Department of Anatomy, Universite du Quebec a Trois-Rivieres (UQTR), Trois-Rivieres, QC, Canada.
Department of Medical Biology, Universite du Quebec a Trois-Rivieres (UQTR), Trois-Rivieres, QC, Canada.
Rhinology. 2024 Feb 1;62(1):63-70. doi: 10.4193/Rhin23.128.
In chronic rhinosinusitis (CRS), nasal obstruction can often be explained by anatomical deformities, polyps, or congested nasal mucosa. However, in cases with little deformity or inflammation, perceived nasal obstruction may result from reduced airflow perception caused by an alteration of the intranasal trigeminal system. The aim of this study was to assess this association.
We performed a prospective case-control study of 15 CRS patients, 18 patients with a deviated nasal septum (DNS) and 16 healthy controls. We assessed olfactory function using the Sniffin' Sticks test and Visual Analog Scales (VAS). We used the Trigeminal Lateralization Task (TLT) with eucalyptol and cinnamaldehyde to examine intranasal trigeminal function. Further, we assessed nasal patency with Peak Nasal Inspiratory Flow and VAS. Finally, we measured protein levels of trigeminal receptors (TRPM8, TRPA1 and TRPV1) and inflammatory markers (IL-13, INF-y and eosinophils) in CRS and DNS patients' mucosal biopsies using Western Blots.
CRS patients had significantly lower olfactory function than DNS and healthy controls. They also had significantly lower TLT scores for eucalyptol than both other groups. CRS patients had significantly lower nasal patency than controls; for DNS patients this was limited to subjective measures of nasal patency. In line with this, CRS patients exhibited significantly higher levels of sTRPM8-18 than DNS patients.
Intranasal trigeminal function is decreased in CRS patients, possibly due to the overexpression of short isoforms of TRPM8 receptors.
在慢性鼻-鼻窦炎（CRS）中，鼻腔阻塞通常可以通过解剖畸形、息肉或充血的鼻腔黏膜来解释。然而，在畸形或炎症程度较轻的情况下，感知到的鼻腔阻塞可能是由于鼻腔内三叉神经系统的改变导致气流感知减弱所致。本研究旨在评估这种关联。
我们进行了一项前瞻性病例对照研究，纳入了 15 例 CRS 患者、18 例鼻中隔偏曲（DNS）患者和 16 例健康对照者。我们使用嗅探棒测试和视觉模拟量表（VAS）评估嗅觉功能。我们使用桉树脑和肉桂醛进行三叉神经偏侧化任务（TLT），以检查鼻腔内三叉神经功能。此外，我们使用峰流速鼻吸气（Peak Nasal Inspiratory Flow）和 VAS 评估鼻腔通畅度。最后，我们使用 Western Blot 法测量 CRS 和 DNS 患者鼻黏膜活检组织中三叉神经受体（TRPM8、TRPA1 和 TRPV1）和炎症标志物（IL-13、INF-y 和嗜酸性粒细胞）的蛋白水平。
CRS 患者的嗅觉功能明显低于 DNS 和健康对照组。他们对桉树脑的 TLT 评分也明显低于其他两组。CRS 患者的鼻腔通畅度明显低于对照组；而对于 DNS 患者，这种情况仅限于鼻腔通畅度的主观测量。与此一致的是，CRS 患者的 sTRPM8-18 水平明显高于 DNS 患者。
CRS 患者的鼻腔内三叉神经功能下降，可能是由于短型 TRPM8 受体的过度表达所致。
