Reflex activation of nasal secretion by unilateral inhalation of cold dry air.
Reflex activation of nasal secretion by unilateral inhalation of cold dry air.
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单侧吸入冷干空气反射性激活鼻腔分泌物。
DOI：
10.1164/ajrccm/148.6_pt_1.1616
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Togias,AG
中科院分区：
文献类型：
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作者：
Philip,G;Jankowski,R;Baroody,FM;Naclerio,RM;Togias,AG
许多人暴露在寒冷干燥的空气中会引起鼻漏和其他鼻腔症状。为了评估这种反应是否涉及神经源性成分，我们对先前记录的对冷干空气有反应的志愿者进行了单侧冷干空气（UniCDA）鼻腔刺激。我们测量了他们的鼻腔分泌反应双侧使用小滤纸圆盘从鼻黏膜吸收分泌物。与对照组相比，UniCDA增加了同侧（p< 0.001）和对侧（p< 0.001）的鼻腔分泌物。外用阿托品（0.225 mg），一种毒蕈碱拮抗剂，当同侧给药UniCDA时，抑制同侧分泌（p< 0.002）。在对侧给药时，对侧分泌有减少的趋势，但对同侧分泌无影响。局部麻醉与利多卡因给予同侧UniCDA刺激后立即抑制同侧分泌（p< 0.02）和对侧分泌（p< 0.05）。表面麻醉对甲基苯丙胺诱导的鼻腔分泌没有抑制作用。因此，UniCDA刺激同侧和对侧的反射分泌，通过阻断反射弧的传出臂或传入臂来抑制。这个人体内模型支持神经机制在气道对环境刺激的反应中的重要性。Philip G, Jankowski R, Baroody FM, Naclerio RM, Togias AG。单侧吸入干燥冷空气时鼻腔分泌物的反射激活。Am Rev Respir杂志1993；148: 1616 - 22所示。当暴露在寒冷多风的环境中时，许多人抱怨有鼻漏、鼻塞和刺激。这种反应在暴露于寒冷天气(1)或滑雪(2)的人群中已有记录。此外，在许多接受鼻腔持续气道正压通气（CPAP）治疗睡眠呼吸暂停的受试者中，也会遇到鼻腔呼吸干燥空气的问题(3)。在过去的10年里，我们研究了一个人体实验模型，在这个模型中，有冷干空气引起的鼻症状的临床病史的受试者在接近冰点的温度下通过鼻子吸入干燥的空气(4)。我们对这个模型的兴趣不仅来自于上述的临床情况，还来自于冷干燥空气引起的鼻腔反应的机制可能会对运动性哮喘的病理生理学有深入的了解，这种情况也可能由高流量的干燥空气吸入引起(5)。
Exposure to cold dry air induces rhinorrhea and other nasal symptoms in many persons. Toevaluate whether this response involves a neurogenic component, we delivered a unilateral cold dry air (UniCDA) nasal challenge to volunteers with previously documented reactivity to cold dry air. We measured their nasal secretory responses bilaterally using small filter paper discs to absorb secretions from the nasal mucosa. UniCDA increased nasal secretion both ipsilateral (p< 0.001) and contralateral (p< 0.001) to the challenge when compared with control challenge. Topical atropine (0.225 mg), a muscarinic antagonist, inhibited ipsilateral secretion (p< 0.002) when given ipsilateral to UniCDA. When atropine was given contralateral to UniCDA, there was a trend toward reduction of contralateral secretion but no effect on ipsilateral secretion. Topical anesthesia with lidocaine given ipsilateral to UniCDA inhibited ipsilateral (p< 0.02) and contralateral (p< 0.05) secretion immediately after challenge. Topical anesthesia did not inhibit methacholine-induced nasal secretion. Thus, UniCDA stimulates reflex secretion both ipsilateral and contralateral to challenge which is inhibitable by interrupting either the efferent or the afferent arm of the reflex arc. This human in vivo model supports the importance of neural mechanisms in airway responsiveness to an environmental stimulus. Philip G, Jankowski R, Baroody FM, Naclerio RM, Togias AG. Reflex activation of nasal secretion by unilateral inhalation of cold dry air. Am Rev Respir Dis 1993; 148: 1616-22.Many persons complain of rhinorrhea, nasal congestion, and irritation when exposed to cold windy environments. This response has been documented in persons exposed to cold weather (1) or during skiing (2). Also, problems with nasal breathing of dry air are encountered in many subjects who receive nasal continuous positive airway pressure (CPAP) treatment for sleep apnea (3). Over the past 10years, we have studied a human experimental model in which subjects with a clinical history of cold dry air-induced nasal symptoms inhale dry air through the nose at near freezing temperatures (4). Our interest in this model derives not only from the clinical situations mentioned above, but also from the possibility that the mechanism of cold dry air-induced nasal reactivity may yield insights into the pathophysiology of exercise-induced asthma, a condition which also can be triggered by inhalation of dry air at high flows (5).