 
         
         
         Zusammenfassung
         
         Neurogene Entzündungen werden hervorgerufen durch Aktivierung unmyelinisierter sensorischer
            Nervenfasern und nachfolgender Freisetzung von Neuropeptiden, z. B. Substanz P und
            Calcitonin Gene-related Peptide (CGRP) aus den peripheren Nervenendigungen. Die lokale
            Entzündungsreaktion am Ort der Reizung besteht aus einer Hyperämie und einem Ödem,
            die unter Umständen mit Schmerzen einhergehen. Die Entzündungszeichen und die Hyperalgesie
            bei chronischen Schmerzsyndromen, z. B. der Migräne, Arthritiden und dem Komplexen
            Regionalen Schmerzsyndrom entsprechen den Charakteristika der neurogenen Entzündung.
            Aufgrund überzeugender Hinweise aus Tierversuchen, die überwiegend an Nagern durchgeführt
            wurden, wird auch beim Menschen angenommen, dass die neurogene Entzündung an vielen
            Erkrankungen der Atemwege, des Magendarmtraktes, des Urogenitaltraktes und der Haut
            beteiligt sind. In Anbetracht der eher enttäuschenden Ergebnisse neuer klinischer
            Studien zur Behandlung neurogener Entzündungen mit selektiven Substanz P- (NK1)-Antagonisten werden in dieser Übersicht die Hypothesen einer Beteiligung neurogener
            Entzündungen an Erkrankungen beim Menschen kritisch hinterfragt. Außer dem inflammatorischen
            Charakter hat die neurogene Entzündung in ganz anderer Weise physiologisch eine besondere
            Bedeutung. Sie hat eine protektive und nozifensive, aber auch trophische Funktion
            und trägt mit zur Gewebeintegrität und -homöostase bei.
         
         
         
         Abstract
         
         Neurogenic inflammation is elicited by activation of unmyelinated sensory neurons
            through noxious stimuli and subsequent release of neuropeptides such as substance
            P and calcitonin gene-related peptide (CGRP) from peripheral nerve endings. The  
            nerve-mediated inflammatory responses in the tissue consist of hyperaemia and oedema
            which under some circumstances may be accompanied by pain. Neurogenic inflammation
            has been implicated in the pathophysiology of various human diseases with uncertain
            etiology. Signs of inflammation and hyperalgesia associated with chronic pain syndromes
            such as migraine, arthritis and complex regional pain syndrome resemble the characteristics
            of neurogenic inflammation. By extrapolation of convincing evidence obtained in rodent
            models, neurogenic inflammation is assumed to contribute to diseases of the respiratory
            system,     gastrointestinal tract, urogenital tract, and skin in humans. Since, however,
            highly selective substance P receptor antagonists, found to be effective against inflammation
            in rodents, failed to inhibit inflammatory processes in clinical trials, the hypothesis
            of an involvement of neurogenic inflammation in human diseases is discussed critically
            in this review. Beyond its primarily inflammatory character neurogenic inflammation
            can be regarded as a mechanism that activates protective responses, thus bringing
            about a first line of defence to maintain the integrity of the tissue and to contribute
            to tissue repair.
            
         
         
         
            
Schlüsselwörter
         
         
            Neurogene Entzündung - Pathophysiologie - Migräne - Arthritis
          
         
            
Keywords
         
         
            Neurogenic inflammation - Pathophysiology - Migraine - Human diseases
          
      
    
   
      
         Literatur
         
         
            - 1 
               Holzer P. 
               Local effector functions of capsaicin-sensitive sensory nerve endings: involvement
               of tachykinins, calcitonin gene-related peptide and other neuropeptides. 
               Neuroscience. 
               1988; 
               24 
               739-768 
               
- 2 
               Holzer P. 
               Peptidergic sensory neurons in the control of vascular functions: mechanisms and significance
               in the cutaneous and splanchnic vascular beds. 
               Rev Physiol Biochem Pharmacol. 
               1992; 
               121 
               49-146 
               
- 3 
               Holzer P. 
               Neurogenic vasodilatation and plasma leakage in the skin. 
               Gen Pharmac. 
               1998; 
               30 
               5-11 
               
- 4 Herbert M K, Holzer P. Die neurogene Entzündung. I. Grundlegende Mechanismen, Physiologie
               und Pharmakologie. Anaesth Intensivmed Notfallmed Schmerzther (eingereicht) 
- 5 
               Donnerer J, Amann R. 
               The inhibition of neurogenic inflammation. 
               Gen Pharmacol. 
               1993; 
               24 
               519-529 
               
- 6 
               Holzer P. 
               Capsaicin: cellular targets, mechanisms of action, and selectivity for thin sensory
               neurons. 
               Pharmacol Rev. 
               1991; 
               43 
               143-201 
               
- 7 
               Szallasi A, Blumberg P M. 
               Vanilloid receptors: new insights enhance potential as a therapeutic target. 
               Pain. 
               1996; 
               68 
               195-208 
               
- 8 
               Resnick D, Niwayama G. 
               Entheses and enthesopathy. 
               Radiology. 
               1983; 
               146 
               1-9 
               
- 9 
               Ball J. 
               Enthesopathy of rheumatoid and ankylosing spondylitis. 
               Ann Rheum Dis. 
               1971; 
               30 
               213-223 
               
- 10 
               Niepel G A, Sitaj S. 
               Enthesopathy. 
               Clin Rheum Dis. 
               1979; 
               5 
               857-872 
               
