Noradrenergic Nerve Fluorescence in the Nasal Mucosa of Rhinitis Patients

Background: It is generally accepted that the parasympathetic nerve predominates in patients with nasal allergies. On the other hand, resection or local anesthetic block of the cervical sympathetic ganglion has been proven to cause ipsilateral hyperaemia, swelling, and hypersecretion of the nasal mucosa. It is interesting to study noradrenergic nerve fluorescence in the nasal mucosa of rhinitis patients. Methods: We examined specimens taken from patients with chronic rhinitis to study the noradrenergic innervation of allergic and nonallergic rhinitis. Our examination used the glyoxylic noradrenergic histofluorescence method. Inferior turbinates were obtained from patients suffering from either allergic or nonallergic rhinitis during corrective nasal surgery. We assigned a score of between 0 (lowest) and 4 (highest) for the degree of noradrenergic nerve fluorescence expression observed in each specimen. One percent neutral red was used as a counterstain. Results: Many noradrenergic fibers were present around the vessels, glands and in the submucosa of the nasal mucosa. However, we found no noradrenergic innervation in the epithelium. In microscopic views, we observed no significant difference in the distribution of noradrenergic innervation of blood vessels and epithelium between allergic and nonallergic nasal mucosa specimens. However, we found that noradrenergic fluorescent fibers were significantly decreased in the glandular region of the allergic nasal mucosa. Conclusions: Our findings suggest that decreasing sympathetic innervation may have a role in the pathophysiology of rhinitis and may be particularly significant in relation to glandular functions in allergic nasal mucosa.