The long-term effects of capsaicin aqueous spray on the nasal mucosa.
BACKGROUND
Capsaicin has been shown previously to reduce nasal complaints in patients with a non-allergic non-infectious perennial rhinitis. Proposed pathophysiological mechanisms for non-allergic non-infectious perennial rhinitis include a chronic inflammatory disorder of an antigenic or neurogenic nature as well as the possibility of a functional neuronal disorder. We hypothesized that the beneficial effect of capsaicin might be the result of a down-regulation of inflammation (by a reduction of inflammatory cells) or through modulation of neural tissue density.


METHODS
Patients were treated with either a placebo or capsaicin spray solution delivering 0.15 mg of capsaicin per nostril once every second or third day for a total of seven treatments. Both sides were treated each visit. Biopsies were taken before and 2 weeks, 3 months and 9 months after the treatment period. Immunohistochemical staining of the biopsy specimen was performed to ascertain the effect of treatment on immunocompetent cell densities (quantitative) and neural tissue densities (semi-quantitative) in the nasal mucosa.


RESULTS
Nasal complaints were significantly reduced in the capsaicin-treated group. The number of CD1+, CD25+, CD3+, CD68+, BMK13+, IgE+, tryptase+, and chymase+ cells did not significantly differ between capsaicin and placebo group. No significant differences between both groups were found in pan-neurogenic staining of nasal mucosa using neurofilament and synaptophysine.


CONCLUSIONS
Capsaicin aqueous nasal spray has previously been shown to reduce nasal complaints without affecting cellular homeostasis or overall neurogenic staining up to 9 months after treatment. Immunocompetent cells are not involved in non-allergic non-infectious perennial rhinitis.
Blom
H M
HM
Department of Otorhinolaryngology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Severijnen
L A
LA
Van Rijswijk
J B
JB
Mulder
P G
PG
Van Wijk
R G
RG
Fokkens
W J
WJ
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D001706:Biopsy; D002211:Capsaicin / Q000494:pharmacology / Q000627:therapeutic use*; D002452:Cell Count / Q000187:drug effects; D053818:Chymases; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000737:chemistry / Q000166:cytology / Q000187:drug effects; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000166:cytology / Q000187:drug effects* / Q000473:pathology; D016900:Neurofilament Proteins / Q000032:analysis; D012220:Rhinitis / Q000188:drug therapy / Q000473:pathology; D012697:Serine Endopeptidases / Q000032:analysis; D016708:Synaptophysin / Q000032:analysis; D013997:Time Factors; D016896:Treatment Outcome; D053802:Tryptases
D015703:Antigens, CD; D016900:Neurofilament Proteins; D016708:Synaptophysin; D007073:Immunoglobulin E; D012697:Serine Endopeptidases; C083294:chymase 2; D053818:Chymases; D053802:Tryptases; D002211:Capsaicin