Article

Neuronal markers in allergic rhinitis: expression and correlation with sensory testing.

Peripheral Neuropathy Unit, Hammersmith Hospital, Faculty of Medicine, Imperial College London, London, UK.
The Laryngoscope (impact factor: 1.75). 09/2007; 117(9):1519-27. DOI:10.1097/MLG.0b013e3180ca7846 pp.1519-27
Source: PubMed

ABSTRACT Although the role of immunoglobulin E-mediated hypersensitivity reactions in allergic rhinitis is well known, the relative contribution of sensory nerves to the symptoms of rhinitis is uncertain. This study looked at the level of specific neuronal markers including the nerve marker protein gene product 9.5 (PGP 9.5), sensory and autonomic neuropeptides, the capsaicin/heat receptor TRPV1, and nerve growth factor (NGF) in patients with allergic rhinitis and controls and their correlation with nasal sensitivity.
Forty patients (23 controls, 17 rhinitis) having nasal surgery were recruited. Nasal sensitivity was tested using graded monofilaments. Inferior turbinate biopsies were collected and studied using immunohistology, with measurement of nerve fibers by direct observation or computerized image analysis.
Nerve fibers (PGP 9.5) in the epithelium, subepithelium, and glandular/vascular regions were significantly increased in allergic rhinitis (P=.037, <.01, and .04, respectively), as were subepithelial and glandular/vascular fibers immunoreactive for neuropeptide substance P (P=.04 subepithelium; .02 glandular/vascular) and neuropeptide tyrosine (P<.01 glandular/vascular), markers for sensory and sympathetic nerves, respectively. TRPV1 epithelial fiber counts were higher in rhinitis, but this was not statistically significant. Epithelial NGF immunoreactivity (% area) was significantly increased in rhinitis (P=.027). Nasal sensitivity was correlated significantly with PGP 9.5 subepithelial innervation (control touch P=.023, irritation P=.046; rhinitis touch P=.042, irritation P=.043). A correlation was also observed between epithelial NGF and subepithelial PGP 9.5 innervation, which included all subjects (P=.044).
The increased number and specific phenotypical changes of sensory nerves may play a role in nasal hypersensitivity and provide new targets for the treatment of rhinitis.

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Keywords

17 rhinitis
 
allergic rhinitis
 
autonomic neuropeptides
 
capsaicin/heat receptor TRPV1
 
computerized image analysis
 
epithelial NGF
 
Epithelial NGF immunoreactivity
 
immunoglobulin E-mediated hypersensitivity reactions
 
Inferior turbinate biopsies
 
nasal hypersensitivity
 
nasal sensitivity
 
nerve growth factor
 
nerve marker protein gene product 9.5
 
neuropeptide substance P
 
sensory nerves
 
specific neuronal markers
 
specific phenotypical changes
 
subepithelial
 
subepithelial PGP 9.5 innervation
 
TRPV1 epithelial fiber counts