or airway inflammation was found.…”