Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-08-2009 | Rhinology

Allergic and idiopathic rhinitis: an ultrastructural study

Authors: Stephan Knipping, H. J. Holzhausen, A. Riederer, T. Schrom

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2009

Abstract

Nasal hyperreactivity is one of the most important underlying mechanisms in both allergic (AR) and idiopathic rhinitis (IR). In order to study the pathomorphological changes in this entity, tissue samples from patients with AR, IR, and from patients without chronic inflammation were taken during nasal surgery. Primary antibodies against Substance P (SP), calcitonin gene-related peptide (CGRP), and endothelial nitric oxide synthases (NOS III) were applied and the immunocomplexes were visualized by immunocytochemistry. The nasal mucosa of patients with AR and IR showed similarities on the ultrastructural level. Neurogenic inflammation was indicated by a strong innervation pattern with sensory nerve fibers containing SP and CGRP. We could show that extensive edema and cellular infiltration might be characteristic for AR. On other hand there was no evidence of eosinophilic or NO involvement in IR. Finally, on the ultrastructural level, AR and IR showed many similarities. Based on these findings anti-inflammatory therapy modalities could be recommended for both types of rhinitis.

Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma (ARIA) 2008 update. Allergy 63(Suppl. 86):18–160

Bousquet J, Fokkens W, Burney P et al (2008) Important research questions in allergy and related diseases: nonallergic rhinitis: a GA²LEN paper. Allergy 63:842–853. doi:10.1111/j.1398-9995.2008.01715.x CrossRefPubMed

Corey JP, Houser SM, Ng BA (2000) Nasal congestion: a review of its aetiology, evaluation, and treatment. ENT 79(9):690–702PubMed

Van Rijswijk JB, Blom HM, Fokkens WJ (2005) Idiopathic rhinitis, the ongoing quest. Allergy 60:1471–1481. doi:10.1111/j.1398-9995.2005.00975.x CrossRefPubMed

Lal D, Corey JP (2004) Vasomotor rhinitis update. Curr Opin Otolaryngol Head Neck Surg 12(3):243–247. doi:10.1097/01.moo.0000122310.13359.79 CrossRefPubMed

Settipane RA (2003) Rhinitis: a dose of epidemiological reality. Allergy Asthma Proc 24:147–154PubMed

Bachert C (2004) Persistent rhinitis–allergic or nonallergic? Allergy 59(Suppl 76):11–15. doi:10.1111/j.0108-1675.2004.00389.x CrossRefPubMed

Riechelmann H (1998) Etagenwechsel und Folgeerkrankungen der allergischen Rhinitis. Laryngorhinootologie 77:646–649. doi:10.1055/s-2007-997056 CrossRef

Fang SY, Shen CL (1998) Neuropeptide innervation and neuroendocrine cells in allergic rhinitis and chronic hypertrophic rhinitis. Clin Exp Allergy 28:228–232. doi:10.1046/j.1365-2222.1998.00204.x CrossRefPubMed

11.

Heppt W, Preiser C, Cryer A, Dinh QT, Zweng M, Witt C, Fischer A, Groneberg DA (2002) Innervation of human nasal mucosa in environmentally triggered hyperreflectoric rhinitis. J Occup Environ Med 44:924–929. doi:10.1097/00043764-200210000-00011 CrossRefPubMed

12.

Elwany S, Bumsted R (1987) Ultrastructural observations on vasomotor rhinitis. ORL 49:199–205CrossRefPubMed

13.

Gianessi F, Fattori B, Ursino F et al (2003) Ultrastructural and ultracytochemical study of the human nasal respiratory epithelium in vasomotor rhinitis. Acta Otolaryngol 123:943–949CrossRef

14.

Numata T, Konno A, Hasegawa S et al (1999) Pathophysiological features of the nasal mucosa in patients with idiopathic rhinitis compared to allergic rhinitis. Int Arch Allergy Immunol 119:304–313. doi:10.1159/000024208 CrossRefPubMed

15.

Sanico AM, Togias A (1998) Noninfectious, nonallergic rhinitis NINAR: considerations on possible mechanisms. Am J Rhinol 12:65–72. doi:10.2500/105065898782103043 CrossRefPubMed

16.

Karlsson U, Schultz RL (1965) Fixation of the central nervous system for electron microscopy by aldehyde perfusion. J Ultrastruct Res 12:160–186. doi:10.1016/S0022-5320(65)80014-4 CrossRefPubMed

17.

Powe DG, Jagger C, Kleinjan A, Carney AS, Jenkins D, Jones NS (2003) Entopy: localized mucosal allergic disease in the absence of systemic responses for atopy. Clin Exp Allergy 33:1374–1379. doi:10.1046/j.1365-2222.2003.01737.x CrossRefPubMed

18.

Fokkens W, Lund V, Bachert C et al (2005) EAACI position paper on rhinosinusitis and nasal polyps. Allergy 60:583–601. doi:10.1111/j.1398-9995.2005.00830.x CrossRefPubMed

19.

Chaen T, Watanabe N, Mogi G, Mori K, Takeyama M (1993) Substance P and Vasoactive Intestinal Peptide in nasal secretions and plasma from patients with nasal allergy. Ann Otol Rhinol Laryngol 102:16–21CrossRefPubMed

20.

