Baraniuk James N, Kim Dennis
Division of Rheumatology, Immunology and Allergy, Room B105, Lower Level Kober-Cogan Building, Georgetown University, 3800 Reservoir Road, NW, Washington, DC 20007-2197, USA.
Curr Allergy Asthma Rep. 2007 May;7(2):105-11. doi: 10.1007/s11882-007-0007-1.
The nasal mucosa is a complex tissue that interacts with its environment and effects local and systemic changes. Receptors in the nose receive signals from stimuli, and respond locally through afferent, nociceptive, type C neurons to elicit nasonasal reflex responses mediated via cholinergic neurons. This efferent limb leads to responses in the nose (eg, rhinorrhea, glandular hyperplasia, hypersecretion with mucosal swelling). Anticholinergic agents appear useful against this limb for symptomatic relief of a "runny nose." Chronic exposure to allergens can lead to hyperresponsiveness of the nasal mucosa. As a result, receptors upregulate specific ion channels to increase the sensitivity and potency of their reflex response. Nasal stimuli also affect distant parts of the body. Nerves in the sinus mucosa cause vasodilation; the lacrimal glands can be stimulated by nasal afferent triggers. Even the cardiopulmonary system can be affected via the trigeminal chemosensory system, where sensed irritants can lead to changes in tidal volume, respiratory rate, and blink frequency. The sneeze is an airway defense mechanism that removes irritants from the nasal epithelial surface. It is generally benign, but can lead to problems in certain circumstances. The afferent pathway involves histamine-mediated depolarization of H1 receptor-bearing type C trigeminal neurons and a complex coordination of reactions to effect a response.
鼻黏膜是一种复杂的组织，它与周围环境相互作用，并引起局部和全身的变化。鼻腔中的感受器接收来自刺激的信号，并通过传入的伤害性C型神经元做出局部反应，以引发由胆碱能神经元介导的鼻鼻反射反应。这条传出支会导致鼻子出现反应（例如，鼻溢、腺体增生、伴有黏膜肿胀的分泌亢进）。抗胆碱能药物似乎对缓解“流鼻涕”的症状有效。长期接触过敏原会导致鼻黏膜反应过度。结果，感受器会上调特定的离子通道，以提高其反射反应的敏感性和效力。鼻腔刺激也会影响身体的其他部位。鼻窦黏膜中的神经会引起血管舒张；鼻传入触发因素可刺激泪腺。甚至心肺系统也会通过三叉化学感应系统受到影响，在该系统中，感知到的刺激物可导致潮气量、呼吸频率和眨眼频率发生变化。打喷嚏是一种气道防御机制，可将刺激物从鼻上皮表面清除。它通常是良性的，但在某些情况下可能会引发问题。传入途径涉及组胺介导的含H1受体的C型三叉神经元去极化以及一系列复杂的反应协调以产生反应。
