Figure 3

Balance of autonomic inputs into nasal mucosa of patients with vasomotor rhinitis (VMR). Central nervous system stimulation causes release of tachykinins, substance P (SP), calcitonin gene-related peptide (CGRP) and neurokinin A (NKA) that result in inhibition of the sympathetic nervous system and shift the balance towards the parasympathetic response. Noradrenaline and neuropeptide tyrosine (NPY) cause vasoconstriction and relief of nasal congestion. Vasodilators acetylcholine (Ach), vasoactive intestinal peptide (VIP) and nitric oxide (NO) cause nasal congestion and glandular secretion [33].