- 11 
               Ljung B O, Forsgren S, Friden J. 
               Substance P and calcitonin gene-related peptide expression at the extensor carpi radialis
               brevis muscle origin: Implications for the etiology of tennis elbow. 
               J Orthop Res. 
               1999; 
               17 
               554-559 
               
- 12 
               Haker E, Theodorsson E, Lundeberg T. 
               An experimental model of tennis elbow in rats: A study of the contribution of the
               nervous system. 
               Inflammation. 
               1998; 
               22 
               435-444 
               
- 13 
               Herbert M K, Tafler R, Schmidt R F, Weis K H. 
               Cyclooxygenase inhibitors acetylsalicylic acid and indomethacin do not affect capsaicin-induced
               neurogenic inflammation in human skin. 
               Agents Actions. 
               1993; 
               38 
               C25-C27 
               
- 14 
               Tafler R, Herbert M K, Schmidt R F, Weis K H. 
               Small reduction of capsaicin-induced neurogenic inflammation in human forearm skin
               by the glucocorticoid prednicarbate. 
               Agents Actions. 
               1993; 
               38 
               31-34 
               
- 15 Herbert M K. Neurogene Entzündung an Haut und Gelenk. Klinische und tierexperimentelle
               Studien. Habilitationsschrift, Julius-Maximilians-Universität Würzburg 1994 
- 16 
               Ferrell W R, Russell N J. 
               Extravasation in the knee induced by antidromic stimulation of articular C fibre afferents
               of the anaesthetized cat. 
               J Physiol Lond. 
               1986; 
               379 
               407-416 
               
- 17 
               Malone D G, Irani A M, Schwartz L B, Barrett K E, Metcalfe D D. 
               Mast cell numbers and histamine levels in synovial fluids from patients with diverse
               arthritides. 
               Arthritis Rheum. 
               1986; 
               29 
               956-963 
               
- 18 
               Marshall K W, Chiu B, Inman R D. 
               Substance P and arthritis: analysis of plasma and synovial fluid levels. 
               Arthritis Rheum. 
               1990; 
               33 
               87-90 
               
- 19 
               Appelgren A, Appelgren B, Eriksson S, Kopp S, Lundeberg T, Nylander M, Theodorsson E.
               
               Neuropeptides in temporomandibular joints with rheumatoid arthritis: a clinical study. 
               Scand J Dent Res. 
               1991; 
               99 
               519-521 
               
- 20 
               Marabini S, Matucci C erinic, Geppetti P, Del Bianco E, Marchesoni A, Tosi S, Cagnoni M,
               Partsch G. 
               Substance P and somatostatin levels in rheumatoid arthritis, osteoarthritis, and psoriatic
               arthritis synovial fluid. 
               Ann N Y Acad Sci. 
               1991; 
               632 
               435-436 
               
- 21 
               Joyce T J, Yood R A, Carraway R E. 
               Quantitation of substance-P and its metabolites in plasma and synovial fluid from
               patients with arthritis. 
               J Clin Endocrinol Metab. 
               1993; 
               77 
               632-637 
               
- 22 
               Anichini M, Cesaretti S, Lepori M, Maddali-Bongi S, Maresca M, Zoppi M. 
               Substance P in the serum of patients with rheumatoid arthritis. 
               Rev Rhum Engl Ed. 
               1997; 
               64 
               18-21 
               
- 23 
               Arnalich F, de Miguel E, Perez Ayala C, Martinez M, Vazquez J J, Gijon B anos, Hernanz A.
               
               Neuropeptides and interleukin-6 in human joint inflammation relationship between intraarticular
               substance P and interleukin-6 concentrations. 
               Neurosci Lett. 
               1994; 
               170 
               251-254 
               
- 24 
               Courtright L J, Kuzell K C. 
               Sparing effect of neurological deficit and trauma on the course of adjuvant arthritis
               in the rat. 
               Ann Rheum Dis. 
               1965; 
               24 
               360-368 
               
- 25 
               Colpaert F C, Donnerer J, Lembeck F. 
               Effects of capsaicin on inflammation and on the substance P content of nervous tissues
               in rats with adjuvant arthritis. 
               Life Sci. 
               1983; 
               32 
               1827-1834 
               
- 26 
               Levine J D, Dardick S J, Roizen M F, Helms C, Basbaum A I. 
               Contribution of sensory afferents and sympathetic efferents to joint injury in experimental
               arthritis. 
               J Neurosci. 
               1986; 
               6 
               3423-3429 
               
- 27 
               Levine J D, Clark R, Devor M, Helms C, Moskowitz M A, Basbaum A I. 
               Intraneuronal substance P contributes to the severity of experimental arthritis. 
               Science. 
               1984; 
               226 
               547-549 
               
- 28 
               Levine J D, Moskowitz M A, Basbaum A I. 
               The contribution of neurogenic inflammation in experimental arthritis. 
               J Immunol. 
               1985; 
               135 
               843s-847s 
               
- 29 
               Basbaum A I, Levine J D. 
               The contribution of the nervous system to inflammation and inflammatory disease. 
               Can J Physiol Pharmacol. 
               1991; 
               69 
               647-651 
               
- 30 
               Donnerer J, Amann R, Lembeck F. 
               Neurogenic and non-neurogenic inflammation in the rat paw following chemical sympathectomy. 
               Neuroscience. 
               1991; 
               45 
               761-765 
               
