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PubMed1995

[Treatment of nonspecific hyper-reflectory rhinopathy (vasomotor rhinitis) with capsaicin].

Apart from adrenergic and cholinergic neurones, peptidergic neurones are involved in the autonomic control of nasal mucosa. Their transmitter substances are peptides, so-called "neuropeptides". It is assumed that they are released from peptidergic neurones in the nasal mucosa after irritation of receptors by unspecific stimuli, and are responsible for the symptoms of hyperreactive rhinopathy. Repeated topical application of Capsaicin (8-methyl-N-vanillyl-6-nonenamide) leads to a selective degeneration of peptidergic neurones and desensitisation of its receptors in the nasal mucosa. 123 patients who were suffering from hyperreactive rhinopathy were treated in a prospective study by repeated topical applications of capsaicin solutions in increasing concentrations. A symptom score demonstrated an improvement of the predominating symptoms (nasal congestion, hypersecretion, sneezing) by 62% to 72%. A reduction of unpleasant side effects following application (epiphora, itching, sneezing, mucosal oedema) indicating a desensitising effect could be documented by a symptom score and by active anterior rhinomanometry. Immunohistochemical investigations of nasal mucosa biopsies revealed no reduction of peptidergic neurones within the nasal mucosa, so that a blockage of receptors seems to be responsible for the positive effects. The treatment of hyperreactive rhinopathy with capsaicin or related substances seems to be a promising new way in the treatment of hyperreactive rhinopathy. Further investigations have to prove the site of effect and mechanism of activity of the substance, such as the best modality of application.

Administration, Intranasal↗
PubMed1986

Autonomic microganglia of the nasal mucosa and their relation to vasomotor rhinitis.

The classical concept of the autonomic innervation of the nasal mucosa states that the postganglionic sympathetic neurones lie in the superior cervical ganglion and those of the postganglionic parasympathetic neurones are in the pterygopalatine ganglion. We have carried out a study of the fine structure of the respiratory nasal mucosa in man and in the cat using the techniques described by Jabonero, Champy Maillet and Koelle-Friedenwald. The most striking finding was the presence of microganglia deep within the mucosa of the inferior turbinate close to the glands. These microganglia were cholinergic in nature since they demonstrated a positive reaction to anticholinesterase. From this we deduce that the nasal parasympathetic pathway has its postganglionic neurones not only in the pterygopalatine ganglion but also in these microganglia of the inferior turbinate. Each of four groups of cats were submitted to different techniques, including administration of neostigmine, inferior turbinectomy and Vidian neurectomy. Resection of the microganglia by means of turbinectomy reduced the hypersecretion caused by neostigmine and this was most noticeable when a Vidian neurectomy was carried out in addition.

Animals↗