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变应性鼻炎患者的鼻内三叉神经敏感性

Intranasal trigeminal sensitivity in subjects with allergic rhinitis.

作者信息

Doerfler H, Hummel T, Klimek L, Kobal G

机构信息

Department of Gastroenterology, University of Erlangen-Nürnberg Medical School, Krankenhausstrasse 12, 91054 Erlangen, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2006 Jan;263(1):86-90. doi: 10.1007/s00405-005-0954-x. Epub 2005 Jun 23.

Abstract

Trigeminal nerve endings of the human nasal mucosa are activated by chemical, physical or thermal stimuli. Activation of these A(delta) and C fibers can be quantified through the recording of chemo-somatosensory event-related potentials (ERP). The aim of this study was to investigate whether allergy-related activation of trigeminal nerve endings leads to changes in their responsiveness to intranasal trigeminal stimulation. Gaseous carbon dioxide (CO(2)) stimuli were applied in three sessions (baseline, after NaCl solution and after allergen application) to the nasal mucosa of 13 subjects with allergic rhinitis. Chemo-somatosensory ERP were recorded, and subjects rated the intensity of rhinitis symptoms. Administration of allergen produced a significant shortening of chemo-somatosensory ERP peak latencies P1 and N1. Observed changes of latencies were in line with rhinitis symptoms subjects indicated during the session. In addition, there was a negative relation between the general symptom score and ERP peak latencies, obtained both at baseline and after allergen exposure. In conclusion, it is hypothesized that in patients suffering from allergic rhinitis, nasal itching and sneezing after allergen exposure are, at least in part, clinical correlates of the activation of trigeminal nerve endings due to local inflammatory mechanisms. The correlations between ERP latencies and the patients' symptoms indicate that ERP latencies may possess a predictive value of the subjects' responsiveness to allergens.

摘要

人类鼻黏膜的三叉神经末梢可被化学、物理或热刺激激活。这些A(δ)纤维和C纤维的激活可通过记录化学体感事件相关电位(ERP)来量化。本研究的目的是调查与过敏相关的三叉神经末梢激活是否会导致其对鼻内三叉神经刺激的反应性发生变化。在三个阶段(基线期、应用氯化钠溶液后和应用变应原后),对13名变应性鼻炎患者的鼻黏膜施加气态二氧化碳(CO₂)刺激。记录化学体感ERP,并让受试者对鼻炎症状的强度进行评分。变应原的施用使化学体感ERP的P1和N1峰潜伏期显著缩短。观察到的潜伏期变化与受试者在该阶段指出的鼻炎症状一致。此外,在基线期和变应原暴露后获得的总体症状评分与ERP峰潜伏期之间存在负相关。总之,据推测,在变应性鼻炎患者中,变应原暴露后的鼻痒和打喷嚏至少部分是由于局部炎症机制导致三叉神经末梢激活的临床相关表现。ERP潜伏期与患者症状之间的相关性表明,ERP潜伏期可能对受试者对变应原的反应性具有预测价值。

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