- 31 
               Koltzenburg M, Kress M, Reeh P W. 
               The nociceptor sensitization by bradykinin does not depend on sympathetic neurons. 
               Neuroscience. 
               1992; 
               46 
               465-473 
               
- 32 
               Cambridge H, Brain S D. 
               The role of sympathetic nerves in bradykinin (BK) induced plasma extravasation in
               the rat knee joint. 
               Can J Physiol Pharmacol. 
               1994; 
               72 
               (Suppl 2) 
               38-40 
               
- 33 
               Donnerer J, Schuligoi R, Stein C. 
               Increased content and transport of substance P and calcitonin gene-related peptide
               in sensory nerves innervating inflamed tissue: evidence for a regulatory function
               of nerve growth factor in vivo. 
               Neuroscience. 
               1992; 
               49 
               693-698 
               
- 34 
               Kuraishi Y, Nanayama T, Ohno H, Fujii N, Otaka A, Yajima H, Satoh M. 
               Calcitonin gene-related peptide increases in the dorsal root ganglia of adjuvant arthritic
               rat. 
               Peptides. 
               1989; 
               10 
               447-452 
               
- 35 
               Marlier L, Poulat P, Rajaofetra N, Privat A. 
               Modifications of serotonin-, substance P- and calcitonin gene-related peptide-like
               immunoreactivities in the dorsal horn of the spinal cord of arthritic rats: a quantitative
               immunocytochemical study. 
               Exp Brain Res. 
               1991; 
               85 
               482-490 
               
- 36 
               Maleki J, LeBel A A, Bennett G J, Schwartzman R J. 
               Patterns of spread of complex regional pain syndrome, type I (reflex sympathetic dystrophy). 
               Pain. 
               2000; 
               88 
               259-266 
               
- 37 
               Pedersen-Bjergaard U, Nielsen L B, Jensen K, Edvinsson L, Jansen I, Olesen J. 
               Calcitonin gene-related peptide, neurokinin A and substance P: effects on nociception
               and neurogenic inflammation in human skin and temporal muscle. 
               Peptides. 
               1991; 
               12 
               333-337 
               
- 38 
               Wallengren J, Hakanson R. 
               Effects of substance P, neurokinin A and calcitonin gene-related peptide in human
               skin and their involvement in sensory nerve-mediated responses. 
               Eur J Pharmacol. 
               1987; 
               143 
               267-273 
               
- 39 
               Stewart J M, Getto C J, Neldner K, Reeve E B, Kirvoy W A, Zimmermann E. 
               Substance P and analgesia. 
               Naunyn Schmiedeberg's Arch. Pharmacol.. 
               1976; 
               262 
               784-785 
               
- 40 
               Kessler W, Kirchhoff C, Reeh P W, Handwerker H O. 
               Excitation of cutaneous afferent nerve endings in vitro by a combination of inflammatory
               mediators and conditioning effect of substance P. 
               Exp Brain Res. 
               1992; 
               91 
               467-476 
               
- 41 
               Herbert M K, Schmidt R F. 
               Sensitization of articular afferents to mechanical stimuli by substance P. 
               Inflamm Res. 
               2001; 
               50 
               275-282 
               
- 42 
               Culp W J, Ochoa J, Cline M, Dotson R. 
               Heat and mechanical hyperalgesia induced by capsaicin. Cross modality threshold modulation
               in human C nociceptors. 
               Brain. 
               1989; 
               112 
               1317-1331 
               
- 43 
               Cervero F, Gilbert R, Hammond R G, Tanner J. 
               Development of secondary hyperalgesia following non-painful thermal stimulation of
               the skin: a psychophysical study in man. 
               Pain. 
               1993; 
               54 
               181-189 
               
- 44 
               Kilo S, Schmelz M, Koltzenburg M, Handwerker H O. 
               Different patterns of hyperalgesia induced by experimental inflammation in human skin. 
               Brain. 
               1994; 
               117 
               385-396 
               
- 45 
               Coderre T J, Melzack R. 
               Cutaneous hyperalgesia: contributions of the peripheral and central nervous systems
               to the increase in pain sensitivity after injury. 
               Brain Res. 
               1987; 
               404 
               95-106 
               
- 46 
               Baumann T K, Simone D A, Shain C N, LaMotte R H. 
               Neurogenic hyperalgesia: the search for the primary cutaneous afferent fibers that
               contribute to capsaicin-induced pain and hyperalgesia. 
               J Neurophysiol. 
               1991; 
               66 
               212-227 
               
- 47 
               LaMotte R H, Shain C N, Simone D A, Tsai E F. 
               Neurogenic hyperalgesia: psychophysical studies of underlying mechanisms. 
               J Neurophysiol. 
               1991; 
               66 
               190-211 
               
- 48 
               LaMotte R H, Lundberg L E, Torebjörk H E. 
               Pain, hyperalgesia and activity in nociceptive C units in humans after intradermal
               injection of capsaicin. 
               J Physiol Lond. 
               1992; 
               448 
               749-764 
               
- 49 
               Simone D A, Sorkin L S, Oh U, Chung J M, Owens C, LaMotte R H, Willis W D. 
               Neurogenic hyperalgesia: central neural correlates in responses of spinothalamic tract
               neurons. 
               J Neurophysiol. 
               1991; 
               66 
               228-246 
               
