Tunica propria in chronic allergic rhinitis. Electron-microscopic study II. The sero-mucinous glands

Allergic and Nonallergic Rhinitis: Classification and Pathogenesis Part I. Allergic Rhinitis

Chronic rhinitis, although not life-threatening, substantially interferes with one's quality of life. Associated symptoms of nasal obstruction, sneezing, rhinorrhea, and anosmia afflict an estimated 40 million Americans. Directed clinical history and physical examination combined with noninvasive and routine procedures permit physicians to diagnose the myriad conditions causing rhinitis. Although the precise etiology of many of these conditions is only partially known, a practical diagnostic classification can be formulated based on clinical and laboratory findings. An understanding of the pathophysiology of allergic rhinitis as well as the other less understood entities provides the clinician with a integral foundation to implement preventative and therapeutic measures. This comprehensive review should provide the reader an opportunity to better understand and appreciate the causes and pathophysiology of chronic rhinitis. Part I of this article concentrates on IgE-mediated reactions, mediators, and drugs involved in allergic rhinitis. Part II focuses on the recent advances gained in understanding the nonallergic (non-IgE) causes of chronic rhinitis.

The human respiratory nasal mucosa in females using contraceptive pills. An ultramicroscopic and histochemical study

The ultrastructure and histochemical changes in 25 females using contraceptive pills were studied. Fifteen pill-using females developing no nasal symptoms showed similar changes to those observed in symptom-free pregnant females. Ten pill-using females developing nasal symptoms showed squamous metaplasia, interepithelial oedema, glandular hyperplasia, histiocytic proliferation and fibrous tissue deposition, all attributed to the action of oestrogen. Their histochemical reactions were similar to those of chronic hypertrophic non-allergic rhinitis.

Ultrastructural and histochemical observations of respiratory epithelium and gland

Secretory products of epithelial cells of the human respiratory tract have been studied biochemically and by a variety of histochemical methods for differentiating and characterizing complex carbohydrates at the light and electron microscopic level. By light microscopy a majority of mucous secretory cells of the surface epithelium secret glycoprotein with terminal sialic acid, penultimate galactose residues, and variable sulfate esters. Ultrastructurally the mucous cells of the surface epithelium vary within and between regions of the respiratory tree and comprise a heterogeneous population of cells differing in the fine structure and cytochemistry of their secretory granules. Serous tubules and demilunes in glands of the lamina propria produce a secretion that contains less carbohydrate than that in the nearby mucous cells, resembles the latter in content of sulfate esters, and differs in having little or no sialic acid and no terminal or penultimate galactose. Mucous tubules produce a carbohydrate-rich secretion containing glycoconjugate with terminal sialic acids, penultimate galactose residues, and a variable degree of sulfation like the glycoconjugate of surface mucous cells. Heterogeneity of cells can be demonstrated in the serous and mucous tubules by ultrastructural, morphologic, and cytochemical methods.