Department of Otorhinolaryngology, Karolinska University Hospital/Huddinge, Stockholm, Sweden.
Rhinology. 2009 Dec;47(4):427-31. doi: 10.4193/Rhin08.191.
Topical application of histamine on the nasal mucosa causes an inflammatory reaction with increased mucosal swelling and perfusion. In the nasal mucosa histamine receptors are found in the vascular epithelium and at free sensory nerve endings. The aim of this randomized double-blind placebo controlled study was to investigate if this inflammatory reaction to locally administered histamine was dependent upon the stimuli of pain-mediating sensory nerves, or if it mainly was the result of direct stimuli of the vascular epithelium. Eighteen healthy non-allergic subjects were treated with sprays of lidocaine or saline (placebo) in the nose, followed by challenge with histamine. Using a cross-over design the participants later returned and were allocated to the opposite treatment followed by histamine. Nasal congestion, and concentration, velocity and perfusion of erythrocytes were measured with rhinostereometry and laser Doppler flowmetry. Symptoms of blockage, discharge and itching were scored. When comparing the lidocaine group to the placebo group, we found no significant differences in the reaction to histamine concerning any of the measured parameters or subjective symptoms. In conclusion, our results suggest that the stimuli of pain-mediating sensory nerves do not significantly contribute to the inflammatory effect of histamine on human nasal mucosa.
组胺局部应用于鼻腔黏膜会引起炎症反应，导致黏膜肿胀和灌注增加。在鼻腔黏膜中，组胺受体存在于血管上皮和游离感觉神经末梢中。本随机双盲安慰剂对照研究的目的是调查局部给予组胺引起的这种炎症反应是否依赖于疼痛介导感觉神经的刺激，还是主要是血管上皮的直接刺激的结果。18 名健康非过敏受试者接受了利多卡因或生理盐水（安慰剂）喷雾治疗，随后用组胺进行挑战。采用交叉设计，参与者随后返回并被分配到相反的治疗方法，然后用组胺进行治疗。使用鼻声描记术和激光多普勒血流仪测量鼻腔充血以及红细胞的浓度、速度和灌注。记录鼻塞、分泌物和瘙痒症状的评分。当将利多卡因组与安慰剂组进行比较时，我们发现对于任何测量参数或主观症状，组胺的反应在两组之间均无显著差异。总之，我们的结果表明，疼痛介导感觉神经的刺激对组胺引起的人鼻腔黏膜炎症反应没有显著贡献。
