Baraniuk J N, Kaliner M
Department of Thoracic Medicine, National Heart and Lung Institute, London, United Kingdom.
Am J Physiol. 1991 Oct;261(4 Pt 1):L223-35. doi: 10.1152/ajplung.1991.261.4.L223.
The nasal mucosa is innervated by the sensory, parasympathetic, and sympathetic nervous systems. Nociceptive sensory nerves are stimulated by mucosal injury, inhalation of irritants, or mast cell degranulation and release of the calcitonin gene-related peptide, the tachykinins substance P and neurokinin A, and other peptides by the axon response mechanism. Sensory nerve stimulation initiates systemic reflexes, such as the sneeze, and central parasympathetic reflexes which release acetylcholine, vasoactive intestinal peptide, and other peptides and lead to glandular secretion. In concert, these proinflammatory neural responses lead to vasodilation, vascular permeability, and glandular secretion. Sympathetic nerves release neuropeptide Y and norepinephrine, potent vasoconstrictors which act to decompress the nasal mucosa and produce nasal patency. The balance between the effects of parasympathetic and sympathetic neurotransmitters may regulate nasal homeostasis, whereas the nociceptive sensory system may be held in reserve as a defense mechanism. Dysfunction of these systems may lead to pathological nasal syndromes. In the future, specific neuropeptide agonists and antagonists may be useful for the treatment of human rhinitic diseases.
鼻黏膜由感觉神经、副交感神经和交感神经系统支配。伤害性感觉神经受到黏膜损伤、吸入刺激物或肥大细胞脱颗粒以及通过轴突反应机制释放降钙素基因相关肽、速激肽P物质和神经激肽A以及其他肽类的刺激。感觉神经刺激引发全身性反射，如打喷嚏，以及中枢副交感神经反射，释放乙酰胆碱、血管活性肠肽和其他肽类，导致腺体分泌。这些促炎神经反应共同导致血管扩张、血管通透性增加和腺体分泌。交感神经释放神经肽Y和去甲肾上腺素，这两种强效血管收缩剂可使鼻黏膜减压并产生鼻腔通畅。副交感神经和交感神经递质作用之间的平衡可能调节鼻腔内环境稳定，而伤害性感觉系统可能作为一种防御机制备用。这些系统功能障碍可能导致病理性鼻综合征。未来，特定的神经肽激动剂和拮抗剂可能对治疗人类鼻病有用。
