The effects of autonomotropic drugs on allergic nasal mucosa

The purpose of the present study was to elucidate the effects of different kinds of autonomotropic drugs on the nasal mucosa as well as on the nasal reaction to specific allergens in patients with nasal allergy. First, phenylephrine (alpha-agonist), phentolamine (alpha-antagonist), isoproterenol (beta-agonist), propranolol (beta-antagonist), methacholine (choline agonist), or ipratropium (choline antagonist) was applied to the nasal mucosa with an atomizer using saline as control. Definitive effects appeared at the spray of alpha-agonist or choline agonist. Phenylephrine reduced nasal airway resistance, and methacholine increased nasal secretion. Secondly, after treatment with the drugs, nasal provocations were performed. The statistically significant effects were noted as follows: phenylephrine spray inhibited the increase of nasal airway resistance, while phentolamine or isoproterenol enhanced it. Methacholine enhanced nasal secretion, while ipratropium inhibited it. None of the drugs, however, affected the number of sneezes. The present results suggest that adrenergic receptors are mainly distributed on the walls of vessels and cholinergic receptors mainly on the secretory glands. Pharmacological conditions of the local autonomic nervous system would affect the nasal response in allergy in different ways according to different conditions.