Title : Neuroimmune mechanisms in nasal hyperreactivity: Unraveling the nose-brain axis
Abstract:
Nasal hyperreactivity (NHR), including conditions such as allergic rhinitis, represents a group of common disorders characterized by complex neuroimmune interactions, with underlying mechanisms that are not fully understood. Communication between the nervous and immune systems plays a pivotal role in host-protective immunity at the nasal mucosa. In NHR, external stimuli such as allergens, thermal variations, mechanical, chemical, and biological factors directly impact nociceptive afferents and adjacent tissues, triggering the release of neuropeptides such as CGRP and substance P, as well as pro-inflammatory cytokines including IL-4, IL-5, and IL-33. These interactions regulate both innate and adaptive immune responses through neuroimmune pathways. This response not only exacerbates local neuroimmune inflammation in the nasal mucosa but also transmits external signals to the central nervous system via afferent nerves. Furthermore, recent studies highlight the role of the body-brain axis in mediating communication between the central and peripheral systems, with specific brain regions exerting significant regulatory effects on peripheral immune activity. Central activation resulting from nasal inflammation may, through efferent neural pathways, further aggravate nasal hypersensitivity, creating a bidirectional amplification of neuroimmune loops. This central-peripheral feedback loop may represent a key driving force behind the persistent pathophysiological changes in NHR. This review aims to elucidate the neuroimmune mechanisms underlying NHR, focusing particularly on the "nose-brain axis," a bidirectional communication pathway linking the peripheral immune system with the central nervous system (CNS). We propose that further exploration of how neuroimmune interactions shape NHR via the nose-brain axis in experimental models is essential. These findings underscore the potential for innovative therapeutic strategies targeting neuroimmune interactions as an effective approach for treating NHR.