- 50 
               Torebjörk H E, Lundberg L E, LaMotte R H. 
               Central changes in processing of mechanoreceptive input in capsaicin-induced secondary
               hyperalgesia in humans. 
               J Physiol Lond. 
               1992; 
               448 
               765-780 
               
- 51 
               Reeh P W, Kocher L, Jung S. 
               Does neurogenic inflammation alter the sensitivity of unmyelinated nociceptors in
               the rat?. 
               Brain Res. 
               1986; 
               384 
               42-50 
               
- 52 
               Meyer R A, Campbell J N, Raja S N. 
               Antidromic nerve stimulation in monkey does not sensitize unmyelinated nociceptors
               to heat. 
               Brain Res. 
               1988; 
               441 
               168-172 
               
- 53 
               Ray B S, Wolff H G. 
               Experimentel studies on headache. Pain-sensitive structures of the head and their
               significance in headache. 
               Arch Surg. 
               1940; 
               41 
               813-856 
               
- 54 Moskowitz M A, Lee W S, Cutrer F M. 
               Sensory neuropeptides in migraine. Geppetti P, Holzer P (eds) Neurogenic inflammation. CRC Press, Boca Raton New York
               London Tokyo 1996: 187-199 
- 55 
               Buzzi M G, Bonamini M, Moskowitz M A. 
               Neurogenic model of migraine. 
               Cephalalgia. 
               1995; 
               15 
               277-280 
               
- 56 
               May A, Shepheard S L, Knorr M, Effert R, Wessing A, Hargreaves R J, Goadsby P J, Hiener H C.
               
               Retinal plasma extravasation in animals but not in humans: implications for the pathophysiology
               of migraine. 
               Brain. 
               1998; 
               121 
               1231-1237 
               
- 57 
               May A, Goadsby P J. 
               Substance P receptor antagonists in the therapy of migraine. 
               Expert Opin Investig Drugs. 
               2001; 
               10 
               673-678 
               
- 58 
               Escott K J, Beattie D T, Connor H E, Brain S D. 
               Trigeminal ganglion stimulation increases facial skin blood flow in the rat: a major
               role for the calcitonin gene-related peptide. 
               Brain Res. 
               1995; 
               669 
               93-99 
               
- 59 
               Messlinger K, Hanesch U, Kurosawa M, Pawlak M, Schmidt R F. 
               Calcitonin gene related peptide released from dural nerve fibers mediates increase
               of meningeal blood flow in the rat. 
               Can J Physiol Pharmacol. 
               1995; 
               73 
               1020-1024 
               
- 60 
               Feuerstein G, Wilette R, Aiyar N. 
               Clinical perspectives of calcitonin gene related peptide pharmacology. 
               Can J Physiol Pharmacol. 
               1995; 
               73 
               1070-1074 
               
- 61 
               O'Connor T P, van der Kooy D. 
               Pattern of intracranial and extracranial projections of trigeminal ganglion cells. 
               J Neurosci. 
               1986; 
               6 
               2200-2207 
               
- 62 
               Phebus L A, Johnson K W, Stengel P W, Lobb K L, Nixon J A, Hipskind P A. 
               The non-peptide receptor antagonist LY 303870 inhibits neurogenic dural infalmmation
               in guinea pigs. 
               Life Sci. 
               1997; 
               60 
               1553-1561 
               
- 63 
               Shepheard S L, Williamson D J, Hill R G, Hargreaves R J. 
               The non-peptide neurokinin-1 receptor antagonist, RP 67580, blocks neurogenic plasma
               extravasation in the dura mater of rats. 
               Br J Pharmacol. 
               1993; 
               108 
               11-12 
               
- 64 
               Lee W S, Moussaoui S M, Moskowitz M A. 
               Oral or parenteral non-peptide NK1 receptor antagonist RpR 100,893 blocks neurogenic plasma extravasation within guinea-pig
               dura mater and conjunctiva. 
               Br J Pharmacol. 
               1994; 
               112 
               920-924 
               
- 65 
               Buzzi M G, Carter W B, Shimizu T, Heath H, Moskowitz M A. 
               Dihydroergotamine and sumatriptan attenuate levels of CGRP in plasma in rat superior
               sagittal sinus during electrical stimulation of the trigeminal anglion. 
               Neuropharmacology. 
               1991; 
               30 
               1193-1200 
               
- 66 
               Goadsby P J, Edvinsson L, Ekam R. 
               Release of vasoactive peptides in the extracerebral circulation in humans and the
               cat during activation of the trigeminovascular system. 
               Ann Neurol. 
               1993; 
               23 
               193-196 
               
- 67 
               Buzzi M G, Moskowitz M A. 
               The antimigraine drug, sumatriptan (GR43175), selectively blocks neurogenic plasma
               extravasation from blood vessels in dura mater. 
               Br J Pharmacol. 
               1990; 
               99 
               202-206 
               
- 68 
               Lee W S, Moskowitz M A. 
               Conformationally restricted sumatriptan analogues, CP-122,288 and CP-122,638 exhibit
               enhanced potency against neurogenic inflammation in dura mater. 
               Brain Res. 
               1993; 
               626 
               303-305 
               
- 69 
               Gupta P, Brown D, Butler P, Ellis P, Grayson K L, Land G C, Macor J E, Robson S F,
               Wythes M J, Shepperson N B. 
               The in vivo pharmacological profile of a 5-HT1 receptor agonist, CP-122,288, a selective
               inhibitor of neurogenic inflammation. 
               Br J Pharmacol. 
               1995; 
               116 
               2385-2390 
               
