Changes in Levels of Nerve Growth Factor in Nasal Secretions after Capsaicin Inhalation in Patients with Airway Symptoms from Scents and Chemicals

Abstract

Patients complaining of upper and lower airway symptoms caused by scents and chemicals have previously been shown to have increased cough sensitivity to inhaled capsaicin, but the precise mechanisms behind this reaction are unknown. Hypothesizing that a neurochemical alteration related to sensory hyperreactivity (SHR) of the airway mucosa occurs, we measured levels of nerve growth factor (NGF) in nasal lavage fluid (NAL) before and after capsaicin inhalation provocations and related the capsaicin cough sensitivity to the NGF levels. Thirteen patients with SHR and 14 control subjects were provoked with capsaicin inhalation at three different doses. We measured NGF in NAL before and after provocation and recorded cough and capsaicin-induced symptoms. All subjects demonstrated a dose-dependent cough response to capsaicin inhalation, with a more pronounced effect in patients than in controls. Basal levels of NGF were significantly lower in the patient group than in the control subjects (p < 0.01). After capsaicin provocation, the patients showed a significant increase in NGF (p < 0.01), which was related to capsaicin cough sensitivity. The findings demonstrate that, in patients with airway symptoms induced by scents and chemicals, SHR is real and measurable, demonstrating a pathophysiology in the airways of these patients compared to healthy subjects.

Vocal cord dysfunction: what do we know?

“…There are studies emerging that suggest that the larynx can become hypersensitive [28] and may demonstrate evidence of a sensory neuropathy [29] or increases in nerve growth factor [30]. SHUSTERMAN and co-workers [31][32][33] have demonstrated the increased odour intolerance of individuals with upper airway dysfunction.…”

Quality of Life and Capsaicin Sensitivity in Patients with Airway Symptoms Induced by Chemicals and Scents: A Longitudinal Study

“…Increased cough sensitivity to inhaled capsaicin has also been found in MCS patients with airway symptoms (Nogami et al 2004; Ternesten-Hasseus et al 2002a). Previously, significantly increased levels of nerve growth factor in nasal lavage after capsaicin inhalation have been found in patients with SHR, suggesting a neurochemical imbalance of the respiratory system in these patients (Millqvist et al 2005). …”

Inhaled ethanol potentiates the cough response to capsaicin in patients with airway sensory hyperreactivity

“…Common symptoms are nasal blockage, rhinorrhea, eye irritation, heavy breathing, cough, hoarseness, and phlegm, as well as general symptoms, such as headache and nausea [4,5]. After capsaicin inhalation, changed levels of nerve growth factor in nasal secretions have been detected, indicating a neurochemical imbalance in the airways, which is related to SHR [6]. Cough sensitivity to capsaicin is a measure of airway sensory reactivity [7,8].…”