The sinonasal mucosa has an essential role in defense
mechanisms of the upper respiratory tract. The innate immune
system presents the primary defense against noxious
microorganisms followed by induction of the adaptive immune
mechanisms as a consequence of the presence of pathogens.
This well-known activation of adaptive immune system in
response to presence of the antigen on mucosal surfaces is now
broadly applicated in vaccinology research. Prevention of
infectious diseases belongs to substantial challenges in
maintaining the population health. Non-invasive, easily applicable
mucosal vaccination purposes various research opportunities that
could be usable in daily practice. However, the existence of
multiple limitations such as rapid clearance of vaccine from nasal
mucosa by means of mucociliary transport represents a great
challenge in development of safe and efficient vaccines. Here we
give an updated view on nasal functions with focus on nasal
mucosal immunity and its potential application in vaccination in
nearly future.
Cough is one of the most important defensive reflexes. However,
extensive non- productive cough is a harmful mechanism leading
to the damage of human airways. Cough is initiated by activation
of vagal afferents in the airways. The site of their convergence is
particularly the nucleus of the solitary tract (nTS). The secondorder neurons terminate in the pons, medulla and spinal cord and
there is also the cortical and subcortical control of coughing. Upper
airway cough syndrome (UACS) – previously postnasal drip
syndrome - is one of the most common causes of chronic cough
together with asthma and gastroesophageal reflux. The main
mechanisms leading to cough in patients with nasal and sinus
diseases are postnasal drip, direct irritation of nasal mucosa,
inflammation in the lower airways, upper airway inflammation and
the cough reflex sensitization. The cough demonstrated by UACS
patients is probably due to hypersensitivity of the upper airways
sensory nerve or lower airways sensory nerve, or a combination of
both. Further studies are needed to clarify this mechanism.