- 70 
               Cutrer F M, Moskowitz M A. 
               Wolff Award 1996. The actions of valproate and neurosteroids in a model of trigeminal
               pain. 
               Headache. 
               1996; 
               36 
               579-585 
               
- 71 
               Brändli P, Löffler B M, Breu V, Osterwalder R, Maire J P, Clozel M. 
               Role of endothelin in mediating neurogenic plasma extravasation in rat dura mater. 
               Pain. 
               1995; 
               64 
               315-322 
               
- 72 
               Ebersberger A, Schaible H G, Averbeck B, Richter F. 
               Is there a correlation between spreading depression, neurogenic inflammation, and
               nociception that might cause migraine headache?. 
               Ann Neurol. 
               2001; 
               49 
               7-13 
               
- 73 
               Lauritzen M. 
               Pathophysiology of the migraine aura: the spreading depression theory. 
               Brain. 
               1994; 
               117 
               199-210 
               
- 74 
               Olesen J, Larsen B, Lauritzen M. 
               Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in
               classic migraine. 
               Ann Neurol. 
               1981; 
               9 
               344-352 
               
- 75 
               Leao A AP. 
               Spreading depression of activity in the cerebral cortex. 
               J Neurophysiol. 
               1944; 
               7 
               359-390 
               
- 76 
               Gardner-Medwin A R. 
               Possible roles of vertebrate neuroglia in potassium dynamics, spreading depression
               and migraine. 
               J Exp Biol. 
               1981; 
               95 
               111-127 
               
- 77 
               Moskowitz M A, Macfarlane R. 
               Neurovascular and molecular mechanisms in migraine headaches. 
               Cerebrovasc Brain Metab Rev. 
               1993; 
               5 
               159-177 
               
- 78 
               Roon K I, Olesen J, Diener H C, Ellis P, Hettiarachchi J, Poole P H, Christianssen I,
               Kleinermans D, Kok J G, Ferrari M D. 
               No acute antimigraine effect of CP-122,288, a highly potent inhibitor of neurogenic
               inflammation: Results of two randomized, double-blind, placebo controlled clinical
               trials. 
               Ann Neurol. 
               2000; 
               47 
               238-241 
               
- 79 
               Herbert M K, Holzer P. 
               Warum versagen Substanz P (NK1)-Rezeptoren in der Schmerztherapie?. 
               Anaesthesist. 
               2002; 
               51 
               308-319 
               
- 80 
               Szolcsanyi J, Bartho L. 
               Capsaicin-sensitive non-cholinergic excitatory innervation of the guinea-pig tracheobronchial
               smooth muscle. 
               Neurosci Lett. 
               1982; 
               34 
               247-251 
               
- 81 
               Szolcsanyi J. 
               Tetrodotoxin-resistant noncholinergic neurogenic contraction evoked by capsaicinoids
               and piperine on the guinea-pig trachea. 
               Neurosci Lett. 
               1983; 
               42 
               83-88 
               
- 82 
               Lundberg J M, Saria A. 
               Bronchial smooth muscle contraction induced by stimulation of capsaicin-sensitive
               sensory neurons. 
               Acta Physiol Scand. 
               1982; 
               116 
               473-476 
               
- 83 
               Lundberg J M, Saria A. 
               Capsaicin-induced desensitization of airway mucosa to cigarette smoke, mechanical
               and chemical irritants. 
               Nature. 
               1983; 
               302 
               251-253 
               
- 84 
               Yamawaki I, Tamaoki J, Takeda Y, Nagai A. 
               Inhaled cromoglycate reduces airway neurogenic inflammation via tachykinin antagonism. 
               Res Commun Mol Pathol Pharmacol. 
               1997; 
               98 
               265-272 
               
- 85 
               Aizawa H, Koto H, Nakano H, Inoue H, Matsumoto K, Takata S, Shigyo M, Hara N. 
               The effect of a specific tachykinin receptor antagonist FK-224 on ozone-induced airway
               hyperresponsiveness and inflammation. 
               Respirology. 
               1997; 
               2 
               261-265 
               
- 86 
               Delay-Goyet P, Satoh H, Lundberg J M. 
               Relative involvement of substance P and CGRP mechanisms in antidromic vasodilation
               in the rat skin. 
               Acta Physiol Scand. 
               1992; 
               146 
               537-538 
               
- 87 
               Quartara L, Maggi C A. 
               The tachykinin NK1 receptor. Part II: distribution and pathophysiological roles. 
               Neuropeptides. 
               1998; 
               32 
               1-49 
               
- 88 
               Scheerens H, Buckley T L, Muis T, van Loveren H, Nijkamp F P. 
               The involvement of sensory neuropeptides in toluene diisocyanate-induced tracheal
               hypereactivity in the mouse airways. 
               Br J Pharmacol. 
               1996; 
               119 
               1655-1671 
               
- 89 
               Lundberg J M. 
               Tachykinins, sensory nerves, and asthma - an overview. 
               Can J Physiol Pharmacol. 
               1995; 
               73 
               980-994 
               
- 90 
               Barnes P J. 
               Overview of neural mechanisms in asthma. 
               Pulm Pharmacol. 
               1995; 
               8 
               151-159 
               
- 91 
               Barnes P J. 
               Neuroeffector mechanisms: The interface between inflammation and neuronal responses. 
               J Allergy Clin Immunol. 
               1996; 
               98 
               S73-S83 
               
