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DOI: 10.1055/s-0043-1775581
Perivascular Innervation in the Nasal Mucosa and Clinical Findings in Patients with Allergic Rhinitis and Idiopathic Rhinitis
Funding The presente research was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, in the Portuguese acronym) as a Regular Research Project.
Abstract
Introduction The nonspecific hyperreactivity of rhinitis has been attributed to neurotrophins activating sensory nerves and inflammatory cells. The relationship between these markers and the intensity of the symptoms is not well established and few studies have evaluated individuals with idiopathic rhinitis.
Objective The present study aims to evaluate whether perivascular innervation and nerve growth factor (NGF) are related to the intensity of the clinical conditions in allergic rhinitis (AR) and idiopathic rhinitis (IR).
Methods A total of 15 patients with AR and 15 patients with IR with the indication for inferior turbinectomy (associated or not with septoplasty) were selected. The patients received a score according to their signs and symptoms. After the surgery, we quantified eosinophils, mast cells, NGF, and nerve fibers in the nasal turbinate.
Results The score of the signs and symptoms was higher in the AR group. Nerve growth factor was found in the cytoplasm of inflammatory cells in the submucosa in greater quantity in the AR group. The nerve fibers were distributed throughout the tissue, mainly in the subepithelial, glandular, and vascular regions, and there was no difference between the groups. Greater perivascular innervation was associated with a higher signs and symptoms score.
Conclusions We concluded that these findings suggest that the NGF produced by submucosal inflammatory cells stimulates increased perivascular innervation in rhinitis, thus directly reflecting in more intense clinical conditions, especially in AR.
Contributions of the Authors
Carvalho T.: Conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, visualization, writing – original draft preparation; Mello Jr J. F.: Conceptualization, project administration, supervision, writing – review and editing; Caldini E. T. E. G.: Conceptualization, Investigation, Methodology, Resources, Supervision; Salgado D. C.: Data Curation, resources; Carvalho N. M. G.: Data Curation, investigation; Damaceno-Rodrigues N. R.: Data curation, investigation, methodology, resources; Richard Louis Voegels R. L.: Funding acquisition, project administration, supervision, writing – review and editing.
Publikationsverlauf
Eingereicht: 08. Juni 2022
Angenommen: 26. September 2022
Artikel online veröffentlicht:
23. Oktober 2023
© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Wise SK, Lin SY, Toskala E. et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol 2018; 8 (02) 108-352
- 2 Papadopoulos NG, Bernstein JA, Demoly P. et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy 2015; 70 (05) 474-494
- 3 Bousquet J, Khaltaev N, Cruz AA. et al; World Health Organization, GA(2)LEN, AllerGen. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 (Suppl. 86) 8-160
- 4 Sakano E, Solé D, Cruz ÁA. et al. IV Consenso Brasileiro sobre Rinites 2017. Documento conjunto da Associação Brasileira de Alergia e Imunologia, ABORL-CCF e SBP. Published online 2017:1–43.
- 5 Mello Jr JF, Mion O. Rinite Alérgica. In: Campos CAH. Costa HO de O, eds. Tratado de Otorrinolaringologia. Sociedade Brasileira de Otorrinolaringología. Vol 3. 1st ed.. Roca; 2002: 68-87
- 6 Segboer CL, Holland CT, Reinartz SM. et al. Nasal hyper-reactivity is a common feature in both allergic and nonallergic rhinitis. Allergy 2013; 68 (11) 1427-1434
- 7 Bernstein JA, Singh U. Neural abnormalities in nonallergic rhinitis. Curr Allergy Asthma Rep 2015; 15 (04) 18
- 8 Hellings PW, Klimek L, Cingi C. et al. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy 2017; 72 (11) 1657-1665
- 9 Eifan AO, Durham SR. Pathogenesis of rhinitis. Clin Exp Allergy 2016; 46 (09) 1139-1151
- 10 Papadopoulos NG, Guibas GV. Rhinitis Subtypes, Endotypes, and Definitions. Immunol Allergy Clin North Am 2016; 36 (02) 215-233
- 11 Muraro A, Lemanske Jr RF, Hellings PW. et al. Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2016; 137 (05) 1347-1358
- 12 Bernstein JA, Hastings L, Boespflug EL, Allendorfer JB, Lamy M, Eliassen JC. Alteration of brain activation patterns in nonallergic rhinitis patients using functional magnetic resonance imaging before and after treatment with intranasal azelastine. Ann Allergy Asthma Immunol 2011; 106 (06) 527-532
- 13 Raap U, Braunstahl GJJ. The role of neurotrophins in the pathophysiology of allergic rhinitis. Curr Opin Allergy Clin Immunol 2010; 10 (01) 8-13
- 14 Pfaar O, Raap U, Holz M, Hörmann K, Klimek L. Pathophysiology of itching and sneezing in allergic rhinitis. Swiss Med Wkly 2009; 139 (3-4): 35-40
- 15 Minnone G, De Benedetti F, Bracci-Laudiero L. NGF and Its Receptors in the Regulation of Inflammatory Response. Int J Mol Sci 2017; 18 (05) 1028
- 16 Noga O, Englmann C, Hanf G, Grützkau A, Seybold J, Kunkel G. The production, storage and release of the neurotrophins nerve growth factor, brain-derived neurotrophic factor and neurotrophin-3 by human peripheral eosinophils in allergics and non-allergics. Clin Exp Allergy 2003; 33 (05) 649-654
- 17 Bresciani M, Lalibertè F, Lalibertè MF, Gramiccioni C, Bonini S. Nerve growth factor localization in the nasal mucosa of patients with persistent allergic rhinitis. Allergy 2009; 64 (01) 112-117
- 18 Keh SM, Facer P, Simpson KD, Sandhu G, Saleh HA, Anand P. Increased nerve fiber expression of sensory sodium channels Nav1.7, Nav1.8, And Nav1.9 in rhinitis. Laryngoscope 2008; 118 (04) 573-579
- 19 O'Hanlon S, Facer P, Simpson KD, Sandhu G, Saleh HA, Anand P. Neuronal markers in allergic rhinitis: expression and correlation with sensory testing. Laryngoscope 2007; 117 (09) 1519-1527
- 20 Lauria G, Hsieh ST, Johansson O. et al; Joint Task Force of the EFNS and the PNS. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. J Peripher Nerv Syst 2010; 15 (02) 79-92
- 21 Greiwe J, Bernstein JA. Nonallergic Rhinitis: Diagnosis. Immunol Allergy Clin North Am 2016; 36 (02) 289-303
- 22 Yum HY, Ha EK, Shin YH, Han MY. Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis. Clin Exp Pediatr 2021; 64 (08) 373-383
- 23 Gelincik A, Aydın F, Özerman B. et al. Enhanced nerve growth factor expression by mast cells does not differ significantly between idiopathic and allergic rhinitis. Ann Allergy Asthma Immunol 2012; 108 (06) 396-401
- 24 Figueroa JM, Mansilla E, Suburo AM. Innervation of nasal turbinate blood vessels in rhinitic and nonrhinitic children. Am J Respir Crit Care Med 1998; 157 (6 Pt 1): 1959-1966
- 25 Gelardi M, Maselli del Giudice A, Fiorella ML. et al. Non-allergic rhinitis with eosinophils and mast cells constitutes a new severe nasal disorder. Int J Immunopathol Pharmacol 2008; 21 (02) 325-331