Nasal reflexes are neurally mediated reactions which arise either through direct stimulation of the nasal mucosa or through stimulation of pathways elsewhere in the body which indirectly involve the nose. The neural pathways involved in these reactions are complex, and the exact nature of the stimuli which trigger these reflexes has not been completely detailed. This review presents a discussion on the innervation of the nose, updates the current understanding about nasal neuropeptides, and then summarizes information about several different types of nasal reflexes.
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References
1.
EcclesR.Neurological and pharmacological considerations. In: ProctorD.F., AndersonI.B., (eds). The Nose: Upper Airway Physiology and the Atmospheric Environment.Amsterdam: Elsevier Biomedical Press, 1982, pp 191–214.
2.
WiddicombeJ.G.Reflexes from the upper respiratory tract. In: FishmanA.P., CherniakN.S., WiddicombeJ.G., GeigerS.R., (eds). Handbook of Physiology. Section 3. The Respiratory System. Volume II, Control of Breathing, Part 1. Washington, DC: American Physiological Society, 1986. pp 363–394.
3.
HuaX-Y. Tachykinins and calcitonin gene-related peptide in relation to peripheral functions of capsaicin-sensitive sensory nerves. Acta Physiol Scand127(suppl 5511): 1–45, 1986.
4.
ÄnggårdA., LundbergJ.M., LundbladL.Nasal autonomic innervation with special reference to peptidergic nerves. Eur J Respir Dis64(suppl 128): 143–148, 1983.
5.
LundbladL.Protective reflexes and vascular effects in the nasal mucosa elicited by activation of capsaicin-sensitive substance P-immunoreactive trigeminal neurons. Acta Physiol Scand Suppl529: 1–42, 1984.
6.
DaleH.Pharmacology and nerve endings. Proc R Soc Med28: 319–332, 1934.
7.
EcclesJ.C.Clinical transmission and Dale's principle. Prog Brain Res68: 3–13, 1986.
8.
IversenL.L.Chemical signaling in the nervous system. Prog Brain Res68: 15–21, 1986.
9.
LundbergJ.M., HökfeltT.Multiple co-existence of peptides and classical transmitters in peripheral, autonomic and sensory neurons: functional and pharmacological implications. Prog Brain Res68: 241–262, 1986.
10.
Stimler-GerardN.P.Neutral endopeptidase-like enzyme controls the contractile activity of substance P in guinea pig lung. J Clin Invest79: 1819–1825, 1987.
HankoJ., HardeboJ.E., KåhrströmJ., OwmanC., SundlerF.Calcitonin knee-related peptide is present in mammalian cerebrovascular nerve fibers and dilates pial and peripheral arteries. Neurosci Lett57: 91–95, 1985.
17.
FurchgottR.F.Role of the endothelium in responses of vascular smooth muscle. Circ Res53: 557–573, 1983.
18.
ColesS.J., BhaskarK.R., O'SullivanD.D., NeillK.H., ReidL.M.Airway mucus: composition and regulation of its secretion by neuropeptides in vitro. In: Mucus and Mucosa, Ciba Foundation Symposium 109.London: Pitman, 1980, pp 40–60.
19.
EkströmJ.Neuropeptide and secretion. J Dent Res66: 524–530, 1987.
20.
LundbergJ.M., FahrenkrugJ., LarsonO., ÄnggårdA.Corelease of vasoactive intestinal polypeptide and peptide histidine isoleucine in relation to atropine-resistant vasodilation in cat submandibular salivary gland. Neurosci Lett52: 37–42, 1984.
21.
UddmanR., AlumetsJ., DensertO., HåkansonR., SundlerF.Occurrence and distribution of VIP nerves in the nasal mucosa and tracheobronchial wall. Acta Otolaryngol (Stockh)86: 443–448, 1978.
22.
UddmanR., SundlerF.Vasoactive intestinal polypeptide nerves in human upper respiratory tract. ORL41: 221–226, 1979.
23.
SaidS.I.Vasoactive intestinal peptide: Isolation, distribution, biological actions, structure-function relationships and possible functions. In: GlassG.B.J., ed. Gastrointestinal Hormones, New York: Raven Press, 1980, pp 245–273.
24.
