Allergy and Respiratory Disease

  • Howard M. Druce
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 107)


As the principal portal for entry of air into the respiratory tract, the nose is important in serving many critical functions, including conditioning inspired air and protecting the lower airways [1]. The human nose has evolved to meet the specific needs of an upright biped, i. e., the olfactory mucosa is poorly developed, the surface area of mucosal surface is markedly reduced as compared to animals with a great need for heat and water exchange, but the reflex and immune defense components are complex [21. Almost all the functions of the nose are served by the nasal mucosa (table 14–1). This tissue, in direct contact with the outside air, can produce a limited range of symptoms, i.e. obstruction, fluid secretion, sneezing, itching, bleeding, and abnormalities of odor perception [3]. Of these, obstruction is the most troublesome to patients, since it impedes breathing. It had been considered that nasal obstruction was produced solely by congestion of the capacitance blood vessels (sinusoids) in the nasal mucosa. However, there are several reasons to believe that this is an oversimplification. First, in chronic rhinitis with nasal obstruction, oral vasoconstrictors are poorly effective [4]. Second, visible decongestion has been observed in the absence of nasal mucosal blood flow (NMBF) changes (unpublished observations). Third, cellular infiltration, such as occurs in the mast-cell-mediated late-phase reaction, is believed to play a significant role in the nasal obstruction of chronic allergic rhinitis [5].


Nasal Mucosa Allergy Clin Immunol Nasal Obstruction Nasal Resistance Chronic Rhinitis 
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© Springer Science+Business Media New York 1990

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  • Howard M. Druce

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