- 92 
               Barnes P J. 
               Neurogenic inflammation in the airways. 
               Respir Physiol. 
               2001; 
               125 
               145-154 
               
- 93 
               Rumsey W L, Aharanoy D, Bialecki R A, Abbott B M, Barthlow H G, Caccese R, Ghanekar S,
               Lengel D, McCarthy M, Wenrich B, Undem B, Ohnmacht C, Shenvi A, Albert J S, Brown F,
               Bernstein P R, Russell K. 
               Pharmacological characterization of ZD6021: A novel, orally active antagonist of the
               tachykinin receptors. 
               J Pharmacol Exp Ther. 
               2001; 
               298 
               307-315 
               
- 94 
               Tampo T, Nabe T, Yasui K, Kamiki T, Kohno S. 
               Participation of neuropeptides in antigen-induced contraction of guinea pig bronchi
               via NK2 but not NK1 receptor stimulation. 
               Pharmacology. 
               2000; 
               60 
               169-174 
               
- 95 
               Lundblad L, Anggard A, Lundberg J M. 
               Effects of antidromic trigeminal nerve stimulation in relation to parasympathetic
               vasodilatation in the cat nasal mucosa. 
               Acta Physiol Scand. 
               1983; 
               119 
               7-13 
               
- 96 
               Asakura K, Shirasaki H, Narita S, Kojima T, Kautura A. 
               Study on the dye leakage response of nasal mucosa following topical capsaicin challenge
               in guinea-pigs. 
               Acta Otolaryngol. 
               1992; 
               112 
               545-551 
               
- 97 
               Petterson G, Malm L, Ekman R, Hakanson R. 
               Capsaicin evokes secretion of nasal fliud and depletes substance P and CGRP from the
               nasal mucosa in the rat. 
               Br J Pharmacol. 
               1989; 
               98 
               930-936 
               
- 98 
               Evangelista S, Paoli S, Giachetti A, Manzini S. 
               Involvement of tachykinin NK1 receptors in plasma protein extravasation induced by tachykinins in the guinea-pig
               upper airways. 
               Neuropeptides. 
               1997; 
               31 
               65-70 
               
- 99 
               Geppetti P, Fusco B M, Marabini S, Maggi C A, Fanciullacci M, Sicuteri F. 
               Secretion, pain and sneezing induced by application of capsaicin to the nasal mucosa
               in man. 
               Br J Pharmacol. 
               1988; 
               93 
               503-514 
               
- 100 
               Philip G, Baroody F M, Proud D, Naclerio R M, Togias A G. 
               The human nasal response to capsaicin. 
               J Allergy Clin Immunol. 
               1994; 
               94 
               1035-1045 
               
- 101 
               Greiff L, Svensson C, Andersson M, Persson C G. 
               Effects of topical capsaicin in seasonal allergic rhinitis. 
               Thorax. 
               1995; 
               50 
               225-229 
               
- 102 
               Sanico A M, Satsuki A, Proud D, Togias A. 
               Dose-dependent effects of capsaicin nasal challenge: In vivo evidence of human airway
               neurogenic inflammation. 
               J Allergy Clin Immunol. 
               1997; 
               100 
               632-641 
               
- 103 
               Baraniuk J N, Lundgren J D, Okayama M, Merida M, Kaliner M A. 
               Substance P and neurokinin A in human nasal mucosa. 
               Am J Resp Cell Mol Biol. 
               1991; 
               4 
               228-236 
               
- 104 
               Joos G F, Kips J C, Peleman R A, Pauwels R A. 
               Tachykinin antagonists and the airways. 
               Arch Int Pharmacodyn. 
               1995; 
               329 
               205-219 
               
- 105 
               Rogers D F. 
               Reflexly running noses: neurogenic inflammation in the nasal mucosa. 
               Clin Exp Allergy. 
               1996; 
               26 
               365-367 
               
- 106 
               Baraniuk J N, Kaliner M. 
               Neuropeptides and nasal secretion. 
               Am J Physiol. 
               1991; 
               261 
               L223-L235 
               
- 107 
               Mantyh C R, Gates T S, Zimmerman R P, Welton M L, Passaro E P, Vigna S R, Magio J E,
               Kruger L, Mantyh P W. 
               Receptor binding sites for substance P, but not substance K or neuromedin K, are expressed
               in high concentrations by arterioles, venules, and lymph nodules in surgical specimens
               obtained from patients with ulcerative colitis and Crohn disease. 
               Proc Natl Acad Sci USA. 
               1988; 
               85 
               3235-3239 
               
- 108 
               Swain M G, Agro A, Blennerhassett P, Stanisz A, Collins S M. 
               Increased levels of substance P in the myenteric plexus of trichinella-infected rats. 
               Gastroenterology. 
               1992; 
               102 
               1913-1919 
               
- 109 
               Pothoulakis C, Castagliuolo I, LaMont J T, O'Keane J C, Snider R M, Leeman S E. 
               CP-96,345, a substance P antagonist, inhibits rat intestinal responses to Clostridium
               difficile A but not cholera toxin. 
               Proc Natl Acad Sci USA. 
               1995; 
               91 
               947-951 
               
- 110 
               McVey D C, Vigna S R. 
               The capsaicin VR1 receptor mediates substance P release in toxin A-induced enteritis
               in rats. 
               Peptides. 
               2001; 
               22 
               1439-1446 
               
