Enhanced chemosensory sensitivity in patients with idiopathic rhinitis and its reversal by nasal capsaicin treatment

Gerven, Laura Van; Alpízar, Yeranddy A.; Steelant, Brecht; Callebaut, Ina; Krohn, Inge Kortekaas; Wouters, Mira M.; Vermeulen, François; Boeckxstaens, Guy E.; Talavera, Karel; Hellings, Peter W.

doi:10.1016/j.jaci.2017.03.014

Cited by 35 publications

(50 citation statements)

References 22 publications

(38 reference statements)

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“…Overall, this pattern of results suggest that not the extent of the training, but rather the number of stimulations over a certain amount of time, may lead to trigeminal lassitude and habituation effects [25, 26]. …”

Section: Discussionmentioning

confidence: 99%

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Effects of “trigeminal training” on trigeminal sensitivity and self-rated nasal patency

Oleszkiewicz

Schultheiss

Schriever

et al. 2018

Eur Arch Otorhinolaryngol

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PurposePatients with the feeling of a congested nose not always suffer from an anatomical obstruction but might just have a low trigeminal sensibility, which prevents them from perceiving the nasal airstream. We examined whether intermittent trigeminal stimulation increases sensitivity of the nasal trigeminal nerve and whether this effect is accompanied by subjective improvement of nasal breathing.MethodThirty-five patients (Mage = 58.4 years; SD = 14.8; Minage = 21 years; Maxage = 79 years; 43% females) and 30 healthy controls (Mage = 36.7 years, SD = 14.5; Minage = 20 years; Maxage = 73 years; 60% females) participated in a study comprised of two sessions separated by “trigeminal training”. During each session, trigeminal sensitivity towards CO2, trigeminal lateralization abilities and ratings of nasal patency were assessed. Age and training compliance were controlled.Results“Trigeminal training” had a positive effect on trigeminal sensitivity in both groups, (p = .027) and this effect depended on the training compliance (p < .001). “Trigeminal training” had no effect on lateralization abilities of the subjects (p > .05). Ratings of nasal patency increased in patients (p = .03), but not in controls.Conclusions“Trigeminal training” consisting of intermittent presentation of diverse stimulants leads to an increase of trigeminal sensitivity, but this effect depended on the training compliance. Importantly, in patients, this training is also associated with an increase in self-rated nasal patency.

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Section: Discussionmentioning

confidence: 99%

“…There is a scant evidence suggesting that trigeminal sensitivity changes after exposure to trigeminally active substances [25, 26]. However, these studies mostly concerned changes in sensitivity towards the specific substance that subjects were exposed to.…”

Section: Introductionmentioning

confidence: 99%

Effects of “trigeminal training” on trigeminal sensitivity and self-rated nasal patency

Oleszkiewicz

Schultheiss

Schriever

et al. 2018

Eur Arch Otorhinolaryngol

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“…In conclusion, the capsaicin nasal spray is effective in a broader group of IR than the purely selected ones described before . The subjective NHR is a good predictor for the chance of success of capsaicin treatment.…”

Section: Patient Characteristicsmentioning

confidence: 67%

“…More recently, we could demonstrate electrophysiological evidence for an increased chemical sensitivity in IR patients compared to healthy controls. The enhanced chemical sensitivity in IR was decreased by capsaicin treatment, along with a reduction of self‐reported NHR and nasal symptoms …”

Section: Patient Characteristicsmentioning

confidence: 96%

“…All previously included IR patients met strict criteria: age between 18 and 60 years, nonsmoking, negative skin prick tests (SPT) for the 18 most frequent regional airborne allergens, no clinical sign of endonasal infection or anatomical nasal deformity, no present/past history of chronic rhinosinusitis with/without nasal polyps, and self‐reported unresponsiveness to intranasal steroids (INS) with a minimal duration of proper treatment for 4 weeks . In clinical practice, however, a significant portion (up to 50%) of IR patients do not meet the criteria of the “strictly selected IR” population and are not included in the reported trials . These patients are often defined as “mixed rhinitis” patients (MR), as the treating physician considers that more than one etiologic factor is involved in the rhinitis phenotype …”

Section: Patient Characteristicsmentioning

confidence: 99%

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Therapeutic effect of capsaicin nasal treatment in patients with mixed rhinitis unresponsive to intranasal steroids

Gerven

Steelant

Alpízar

et al. 2017

Allergy

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Literature is convincing regarding the efficacy of capsaicin nasal treatment in idiopathic rhinitis (IR). However, up to 50% of IR patients do not meet the strict inclusion criteria of the trials conducted so far. As a consequence, the efficacy of capsaicin is unknown in a significant number of IR patients that do not meet the strict inclusion/exclusion criteria (J Allergy Clin Immunol. 2014;133:1332, J Allergy Clin Immunol. 2017; [Epub ahead of print]). "Mixed rhinitis" (MR) patients have more than one major etiologic factor involved in the mucosal pathology. We have no idea about the efficacy of capsaicin nasal spray in these patients nor about the time interval to seek a second application. We report here that capsaicin nasal spray is effective in a broader group of IR than the purely selected ones described before, that subjective nasal hyper-reactivity is a good predictor of positive outcome, and that the time interval for seeking a second treatment is likely to be shorter in MR patients than in the strictly selected IR patients.

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Trigeminal Sensitivity in Patients With Allergic Rhinitis and Chronic Rhinosinusitis

et al. 2022

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Objective Allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP) are of high importance in otorhinolaryngology. Some of their symptoms are related to changes in the nasal trigeminal sensitivity. The aim of this study was to compare nasal trigeminal sensitivity in patients with AR, CRSwNP, and healthy controls (HC). Methods A total of 75 individuals participated (age 19–78 years; 34 AR, 10 CRSwNP and 31 HC). Olfactory function was determined using the extended Sniffin’ Sticks test battery. Trigeminal sensitivity was assessed with CO2 detection thresholds. Trigeminal negative mucosal potentials (NMP) and EEG‐derived event‐related potentials (ERP) were recorded in response to selective olfactory (phenylethyl alcohol) and trigeminal (CO2) stimuli using high‐precision air‐dilution olfactometry. Results In comparison to HC, AR patients had lower CO2 thresholds, also reflected in shorter peak latencies in NMP and trigeminal ERP measurements. CRSwNP patients had a decreased sensitivity for trigeminal stimuli, also reflected in prolonged trigeminal ERP latencies, and reduced olfactory function compared to HC. Conclusion AR patients seemed to be more sensitive to trigeminal stimuli than CRSwNP patients. Importantly, the differences could be shown on psychophysical and electrophysiological levels. The changes in trigeminal sensitivity appear to be present already at the level of the respiratory epithelium. The differences between the two groups may depend on the specific inflammatory changes accompanying each disorder, the degree of inflammatory activity, or duration of the inflammatory disorder. However, because the sample sizes are relatively small, these results need to be confirmed in the future studies with larger groups. Level of Evidence 4 Laryngoscope, 133:654–660, 2023

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Enhanced chemosensory sensitivity in patients with idiopathic rhinitis and its reversal by nasal capsaicin treatment

Cited by 35 publications

References 22 publications

Effects of “trigeminal training” on trigeminal sensitivity and self-rated nasal patency

Effects of “trigeminal training” on trigeminal sensitivity and self-rated nasal patency

Therapeutic effect of capsaicin nasal treatment in patients with mixed rhinitis unresponsive to intranasal steroids

Trigeminal Sensitivity in Patients With Allergic Rhinitis and Chronic Rhinosinusitis

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