vasoactive-intestinal-peptide and Nasal-Obstruction

Deviated nasal septum (DNS) is suggested to be associated with nonspecific inflammation of the nasal mucosa. The authors hypothesized septoplasty may reduce nasal mucosal inflammation, therefore the authors aimed to measure various inflammatory biomarkers in the nasal secretion following septoplasty. Prospectively, 17 patients undergoing elective septoplasty were included. Symptomatic changes after septoplasty were evaluated with Sino-nasal Outcome Test (SNOT-22) and Nasal obstruction symptom evaluation (NOSE) scores. Using acoustic rhinometry, changes of the nasal airway volume were measured. Nasal secretion was collected within 2 weeks and 3 months before and after septoplasty, respectively. The inflammatory biomarker high-mobility group box 1 (HMGB1) and vasoactive intestinal peptide (VIP), and inflammatory cytokines including tumor necrosis factor α (TNF α), interferon γ (IFN-γ), interleukin-4 (IL-4), eotaxin-1, and regulated upon activation, normal T cell expressed and presumably secreted (RANTES) were quantified in the nasal secretion by enzyme-linked immunosorbent assays or multiplex bead array assays. The patients' mean age was 30.5 ± 6.8 (ranging from 19 to 43), consisting of 15 male and 2 female patients. The median SNOT-22 and NOSE scores changed from 54 to 14 and 78 to 15, respectively, both showing a significant decrease. In acoustic rhinometry, nasal cavity volume of convex side significantly increased after septoplasty, whereas significant discrepancy of nasal airway volume between concave and convex sides became insignificant. No significant difference was noted both before and after septoplasty between the concave and convex sides in all seven biomarkers. The HMGB1, RANTES, IL-4, and TNF-α concentrations following septoplasty showed significant decrease in 34 nasal cavities of 17 patients (all p < 0.05). However, when the 17 concave and 17 convex sides were analyzed separately, the significant reduction in four biomarkers were only significant in the concave sides (all p < 0.05), but not significantly reduced in convex sides. Septoplasty may have benefited not only in normalizing the nasal airflow and symptom improvement, but also in nonspecific inflammation attenuation in the nasal airway.

Topics: Adult; Biomarkers; Chemokine CCL11; Chemokine CCL5; Female; HMGB1 Protein; Humans; Inflammation; Interferon-gamma; Interleukin-4; Male; Nasal Mucosa; Nasal Obstruction; Nasal Septum; Treatment Outcome; Tumor Necrosis Factor-alpha; Vasoactive Intestinal Peptide; Young Adult

Besides classic neurotransmitters, neuropeptides seem to participate in the control of human nasal physiology. In this region vasoactive intestinal peptide (VIP) is found in higher concentration than other neuropeptides. The aim of this study was to localize VIP in neuronal and non-neuronal structures of the human nasal mucosa using immunocytochemical techniques. Paraffin and frozen serial sections of the inferior turbinate were incubated with antibodies against neuronspecific enolase (NSE) to demonstrate neuronal structures or against VIP. The immunocomplexes were visualized by the Avidin-Biotin-Complex (ABC)-method. VIP-positive nerve fibers were found around the acinus cells and the ducts of the seromucous glands. These results emphasize the influence of VIP on nasal gland secretion. Few immunoreactions to the VIP were demonstrated in the nerves of the adventitia of veins and arteries. Additionally, by comparing NSE nad VIP localization, strong extranerval immunoreactions in the tunica medica of the arterioles were demonstrated, as were lesser but still visible immunoreactions in the muscular layer of thick veins. These morphological findings in vessels and the well known vasodilatory effect of VIP underline the functions of this neuropeptide on the nasal mucosa in man. Thus, by increasing the blood flow and volume, VIP, in conjunction with other control factors, seems to participate in the physiological processes of the swelling mechanism of nasal turbinates and influence nasal congestion.

Topics: Adult; Female; Humans; Immunoenzyme Techniques; Male; Nasal Mucosa; Nasal Obstruction; Reference Values; Turbinates; Vasoactive Intestinal Peptide

Twenty-one pregnant women with nasal congestion, verified by rhinomanometry, did not differ significantly from 8 pregnant women without nasal congestion regarding the serum levels of the hormones oestradiol, progesterone and VIP. The congested group had a significantly lower serum level of oxytocin than the reference group. There were no differences in the symptoms urinary incontinence, constipation, and heartburn between the groups. The pathophysiology of nasal congestion during pregnancy is still veiled in obscurity.

Topics: Airway Resistance; Estradiol; Female; Humans; Nasal Mucosa; Nasal Obstruction; Oxytocin; Pregnancy; Pregnancy Complications; Progesterone; Vasoactive Intestinal Peptide