The effect of posterior nasal neurectomy for allergic rhinitis.

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K20185
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Otorhinolaryngology
• Research Institution: The University of Tokyo
• Principal Investigator: Nishijima Hironobu 東京大学, 医学部附属病院, 助教 (50704938)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 後鼻神経切断術 / アレルギー性鼻炎

Outline of Final Research Achievements

Posterior nasal neurectomy (PNN) suppresses the nasal symptoms of allergic rhinitis. However, the cellular mechanisms underlying these effects are not known. We investigated the impact of denervation of nasal mucosa on allergic rhinitis. We established a rat model of PNN. After PNN, neurofilaments, choline acetyltransferase and neuropeptides were absent in respiratory mucosa. Nasal secretion was reduced due to deficient acetylcholine synthesis. In the allergic rhinitis model, PNN induced disappearance of neurofilament, choline acetyltransferase and neuropeptides in the nasal mucosa and suppressed nasal secretion. However, other allergic symptoms and findings, including sneezing, nasal scratching, mucosal thickening, infiltration of eosinophils and mast cells, and cytokine mRNA expression, were unchanged even after PNN. Together, these data indicate that the peripheral nervous system and corresponding neuropeptides are not major contributors to hypersensitivity in allergic rhinitis.

Free Research Field

耳鼻咽喉科

Academic Significance and Societal Importance of the Research Achievements

耳鼻咽喉科の診療においてアレルギー性鼻炎に対して後鼻神経切断術がしばしば行われているが、その治療の基礎的なエビデンスは少なかった。今回の検討を通して、後鼻神経切断術は鼻汁を減少させるが過敏症には効果が少ない可能性があるという基礎的なエビデンスを示すことができたことの意義は大きい。