Enhanced chemosensory sensitivity in patients with idiopathic rhinitis and its reversal by nasal capsaicin treatment Laura Van Gerven, MD, PhD, Yeranddy.

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Presentation transcript:

Enhanced chemosensory sensitivity in patients with idiopathic rhinitis and its reversal by nasal capsaicin treatment Laura Van Gerven, MD, PhD, Yeranddy A. Alpizar, PhD, Brecht Steelant, PhD, Ina Callebaut, PhD, Inge Kortekaas Krohn, MSc, Mira Wouters, PhD, François Vermeulen, MD, Guy Boeckxstaens, MD, PhD, Karel Talavera, PhD, Peter W. Hellings, MD, PhD Journal of Allergy and Clinical Immunology Volume 140, Issue 2, Pages 437-446.e2 (August 2017) DOI: 10.1016/j.jaci.2017.03.014 Copyright © 2017 Terms and Conditions

Fig 1 Baseline NMP measurements in HC subjects and patients with IR. A and B, Representative experiments of NMP recordings during exposure to AITC in an HC subject (Fig 1, A) and a patient with IR (Fig 1, B). C, Distribution of HC subjects and patients with IR according to the concentration threshold for NMP responses to AITC. D, Distribution of patients with IR with and without NHR according to the concentration threshold for NMP responses to AITC. *P < .05. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig 2 Response of patients with IR to capsaicin and placebo treatments. A and B, Average TSSs (Fig 2, A) and average VAS scores for major symptoms at baseline and at 4, 12, and 26 weeks after capsaicin or placebo treatment in patients with IR (n = 24 and n = 9, respectively). C-F, Average VAS scores for individual symptoms at 4, 12, and 26 weeks after capsaicin or placebo treatment in patients with IR. The maximum of the scale for TSSs and VAS scores for major symptom/individual symptoms were 40 and 10 cm, respectively. *P < .05 and **P < .005. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig 3 Distribution of TREs at 4, 12, and 26 weeks after capsaicin (Caps) or placebo treatment in relation to baseline. *P < .05 and **P < .005. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig 4 Distribution of the capsaicin- and placebo-treated patients according to their threshold for the NMP responses to AITC determined at baseline and at 4, 12, and 26 weeks after treatment. *P < .05. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig 5 Capsaicin treatment decreases the sensitivity to AITC in patients with IR in parallel with nasal symptoms. A and B, Correlation between change in threshold for NMP responses to AITC and changes in TSSs (Fig 5, A) and VAS scores for major symptoms (Fig 5, B) determined 4 weeks after capsaicin treatment. C and D, Examples of NMP responses to AITC recorded in a patient with IR before (Fig 5, C) and 4 weeks after (D-F) capsaicin treatment. Note the sharp negative deflection of the trace in response to application of 5 mmol/L AITC before treatment, and the lack of such a response 4 weeks after treatment even at 20 mmol/L AITC. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig 6 Therapeutic response of patients with IR 12 weeks after capsaicin/placebo treatment. Distribution of the therapeutic response of patients when classified according to the presence of NHR (A) or the concentration threshold for the NMP response to AITC determined at baseline (B) is shown. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig 7 TRPV1 expression in HC subjects and patients with IR at baseline and in relation to the therapeutic response. A, TRPV1 mRNA expression (RT-PCR) in homogenates of nasal biopsy specimens in HC subjects and patients with IR at baseline. The IR group is subdivided into patients with IR with and without NHR. B, Relation between baseline TRPV1 mRNA expression in patients with IR and the therapeutic response 12 weeks after capsaicin treatment. *P < .05 and ***P < .0005. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions

Fig E1 Illustration of the multichannel aerosol. Journal of Allergy and Clinical Immunology 2017 140, 437-446.e2DOI: (10.1016/j.jaci.2017.03.014) Copyright © 2017 Terms and Conditions