Capsaicin for allergic rhinitis in adults

 

Abstract

Background

This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2006.

Allergic rhinitis represents a global health problem. Non-specific nasal hyper-responsiveness is an important feature of allergic and non-allergic rhinitis. This phenomenon is believed to result from the effect of allergic inflammation on the sensory nerves that supply the upper airway mucosa. A pharmacological agent that has proved useful in the investigation of effects of neuronal stimulation is capsaicin, the pungent component of hot pepper. Intranasal capsaicin specifically stimulates afferent nerves consisting mostly of unmyelinated C fibers and some myelinated A-delta fibers. As a result it can trigger central and axonal reflexes, the latter being putatively mediated by the release of neuropeptides. Capsaicin, as a blocking agent of neuropeptides, blocks the axon reflex and may exert a curative effect on allergic rhinitis.

Objectives

To assess the effectiveness of capsaicin for allergic rhinitis in adults.

Search methods

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 2 September 2009.

Selection criteria

Randomized controlled trials of capsaicin for allergic rhinitis in adults.

Data collection and analysis

Three authors read each paper, blind to its identity. Decisions concerning inclusion were made by simple majority. We all performed quality assessment independently.

Main results

One small trial did not find evidence that intranasal capsaicin had a therapeutic effect in allergic rhinitis. A small pharmacological effect on clinical histamine dose response was found. After treatment, leukotriene levels in nasal lavage did not increase in the capsaicin group.

Authors' conclusions

There is insufficient evidence to assess the use of capsaicin in clinical practice.

 

Plain language summary

Capsaicin for allergic rhinitis

Allergic rhinitis is a common health problem affecting between 10% and 25% of the population, and its prevalence is increasing. The symptoms include a running or blocked nose, itching and sneezing. Several drug therapies are available including antihistamines and steroids. Capsaicin, which is the pungent component of hot pepper, has also been used. With repeated doses applied topically it may desensitize the lining of the nose and have a therapeutic effect on allergic rhinitis. The review found one small, low quality randomized controlled trial which did not demonstrate a therapeutic effect of capsaicin on allergic rhinitis symptoms. Further trials are needed.

 

摘要

背景

以辣椒素(Capsaicin)治療成人過敏性鼻炎

過敏性鼻炎是一個全球性健康問題。非特異性鼻的過度反應是過敏性和非過敏性鼻炎的一個重要特徵。這種現象被認為是支配上呼吸道粘膜感覺神經過敏性發炎的結果。辣椒素為辣椒中辛剌的成分，這種藥劑在神經刺激研究中已證明是有用的。鼻內使用辣椒素專一性的刺激傳入神經包含大部分無髓鞘的C纖維和一些有髓鞘的阿三角洲纖維(Adelta fibers)。 因此，它會引發中央和軸突反射，後者是假定神經胜(月太)釋放的調節是存在的。辣椒素是作為神經胜(月太)阻斷劑，阻斷軸突反射或許對過敏性鼻炎有治療的效果

目標

評估辣椒素對於成人過敏性鼻炎的成效

搜尋策略

我們搜尋了 Cochrane Ear, Nose and Throat Disorders Group Trials Register、the Cochrane Central Register of Controlled Trials (CENTRAL)、PubMed、 EMBASE、CINAHL、Web of Science、BIOSIS Previews、Cambridge Scientific Abstracts、mRCT ，額外的發表以及未發表的試驗。最近搜尋日期是2009年9月2日

選擇標準

辣椒素對成人過敏性鼻炎的隨機對照試驗

資料收集與分析

三位評審閱讀每篇文章，對於文章的身份並不知情。以獲得多數票的文章作為列入的標準。所有文章都獨立地進行品質評估

主要結論

在一個小型試驗中，對於過敏性鼻炎鼻腔內辣椒素施用是否有治療效果，結果並沒有發現任何證據。一個小的藥理作用於組織胺劑量上的反應被發現。在辣椒素組，治療後，用鼻灌洗的方式測量白三烯並沒有增加的情形

作者結論

沒有足夠的證據來評估辣椒素在臨床上的使用

翻譯人

本摘要由國泰綜合醫院陳育斌翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

沒有足夠的證據來評估辣椒素在臨床上的使用是否有效。過敏性鼻炎是一種常見的健康問題，影響到10％至25％的人口，而且其發病率繼續在增加。期症狀包括流鼻水或鼻塞，瘙癢和打噴嚏。有許多藥物可用來治療，包括抗組織胺和類固醇。辣椒素，它是辣椒中辛辣的成分，已被用來治療過敏性鼻炎。反覆局部施用辣椒素，可降低鼻黏膜的敏感性，有治療過敏性鼻炎的效果。審查發現只有一個小且低品質的隨機對照試驗，此試驗並無顯示辣椒素對過敏性鼻炎的症狀具有治療效果。進一步的試驗是必要的