Neuropathology in rhinosinusitis

James N. Baraniuk, Kristina Naranch Petrie, Uyenphuong Le, Chih Feng Tai, Yong Jin Park, Atsushi Yuta, Mushtaq Ali, Christopher J. VandenBussche, Benjamin Nelson

Research output: Contribution to journalArticlepeer-review

Abstract

Pathophysiologic differences in neural responses to hypertonic saline (HTS) were investigated in subjects with acute sinusitis (n = 25), subjects with chronic fatigue syndrome (CFS) with nonallergic rhinitis (n = 14), subjects with active allergic rhinitis (AR; n = 17), and normal (n = 20) subjects. Increasing strengths of HTS were sprayed into their nostrils at 5-minute intervals. Sensations of nasal pain, blockage, and drip increased with concentration and were significantly elevated above normal. These parallels suggested activation of similar subsets of afferent neurons. Urea and lysozyme secretion were dose dependent in all groups, suggesting that serous cell exocytosis was one source of urea after neural stimulation. Only AR and normal groups had mucin dose responses and correlations between symptoms and lysozyme secretion (R 2 = 0.12-0.23). The lysozyme dose responses may represent axon responses in these groups. The neurogenic stimulus did not alter albumin (vascular) exudation in any group. Albumin and mucin concentrations were correlated in sinusitis, suggesting that nonneurogenic factors pre-dominated in sinusitis mucous hypersecretion. CFS had neural hypersensitivity (pain) but reduced serous cell secretion. HTS nasal provocations identified significant, unique patterns of neural and mucosal dysregulation in each rhinosinusitis syndrome.

Original languageEnglish (US)
Pages (from-to)5-11
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume171
Issue number1
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

Keywords

  • Axon response
  • Glandular exocytosis
  • Mucosal hyperresponsiveness
  • Neurogenic inflammation
  • Urea secretion

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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