- 111 
               Croci T, Landi M, Edmonds X, Le Furg G, Maffrand J P, Manara L. 
               Role of tachykinins in castor oil induced diarrhea in rats. 
               Br J Pharmacol. 
               1997; 
               121 
               375-380 
               
- 112 
               Stucchi A F, Shofer S, Leeman S, Materne O, Beer E, McClung A, Shebani K, Moore F,
               O'Brien M, Becker J M. 
               NK-1 antagonist reduces colonic inflammation and oxidative stress in dextran sulfate-induced
               colitis in rats. 
               Am J Physiol Gastrointest Liver Physiol. 
               2000; 
               279 
               G1298-G1306 
               
- 113 
               Sann H, Dux M, Schemann M, Jancso G. 
               Neurogenic inflammation in the gastrointestinal tract of the rat. 
               Neurosci Lett. 
               1996; 
               219 
               147-130 
               
- 114 
               Yiangou Y, Facer P, Dyer N HC, Chan C LH, Knowles C, Williams N S,      Anand P. 
               Vanilloid receptor 1 immunoreactivity in inflamed human bowel. 
               Lancet. 
               2001; 
               357 
               1338-1339 
               
- 115 
               Sturiale S, Barbara G, Qiu B, Figini M, Geppetti P, Gerard N, Gerard C, Grady E F,
               Bunnett N W, Collins S M. 
               Neutral endopeptidase (EC 3.4.24.11) terminates colitis by degrading substance P. 
               Proc Natl Acad Sci USA. 
               1999; 
               96 
               11653-11658 
               
- 116 
               Talmage E K, Pouliot W A, Cornbrooks E B, Mawe G M. 
               Transmitter diversity in ganglion cells of the guinea pig gallbladder: An immunohistochemical
               study. 
               J Comp Neurol. 
               1992 ; 
               317 
               45-56 
               
- 117 
               Mawe G, Gershon M D. 
               Structure, afferent innervation, and transmitter content of ganglia of the guinea
               pig gallbladder: Relationship to the enteric nervous system. 
               J Comp Neurol. 
               1989 ; 
               283 
               374-390 
               
- 118 
               de Giorgio R, Zittel T T, Parodi J E, Becker J M, Brunicardi F C, Go V LW, Brecha N C,
               Sternini C. 
               Peptide immunoreactivities in the ganglionated olexuses and nerve fibres innervating
               the human gallbladder. 
               J Auton Nerv Syst. 
               1995; 
               51 
               37-47 
               
- 119 
               Jivegard L, Thornell E, Svanvik J. 
               Fluid secretion by gallblader mucosa in experimental cholecystitis is influenced by
               intramural nerves. 
               Dig Dis Sci. 
               1987; 
               32 
               389-1394 
               
- 120 
               Prystowsky J B, Rege R V. 
               Neurogenic inflammation in cholecystitis. 
               Dig Dis Sci. 
               1997; 
               42  
               1489-1494 
               
- 121 Maggi C A. 
               The dual, sensory and „efferent” function of the capsaicin-sensitive primary sensory
                  neurons in the urinary bladder and urethra. Maggi CA (ed) Nervous control of the urogenital system. Hardwood Publisher 1993:
               383-422 
- 122 
               Lecci A, Maggi C A. 
               Tachykinins as modulators of the micturition reflex in the central and peripheral
               nervous system. 
               Regul Peptides. 
               2001; 
               101 
               1-18 
               
- 123 
               Maggi C A, Patacchini R, Rovero P, Giachetti A. 
               Tachykinin receptors and tachykinin receptor antagonists. 
               J Auton Pharmacol. 
               1993; 
               13 
               23-93 
               
- 124 
               Ahluwalia A, Giuliani S, Scotland R, Maggi C A. 
               Ovalbumin-induced neurogenic inflammation in the bladder of sensitized rats. 
               Br J Pharmacol. 
               1998; 
               124 
               190-196 
               
- 125 
               de Ridder D, Chandiramani V, Dasgupta P, van Poppel H, Baert L, Fowler C J. 
               Intravesical capsaicin as a treatment for refractory detrusor hyperreflexia: A dual
               center study with long-term followup. 
               J Urol. 
               1997; 
               158 
               2087-2092 
               
- 126 
               Cruz F, Guimaraes M, Silva C, Rio M E, Coimbra A, Reis M. 
               Desensitization of bladder sensory fibers by intravesical capsaicin has long lasting
               clinical and urodynamic effects on patients with hyperactive or hypersensitive bladder
               dysfunction. 
               J Urol. 
               1997; 
               157 
               585-589 
               
- 127 
               Elbadawi A. 
               Interstitial cystitis: a critique of current concepts with a new proposal for pathologic
               diagnosis and pathogenesis. 
               Urology. 
               1997; 
               49 
               (Suppl 5A) 
               14-40 
               
- 128 
               Theoharides T C, Kempuraj D, Sant G R. 
               Mast cell involvement in interstitial cystitis: a review of human and experimental
               evidence. 
               Urology. 
               2001; 
               57 
               (Suppl) 
               47-55 
               
- 129 
               Wesselmann U. 
               Neurogenic inflammation and chronic pelvic pain. 
               World J Urol. 
               2001; 
               19 
               180-185 
               
- 130 
               Scholzen T, Armstrong C A, Bunnett N W, Luger T A, Olerud J E, Ansel J C. 
               Neuropeptides in the skin: interactions between the neuroendocrine and skin immune
               systems. 
               Exp Dermatol. 
               1998; 
               7 
               81-96 
               
