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RHINITIS
PROPOSED ECHANISM
Non-Allergic Rhinitis:
Vasomotor Rhinitis
CNS stimulation leading to inhibition of the sympathetic nervous system response and enhancement of the parasympathetic response[33 ].
Gustatory Rhinitis
Muscarinc receptor stimulation[45 ].
Infectious Rhinitis
Typically viral or bacterial induced inflammation[20 ].
Non-allergic rhinitis with eosinophilia syndrome (NARES)
Eosinophilia leading to direct nasal mucosal damage and decreased mucocilliary clearance[48 –53 ].
Occupational Rhinitis: [54 –58 ]
Annoyance
Subjective without evidence of inflammation.
Irritant
Substance P induced neutrophilic inflammation.
Corrosive
Agent directly damages nasal mucosa.
Allergic
IgE mediated.
Other Rhinitis Syndromes: [60 –63 ]
Hormonally induced Rhinitis
Increased circulating blood volume and possible hormonal influences (e.g. estrogen, progesterone) leading to vascular pooling and smooth muscle relaxation causing nasal congestion.
Rhinitis Medicamentosa
Direct mucosal damage by alpha-adrenergic agent causing loss of ciliated cells and interstitial edema[64 , 65 ].
Atrophic Rhinitis: [66 –68 ]
Primary Atrophic Rhinitis
Infectious i.e. Klebsiella ozaenae
Secondary Atrophic Rhinitis
Identifiable causes: Chronic sinusitis, turbinate surgery and irradiation
Listed above are some of the proposed mechanisms for the different types of non-allergic rhinitis.
