The role of the nervous system in rhinitis

Sarin, Seema; Undem, Bradley J.; Sanico, Alvin M.; Togias, Alkis

doi:10.1016/j.jaci.2006.09.013

Cited by 210 publications

(174 citation statements)

References 191 publications

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“…The nose provides defensive and homeostatic functions requiring rapid responses to physical and chemical stimuli (120). As a result, it is armed with a complex nervous system that includes sensory, parasympathetic and sympathetic nerves.…”

Section: Mechanisms: Neurogenic Mechanismsmentioning

confidence: 99%

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper

Bousquet

Fokkens

Burney

et al. 2008

Allergy

170

148

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Important research questions in allergy and related diseases: nonallergic rhinitis: a GA 2 LEN paper Nonallergic rhinitis (NAR) can be defined as a chronic nasal inflammation which is not caused by systemic IgE-dependent mechanisms. It is common and probably affects far more than 200 million people worldwide. Both children and adults are affected. However, its exact prevalence is unknown and its phenotypes need to be evaluated using appropriate methods to better understand its pathophysiology, diagnosis and management. It is important to differentiate between infectious rhinitis, allergic/NAR and chronic rhinosinusitis, as management differs for each of these cases. Characterization of the phenotype, mechanisms and management of NAR represents one of the major unmet needs in allergic and nonallergic diseases. Studies on children and adults are required in order to appreciate the prevalence, phenotype, severity and co-morbidities of NAR. These studies should compare allergic and NAR and consider different age group populations including elderly subjects. Mechanistic studies should be carried out to better understand the disease(s) and risk factors and to guide towards an improved diagnosis and therapy. These studies need to take the heterogeneity of NAR into account. It is likely that neuronal mechanisms, T cells, innate immunity and possibly auto-immune responses all play a role in NAR and may also contribute to the symptoms of allergic rhinitis.

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Section: Mechanisms: Neurogenic Mechanismsmentioning

confidence: 99%

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper

Bousquet

Fokkens

Burney

et al. 2008

Allergy

170

148

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show abstract

“…Thirdly, bronchoconstrictor neuronal responses may play a role, though the existence of nasobronchial reflexes remains controversial. 29 Finally, the relationship between postnasal drip and lower airway bacterial colonisation 16 suggests that direct passage of mediators or pathogens along the respiratory mucosa may be important. These concepts are summarised in fig 3. …”

Section: Mechanisms Of Interaction Between the Upper And Lower Airwaymentioning

confidence: 99%

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hurst

2009

Thorax

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This review presents the evidence that chronic obstructive pulmonary disease (COPD) is associated with significant sinonasal symptoms, inflammation and airway obstruction. Upper airway symptoms in COPD cause impairment to quality of life. The severity of upper airway involvement relates to that present in the lower airway, suggesting that the nose may be used to model the lung in COPD. More importantly, relationships between upper and lower airway bacteria and inflammation, and the association between sinusitis and treatment failure at exacerbation raise the possibility that nasal intervention in COPD may not only improve health status but may also affect important clinical outcomes such as exacerbation frequency.

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“…Trigeminal excitation by airborn pollutants initiates the sensation of irritation, pain, lacrimation and sneezing [12]. Sensory-autonomic parasympathetic efferent reflex pathways induce secretions from nasal, lacrimatory, and salivary glands, and the dilation of vessels in the nasal mucosa and sinuses.…”

Section: What Happens If the Nose Is Exposed To Airborn Irritants?mentioning

confidence: 99%

“…irritants, mainly the parasympathetic nerves are called upon the action, and their main effects are similar to those provided by tachykinis -so the exposure to irritants induces parasympathetic nerves mediated hypersecretion and vasodilatation with venous sinus engorgement [12]. Stimuation of the trigeminal afferents by relevant stimuli (cold, chemical irritants, mechanical probing) may induce also strong cardiovascular responses.…”

Section: What Happens If the Nose Is Exposed To Airborn Irritants?mentioning

confidence: 99%

The Nose as a Target of Air Pollution, Physiological Aspects and Clinical Relevance of Nasal Trpa1 (Transient Receptor Potential A1) Receptors

Biringerová¹,

Buday²,

Calkovský³

et al. 2011

Acta Medica Martiniana

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A b s t r a c tWorldwide more than several hundred million humans are exposed to severe air pollution, and a significant part of them also smoke. The effect of air pollution on human health has been recognized for many years.The nose, as the first portal of entry to the respiratory system is constantly exposed to a large volumes of air, which is composed of a mixture of gases, particulate matter and infectious agent, and any material other than physiological amount of oxygen, nitrogen, carbon dioxide and water is considered as pollutant. Being exposed to critical amount of air pollutants, nasal cavity shares sophisticated system of protective and defensive mechanisms regarding the lower airways and lungs, however the highest risk of direct exposure to relevant air pollutants is just within the nose. Air pollution is considered to be responsible for some of the pathological processes affecting airways prone to allergic reactions in predisposed subjects, onset of nasal sensorineural hyperresponsiveness, nonspecific inflammation, sinonasal cancer and definitely, the risk is not limited just to the nasal mucosa, but can proceed toward the lower airways.The broad spectrum of irritants probably shares very similar molecular background of action. They are capable to activate the cation channenl tranisient receptor potential A1-TRPA1 by covalent modification of the channel protein, because many of them are highly reactive and nonstable molecules with possibilities for various chemical reactions. Activation of this channel is responsible for nociceptive reactions mediated by stimulation of afferent trigeminal nerves, retrograde release of tachykinins, activation of parasympathetic afferent drive leading to increase of mucus output and decrease of nasal patency, with subsequent alteration of nasal functions. Based on the recently described neuro-immune bidirectional relationships, air pollutants may be responsible for recruitment of immune cells with infiltration of the nasal mucosa possibly leading to the inflammatory processes and allergies.Our paper is discussing the nose as the target for air pollution, and focuses on the relevance of TRPA1 channel on trigeminal afferents in pollution mediated responses.

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The role of the nervous system in rhinitis

Cited by 210 publications

References 191 publications

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

The Nose as a Target of Air Pollution, Physiological Aspects and Clinical Relevance of Nasal Trpa1 (Transient Receptor Potential A1) Receptors

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The role of the nervous system in rhinitis

Cited by 210 publications

References 191 publications

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

The Nose as a Target of Air Pollution, Physiological Aspects and Clinical Relevance of Nasal Trpa1 (Transient Receptor Potential A1) Receptors

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Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper