title: Capsaicin for Rhinitis.
abstract: Rhinitis is a multifactorial disease characterized by symptoms of sneezing, rhinorrhea, postnasal drip, and nasal congestion. Non-allergic rhinitis is characterized by rhinitis symptoms without systemic sensitization of infectious etiology. Based on endotypes, we can categorize non-allergic rhinitis into an inflammatory endotype with usually eosinophilic inflammation encompassing at least NARES and LAR and part of the drug induced rhinitis (e.g., aspirin intolerance) and a neurogenic endotype encompassing idiopathic rhinitis, gustatory rhinitis, and rhinitis of the elderly. Patients with idiopathic rhinitis have a higher baseline TRPV1 expression in the nasal mucosa than healthy controls. Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is the active component of chili peppers, plants of the genus Capsicum. Capsaicin is unique among naturally occurring irritant compounds because the initial neuronal excitation evoked by it is followed by a long-lasting refractory period, during which the previously excited neurons are no longer responsive to a broad range of stimuli. Patients with idiopathic rhinitis benefit from intranasal treatment with capsaicin. Expression of TRPV1 is reduced in patients with idiopathic rhinitis after capsaicin treatment. Recently, in a Cochrane review, the effectiveness of capsaicin in the management of idiopathic rhinitis was evaluated and the authors concluded that given that many other options do not work well in non-allergic rhinitis, capsaicin is a reasonable option to try under physician supervision. Capsaicin has not been shown to be effective in allergic rhinitis nor in other forms of non-allergic rhinitis like the inflammatory endotypes or other neurogenic endotypes like rhinitis of the elderly or smoking induced rhinitis.
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands. w.j.fokkens@amc.uva.nl.
authors.forename: Wytske
authors.initials: W
authors.lastname: Fokkens
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Hellings
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Christine
authors.initials: C
authors.lastname: Segboer
mesh_terms: D000281:Administration, Intranasal; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002211:Capsaicin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012220:Rhinitis / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D002211:Capsaicin
keywords: Capsaicin; Idiopatic rhinitis; Non-allergic rhinitis; Rhinitis