Department of Otorhinolaryngology-Head and Neck Surgery and Texas Sinus Institute, University of Texas Medical School at Houston, Houston, TX.
Int Forum Allergy Rhinol. 2013 Oct;3(10):795-800. doi: 10.1002/alr.21184. Epub 2013 Jun 3.
Patients with nonallergic irritant rhinitis (NAIR) have symptoms of nasal congestion, nasal irritation, rhinorrhea, and sneezing in response to nasal irritants. We currently have no reliable objective means to quantify these patients' subjective symptoms. In this study, we used the transient receptor potential vanilloid receptor (TRPV1) receptor agonist, capsaicin, as an intranasal challenge while comparing the changes in blood flow with optical rhinometry between subjects with NAIR and healthy controls (HCs).
Six HCs and 6 NAIR subjects were challenged intranasally with saline solution followed by increasing concentrations of capsaicin (0.005 mM, 0.05 mM, and 0.5 mM) at 15-minute intervals. We recorded maximum optical density (OD) and numeric analog scores (NAS) for nasal congestion, nasal irritation, rhinorrhea, and sneezing for each subject after each challenge. Correlations between NAS and maximum OD were calculated.
Maximum OD increased with increasing concentrations of intranasal capsaicin in NAIR subjects. There were significant differences in maximum OD obtained for 0.05 mM and 0.5 mM capsaicin between NAIR subjects and HCs. Significant differences were found in the NAS for nasal irritation at 0.005 mM, 0.05 mM, and 0.5 mM, and nasal congestion at 0.5 mM. Correlation between maximum OD and mean NAS was most significant for 0.05 mM capsaicin.
Optical rhinometry with intranasal capsaicin challenge could prove a viable option in the diagnosis of NAIR. Further studies will investigate its use to monitor a patient's response to pharmacologic therapy and provide further information about the underlying mechanisms of NAIR.
非变应性刺激性鼻炎（NAIR）患者在接触鼻内刺激物后会出现鼻塞、鼻刺激、流涕和打喷嚏等症状。目前，我们还没有可靠的客观方法来量化这些患者的主观症状。在这项研究中，我们使用辣椒素（一种瞬时受体电位香草酸受体（TRPV1）受体激动剂）作为鼻内挑战，同时比较 NAIR 患者和健康对照者（HCs）的血流变化与光鼻测仪测量值。
6 名 HCs 和 6 名 NAIR 患者每隔 15 分钟分别用生理盐水和递增浓度的辣椒素（0.005 mM、0.05 mM 和 0.5 mM）进行鼻内挑战。我们记录了每位患者在每次挑战后的最大光密度（OD）和鼻塞、鼻刺激、流涕和打喷嚏的数字模拟评分（NAS）。计算了 NAS 与最大 OD 之间的相关性。
NAIR 患者的最大 OD 随鼻内辣椒素浓度的增加而增加。在 0.05 mM 和 0.5 mM 辣椒素浓度下，NAIR 患者与 HCs 之间的最大 OD 差异有统计学意义。在 0.005 mM、0.05 mM 和 0.5 mM 时，鼻刺激的 NAS 以及在 0.5 mM 时的鼻塞 NAS 差异有统计学意义。最大 OD 与平均 NAS 之间的相关性在 0.05 mM 辣椒素时最为显著。
鼻内辣椒素挑战的光鼻测仪检查可能是诊断 NAIR 的一种可行选择。进一步的研究将探讨其在监测患者对药物治疗反应方面的应用，并提供有关 NAIR 潜在机制的更多信息。