UddmanR., MalmL., FahrenkrugJ., SundlerF.VIP increases in nasal blood during stimulation of the Vidian nerve. Acta Otolaryngol91: 135–138, 1981.
25.
LundbergJ.M., ÄnggårdA., HökfeltT., KimmelJ.Avian pancreatic polypeptide (APP) inhibits atropine resistant vasodilation in cat submandibular salivary gland and nasal mucosa: possible interaction with VIP. Acta Physiol Scand110: 199–201, 1980.
26.
PatowC.A., KalinerM.A.Nasal and cardiopulmonary reflexes. ENT J63: 78–81, 1984.
WiddicombeJ.G.Defensive mechanisms of the respiratory system. In: WiddicombeJ.G., ed. International Review of Physiology, Vol 14, Respiratory Physiology II.Baltimore: University Park Press, 1977, pp 291–315.
29.
DrettnerB.Pathophysiologic relationship between the upper and lower airways. Ann Otol Rhinol Laryngol79: 499–505, 1970.
30.
YanK., SalomeC.The response of the airways to nasal stimulation in asthmatics with rhinitis. Eur J Resp Dis64(suppl 128): 105–108, 1983.
31.
KautmanJ., WrightG.W.The effect of nasal and nasopharyngeal irritation on airway resistance in man. Am Rev Respir Dis100: 626–630, 1969.
32.
WiddicombeJ.G., KentD.C., NadelJ.A.Mechanism of bronchoconstriction during inhalation of dust. J Appl Physiol17: 613–616, 1962.
33.
KaufmanJ., ChenJ.C., WrightG.W.The effect of trigeminal resection on reflex bronchoconstriction after nasal and nasopharyngeal irritation in man. Am Rev Respir Dis101: 768–769, 1970.
34.
AllenW.F.Effect of various inhaled vapors on respiration and blood pressure in anesthetized, unanesthetized, sleeping, and anosmic subjects. Am J Physiol88: 620–632, 1929.
35.
AllisonD.J.Reflexes from the nose. N Engl J Med299: 1468, 1978.
36.
JamesJ.E.A., DalyMdeB. Reflex respiratory and cardiovascular effects of stimulation of receptors in the nose of the dog. J Physiol220: 673–696, 1972.
DaviesA.M., EcclesR.Reciprocal changes in nasal resistance to airflow caused by pressure applied to the axilla. Acta Otolaryngol (Stockh)99: 154–159, 1985.
SyabbaloN.C., BundgaardA., WiddicombeJ.G.Effects of exercise on nasal airflow resistance in healthy subjects and in patients with asthma and rhinitis. Bull Eur Physiopathol Respir21: 507–513, 1985.
45.
OlsonL.G., StrohlK.P.The response of the nasal airway to exercise. Am Rev Respir Dis135: 356–359, 1987.
AndersonI.B., LundqvistG.R., ProctorD.F.Human nasal mucosal function under four controlled humidities. Am Rev Respir Dis106: 438–449, 1972.
48.
TogiasA.G., NaclerioR.M., ProudD., FishJ.E., AdkinsonN.F.Jr., Kagey-SobotkaA., NormanP.S., LichtensteinL.M. Nasal challenge with cold, dry air results in release of inflammatory mediators. Possible mast cell involvement. J Clin Invest76: 1375–1381, 1985.
49.
ØstbergB., WintherB., MygindN.Cold air-induced rhinorrhea and high-dose ipratropium. Arch Otolaryngol Head Neck Surg113: 160–162, 1987.
50.
JosenhansW.T., MelvilleG.N., UlmerW.T.The effect of facial cold stimulation on airway conductance in healthy man. Can J Physiol Pharmacol47: 453–457, 1969.
51.
KawakamiY., NatelsonB.H., DuBoisA.B.Cardiovascular effects of face immersion and factors affecting diving reflex in man. J Appl Physiol23: 964–970, 1967.
52.
KeatingeW.R., NadelJ.A.Immediate respiratory response to sudden cooling of the skin. J Appl Physiol20: 65–69, 1965.
53.
EverettH.C.Sneezing in response to light. Neurology14: 483–490, 1964.
54.
GhersonG., MoscatoG., VidiI., SalvaterraA., CanduraF.Non-specific nasal reactivity: a proposed method of study. Eur J Respir Dis69: 24–28, 1986.