Undem BJ, Kajekar R, Hunter DD, Myers AC (2000) Neural integration and allergic disease. J Allergy Clin Immunol 106:213–220. doi:10.1067/mai.2000.110153 CrossRef

21.

Tai CF, Baraniuk JN (2002) Upper airway neurogenic mechanisms. Curr Opin Allergy Clin Immunol 2(1):11–19. doi:10.1097/00130832-200202000-00003 CrossRefPubMed

22.

Knipping S, Riederer A (2007) Basic autonomic and sensory innervation pattern of human nasal mucosa. In: Kaneko M (ed) Sympathetic nervous system research developments, 1st edn. Nova Science Publishers, New York, pp 185–212

23.

Turner PJ, Foreman JC (1999) Hyperresponsiveness in the human nasal airway: new targets for the treatment of allergic airway disease. Mediators Inflamm 8:133–146. doi:10.1080/09629359990469 CrossRefPubMedPubMedCentral

24.

Baraniuk JN, Petrie KN, Uyenphuong L et al (2004) Neuropathology in rhinosinusitis. Am J Respir Crit Care Med 171:5–11. doi:10.1164/rccm.200403-357OC CrossRefPubMed

25.

Fajac I, Braunstein G, Ickovic MR, Lacronique J, Frossard N (1995) Selective recruitment of eosinophils by Substance P after repeated allergen exposure in allergic rhinitis. Allergy 50(12):970–975. doi:10.1111/j.1398-9995.1995.tb02509.x CrossRefPubMed

26.

Sato M, Fukuyama N, Sakai M, Nakazawa H (1998) Increased nitric oxide in nasal lavage fluid and nitrotyrosine formation in nasal mucosa-indices for severe perennial nasal allergy. Clin Exp Allergy 28:597–605. doi:10.1046/j.1365-2222.1998.00270.x CrossRefPubMed

27.

Kang BH, Chen SS, Jou LS, Weng PK, Wang HW (2000) Immunolocalization of inducible nitric oxide synthase and 3-nitrotyrosine in the nasal mucosa of patients with rhinitis. Eur Arch Otorhinolaryngol 257(5):242–246. doi:10.1007/s004050050231 CrossRefPubMed

28.

Olthoff A, Rohrbach S, Faber M, Gotz W, Laskawi R (2002) Neuronal nitric oxide synthase immunoreactivity in the nasal mucosa of patients with idiopathic and allergic rhinitis. ORL Relat 64(Spec):180–185. doi:10.1159/000058022 CrossRef

29.

Kawamoto H, Takumida M, Takeno S, Watanabe H, Fukushima N, Yajin K (1998) Localization of nitric oxide synthase in human nasal mucosa with nasal allergy. Acta Otolaryngol Suppl 539:65–70. doi:10.1080/00016489850182161 CrossRefPubMed

30.

Webb DR, Meltzer EO, Finn AF Jr, Rickard KA, Pepsin PJ, Westlund R, Cook CK (2002) Intranasal fluticasone propionate is effective for perennial nonallergic rhinitis with or without eosinophilia. Ann Allergy Asthma Immunol 88:385–390CrossRefPubMed

31.

Liebermann P, Kaliner MA, Wheeler WJ (2005) Open label evaluation of azelastin nasal spray in patients with seasonal allergic rhinitis and nonallergic vasomotor rhinitis. Curr Med Res Opin 21(4):611–618. doi:10.1185/030079905X41408 CrossRef

32.

Lacroix JS, Buvelot JM, Polla BS, Lundberg JM (1991) Improvement of symptoms of non-allergic chronic rhinitis by local treatment with capsaicin. Clin Exp Allergy 21(5):595–600. doi:10.1111/j.1365-2222.1991.tb00852.x CrossRefPubMed

33.

Van Rijswijk JB, Boeke EL, Keizer JM, Mulder PG, Blom HM, Fokkens WJ (2003) Intranasal capsaicin reduces nasal hyperreactivity in idiopathic rhinitis: a double-blind randomized application regime study. Allergy 58:754–761. doi:10.1034/j.1398-9995.2003.00203.x CrossRefPubMed

Title: Allergic and idiopathic rhinitis: an ultrastructural study
Authors: Stephan Knipping
H. J. Holzhausen
A. Riederer
T. Schrom
Publication date: 01-08-2009
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 8/2009
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-008-0898-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Allergic and idiopathic rhinitis: an ultrastructural study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2009

Radiofrequency thermal ablation for patients with nasal symptoms: a systematic review of effectiveness and complications

Prospective radiological study concerning a series of patients suffering from conductive or mixed hearing loss due to superior semicircular canal dehiscence

Estimation of influence of myofascial release techniques on esophageal pressure in patients after total laryngectomy

Magnetic resonance imaging in patients with meningitis induced hearing loss

Functional effects of repeated pressure loads upon the tympanic membrane: mechanical stiffness measurements after simulated habitual sniffing

Induction chemotherapy with paclitaxel and cisplatin followed by radiotherapy for larynx organ preservation in advanced laryngeal and hypopharyngeal cancer offers moderate late toxicity outcome (DeLOS-I-trial)