gms | German Medical Science

Figure

Figure 4: Allergic inflammation reaction

During the immediate phase of AR mast cells degranulate; mediators such as histamine, leukotrienes, prostaglines and tryptase are released into the tissue. During the late phase of AR, effector cells like eosinophils, neutrophils and basophils were recruited from blood flow to the nasal mucosa. Here, eosinophils synthesise cytotoxic proteins: eosinophilic cationic protein (ECP), major basic protein (MBP) and eosinophilic peroxidase (EPO). Additionally, a neurogenic inflammation reaction occurs after stimulation of afferent nerves with histamine. Stimulation of afferent nerves becomes part of trigeminal reflexes to the central nerve system. Parasympathic efferent fibers mediate as the second part of the reflexes the mucosal thickness by increasing superficial blood flow and regulating glandular activity. Besides central reflexes, nasal mucosa action is characterized by a local axon reflex (-----).

Action on glands and bloodvessels is controlled by neuropeptides as substance P (SP), and calcitonin Gene related Peptide (CGRP).