Nitric oxide is a mediator of neurogenic vascular exudation in the nose

Rhinorrhea is a troublesome symptom of rhinitis seen commonly by otolaryngologists. The sources of nasal fluid production are glandular secretions and exudation from submucosal blood vessels. This study was designed to investigate the role of nitric oxide in neurogenically mediated vascular exudation in the nose. A rat model of the nasonasal reflex was developed in which one nasal cavity was challenged with histamine while albumin exudation was measured on the contralateral side. Histamine challenge was associated with a significant rise in albumin leakage, indicating an increase in vascular permeability. Perfusion with a nitric oxide synthase inhibitor (N-nitro-L-arginine methyl ester (L-NAME)) in the nasal cavity contralateral to nasal challenge was found to block albumin exudation on that side. This inhibition was overcome by the addition of L-arginine, the natural substrate of nitric oxide synthase, to the perfusate. Treatment of the ipsilateral nasal cavity with L-NAME did not significantly decrease the contralateral response. These findings indicate that NO is an important mediator of the effector arm of the nasonasal reflex that increases vascular permeability but is not involved in the sensory nerve afferent pathway. Further elucidation of the role of NO in nasal physiology may lead to novel pharmacotherapeutic approaches to the treatment of allergic and nonallergic rhinorrhea.