TY - JOUR
T1 - The role of the nervous system in rhinitis
AU - Sarin, Seema
AU - Undem, Bradley
AU - Sanico, Alvin
AU - Togias, Alkis
N1 - Funding Information:
(Supported by an unrestricted educational grant from Genentech, Inc. and Novartis Pharmaceuticals Corporation)
Funding Information:
Disclosure of potential conflict of interest: A. Togias has consultant arrangements with AirPharma, Altana, Genentech, GlaxoSmithKline, MedPointe, Merck, and Novartis and is on the speakers' bureau for Genentech, Merck, and Novartis. A. Sanico has consultant arrangements with Merck and AstraZeneca; has received grant support from NIH K23, Merck, and Alcon; and is on the speakers' bureau for Merck, Pfizer, UCB, GlaxoSmithKline, and Aventis. The rest of the authors have declared that they have no conflict of interest.
Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2006/11
Y1 - 2006/11
N2 - The nose provides defensive and homeostatic functions requiring rapid responses to physical and chemical stimuli. As a result, it is armed with a complex nervous system that includes sensory, parasympathetic, and sympathetic nerves. Sensory nerves transmit signals from the mucosa, generating sensations, such as pruritus; motor reflexes, such as sneezing; and parasympathetic and sympathetic reflexes that affect the glandular and vascular nasal apparatuses. Reflexes directed to the nose are also generated by inputs from other body regions. Hence all symptoms that constitute the nosologic entity of rhinitis can be triggered through neural pathways. In addition, neural signals generated in the nose can influence distal physiology, such as that of the bronchial tree and the cardiovascular system. Neural function can be chronically upregulated in the presence of mucosal inflammation, acutely with an allergic reaction, or even in the absence of inflammation, as in cases of nonallergic rhinitis. Upregulation of the nasal nervous system can occur at various levels of the reflex pathways, resulting in exaggerated responses (neural hyperresponsiveness), as well as in increased capacity for generation of neurogenic inflammation, a phenomenon that depends on the release of neuropeptides on antidromic stimulation of nociceptive sensory nerves. The molecular mechanisms of hyperresponsiveness are not understood, but several inflammatory products appear to be playing a role. Neurotrophins, such as the nerve growth factor, are prime candidates as mediators of neural hyperresponsiveness. The many interactions between the nervous and immune systems contribute to nasal physiology but also to nasal disease.
AB - The nose provides defensive and homeostatic functions requiring rapid responses to physical and chemical stimuli. As a result, it is armed with a complex nervous system that includes sensory, parasympathetic, and sympathetic nerves. Sensory nerves transmit signals from the mucosa, generating sensations, such as pruritus; motor reflexes, such as sneezing; and parasympathetic and sympathetic reflexes that affect the glandular and vascular nasal apparatuses. Reflexes directed to the nose are also generated by inputs from other body regions. Hence all symptoms that constitute the nosologic entity of rhinitis can be triggered through neural pathways. In addition, neural signals generated in the nose can influence distal physiology, such as that of the bronchial tree and the cardiovascular system. Neural function can be chronically upregulated in the presence of mucosal inflammation, acutely with an allergic reaction, or even in the absence of inflammation, as in cases of nonallergic rhinitis. Upregulation of the nasal nervous system can occur at various levels of the reflex pathways, resulting in exaggerated responses (neural hyperresponsiveness), as well as in increased capacity for generation of neurogenic inflammation, a phenomenon that depends on the release of neuropeptides on antidromic stimulation of nociceptive sensory nerves. The molecular mechanisms of hyperresponsiveness are not understood, but several inflammatory products appear to be playing a role. Neurotrophins, such as the nerve growth factor, are prime candidates as mediators of neural hyperresponsiveness. The many interactions between the nervous and immune systems contribute to nasal physiology but also to nasal disease.
KW - Neuroimmune interactions
KW - allergic rhinitis
KW - capsaicin
KW - nasal hyperresponsiveness
KW - nasal reflexes
KW - nerve growth factor
KW - neurogenic inflammation
KW - neuropeptides
KW - nociception
KW - nonallergic rhinitis
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U2 - 10.1016/j.jaci.2006.09.013
DO - 10.1016/j.jaci.2006.09.013
M3 - Review article
C2 - 17088122
AN - SCOPUS:33750519286
SN - 0091-6749
VL - 118
SP - 999
EP - 1014
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 5
ER -