- 131 
               Johansson O, Virtanen M, Hilliges M. 
               Histaminergic nerves demonstrated in the skin. A new direct mode of neurogenic inflammation?. 
               Exp Dermatol. 
               1995; 
               4 
               93-96 
               
- 132 
               Brzezinska-Blaszczyk E, Zalewska A. 
               In vitro reactivity of mast cells in urticaria pigmentosa skin. 
               Arch Dermatol Res. 
               1998; 
               290 
               14-17 
               
- 133 Brain S M. 
               Sensory neuropeptides in the skin. Geppetti P, Holzer P (eds) Neurogenic inflammation. CRC Press, Boca Raton New York
               London Tokyo 1996: 229-244 
- 134 
               Liang Y, Jacobi H H, Reimert C M, Haak-Frendscho M, Marcusson J A,  Johansson O. 
               CGRP-immunoreactive nerves in prurigo nodularis - an exploration of neurogenic inflammation. 
               J Cutan Pathol. 
               2000; 
               27 
               359-366 
               
- 135 
               Rossi R, Johannson O. 
               Cutaneous innervation and the role of neuronal peptides in cutaneous inflammation:
               a minireview. 
               Eur J Dermatol. 
               1998; 
               8 
               299-306 
               
- 136 
               Maggi C A. 
               Tachykinins and CGRP as co-transmitters released from peripheral endings of sensory
               nerves. 
               Prog Neurobiology. 
               1995; 
               45 
               1-98 
               
- 137 
               Kjartansson J, Dalsgaard C J, Jonsson C E. 
               Decreased survival of experimental critical flaps in rats after sensory denervation
               with capsaicin. 
               Plast Reconstr Surg. 
               1987; 
               79 
               218-221 
               
- 138 
               Khalil Z, Helme R. 
               Sensory peptides as neuromodulators of wound healing in aged rats. 
               J Gerontology. 
               1996; 
               51A  
               B354-B361 
               
- 139 
               Gherardini G, Gürlek A, Milner S M, Matarasso A, Evans G RD, Jernbeck J, Lundeberg .
               
               Calcitonin gene-related peptide improves skin flap survival and tissue inflammation. 
               Neuropeptides. 
               1998; 
               32 
               269-273 
               
- 140 
               Németh J, Szilvássy Z, Thán M, Oroszi G, Sári R, Szolcsányi J. 
               Decreased sensory neuropeptide release from trachea of rats with streptozotocin-induced
               diabetes. 
               Eur J Pharmacol. 
               1999; 
               369 
               221-224 
               
- 141 
               Walmsley D, Wiles P G. 
               Early loss of neurogenic inflammation in the human diabetic foot. 
               Clin Sci Colch. 
               1991; 
               80 
               605-610 
               
- 142 
               Gyorfi A, Feazekas A, Feher E, Ender F, Rosivall L. 
               Effects of streptocotozin-induced diabetes on neurogenic inflammation of gingivomusocal
               tissue in rat. 
               J Periodontal Res. 
               1996; 
               31 
               249-255 
               
- 143 
               Forst T, Pfutzner A, Kunt T, Pohlmann T, Schenk U, Bauersachs R, Kustner E, Beyer J.
               
               Clin Sci. 
               Clin Sci. 
               1998; 
               94 
               255-261 
               
- 144 
               Gamse R, Jancso G. 
               Reduced neurogenic inflammation in streptozotocin-diabetic rats due to microvascular
               changes but not to substance P depletion. 
               Eur J Pharmacol. 
               1985; 
               118 
               175-180 
               
- 145 
               Diemel L T, Stevens E J, Willars G B, Tomlinson D R. 
               Depletion of substance P and calcitonin gene-related peptide in sciatic nerve of rats
               with experimental diabetes; effects of insulin and aldose reductase inhibition. 
               Neurosci Lett. 
               1992; 
               137 
               253-256 
               
- 146 
               Németh J, Thán M, Sári R, Peitl B, Oroszi G, Farkas B, Szolcsányi J, Szilvássy Z.
               
               Impairment of neurogenic inflammation and anti-inflammatory responses in diabetic
               rats. 
               Eur J Pharmacol. 
               1999; 
               386 
               83-88 
               
- 147 Ziche M. 
               Sensory neuropeptides: mitogenic and trophic functions. Geppetti P, Holzer P (eds) Neurogenic inflammation. CRC Press, Boca Raton New York
               London Tokyo 1996: 253-263 
- 148 
               Fan T P, Hu D E, Guard S, Gresham G A, Watling K J. 
               Stimulation of angiogenesis by substance P and interleukin-1 in the rat and its inhibition
               by interleukin-1 or interleukin-1 receptor antagonists. 
               Br J Pharmacol. 
               1993; 
               110 
               43-49 
               
- 149 
               Ziche M, Morbidelli L, Masini E, Amerini S, Granger H J, Maggi C A,   Geppetti P,
               Ledda F. 
               Nitric oxide mediates angiogenesis in vivo and endothelial cell growth and migration
               in vitro promoted by subtance P. 
               J Clin Invest. 
               1994; 
               94 
               2036-2044 
               
Priv.-Doz. Dr. med. Michael K. Herbert
            Klinik für Anaesthesiologie der Universität Würzburg
            
            
            
Josef-Schneider-Straße 2
            
            97080 Würzburg
            
            Email: mherbert@anaesthesie.uni-wuerzburg.de