The bioflavonoid compound, sinupret, stimulates transepithelial chloride transport in vitro and in vivo

Virgin, Frank W.; Zhang, Shaoyan; Schuster, Daniel P.; Azbell, Christopher; Fortenberry, James A.; Sorscher, Eric J.; Woodworth, Bradford A.

doi:10.1002/lary.20871

Cited by 54 publications

(63 citation statements)

References 21 publications

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“…23 These ion transport mechanisms represent potential therapeutic targets, whereby investigational pharmacologic agents may be used to modify chloride transport and change the mucus structure to facilitate mucociliary clearance. [24][25][26] …”

mentioning

confidence: 99%

Acquired Cilia Dysfunction in Chronic Rhinosinusitis

Gudis

Zhao

Cohen

2012

Am J Rhinol�Allergy

147

136

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Background: Cilia are complex and powerful cellular structures of the respiratory mucosa that play a critical role in airway defense. Respiratory epithelium is lined with cilia that perform an integrated and coordinated mechanism called mucociliary clearance. Mucociliary clearance is the process by which cilia transport the mucus blanket overlying respiratory mucosa to the gastrointestinal tract for ingestion. It is the primary means by which the airway clears pathogens, allergens, debris, and toxins. The complex structure and regulatory mechanisms that dictate the form and function of normal cilia are not entirely understood, but it is clear that ciliary dysfunction results in impaired respiratory defense.Methods: A literature review of the current knowledge of cilia dysfunction in chronic rhinosinsusitis was conducted.Results: Ciliary dysfunction may be primary, the result of genetic mutations resulting in abnormal cilia structure, or, more commonly, secondary, the result of environmental, infectious, or inflammatory stimuli that disrupt normal motility or coordination. Patients with chronic rhinosinusitis (CRS) have been found to have impaired mucociliary clearance. Many biochemical, environmental, and mechanical stimuli have been shown to influence ciliary beat frequency, and common microbial pathogens of respiratory mucosa such as Pseudomonas aeruginosa and Haemophilus influenzae have developed toxins that appear to interrupt normal mucociliary function. Furthermore, inflammatory mediators known to be present in patients with CRS appear to impair secondarily mucociliary clearance. Conclusion:The goal of this article is to summarize the recent developments in the understanding of cilia dysfunction and mucociliary clearance in CRS.

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mentioning

confidence: 99%

Acquired Cilia Dysfunction in Chronic Rhinosinusitis

Gudis

Zhao

Cohen

2012

Am J Rhinol�Allergy

147

136

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“…Primary Cl -channel in respiratory epithelium responsible for good mucoliliary transport is the 'cystic fibrosis transmembrane conductance regulator' (CFTR), which is dysfunctional or absent in patients with cystic fibrosis resulting in a significant reduction of ciliary beat frequency. [7,16] Improvement of mucociliary clearance represents an important therapeutic strategy for patients with sinonasal inflammation by accelerating clearance of inflammatory products and pathogenic bacteria. Bioflavonoids, the main pharmacological components in Sinupret, strongly activate transepithelial Cl -secretion in airway epithelial cells resulting in hydration of airway surface liquid and reduction of nasal fluid viscosity.…”

Section: (Gentiana Lutea) Primrose (Primula Veris) Common Sorrel (Rmentioning

confidence: 99%

“…Bioflavonoids, the main pharmacological components in Sinupret, strongly activate transepithelial Cl -secretion in airway epithelial cells resulting in hydration of airway surface liquid and reduction of nasal fluid viscosity. [7,16] Therefore, Sinupret stimulates the ciliary beat frequency of human epithelial cells in vitro, with a significant increase only 10 minutes post-application and dosedependent effects lasting up to 1 hour. [8] So, in patients treated with Sinupret and MFNS, accelerate nasal fluid clearance and low nasal secretion viscosity annul the inhibitory corticosteroid effects on mucosal gland secretion and inflammatory exudation, resulting in subjective sense of increased postnasal drip.…”

Section: (Gentiana Lutea) Primrose (Primula Veris) Common Sorrel (Rmentioning

confidence: 99%

“…Previous investigations clearly demonstrated mucolytic, secretomotoric, anti-inflammatory, antiviral and antibacterial effects of this medicinal product. [7][8][9][10] These characteristics, as well as the results of two double-blind, placebo-controlled studies recommended the use of Sinupret as a good treatment option in both ARS and chronic rhinosinusitis (CRS). [11,12] The aim of our study was to evaluate the efficacy and safety of combined mometasone furoate nasal spray (MFNS) and oral Sinupret therapy in comparison to MFNS monotherapy when treating mild to moderate ARS.…”

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confidence: 99%

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Efficacy and safety of combined treatment of acute rhinosinusitis by herbal medicinal product Sinupret and mometasone furoate nasal spray

Perić¹,

Kovačević²,

Gaćeša³

et al. 2017

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Özet: Akut rinosinüzit tedavisinde bitkisel t›bbi ürün Sinupret ile mometazon furoat›n kombine kullan›m›n›n etkinli¤i ve güvenilirli¤iAmaç: Bitkisel t›bbi ürünlerin üst solunum yolu enflamasyonlar›ndaki etkinli¤i bilinmektedir. Güncel bilgilerimiz komplike olmayan akut rinosinüzitte, intranazal kortikosteroidlerin semptomlar› iyilefltirdi¤ini desteklemektedir. Bu çal›flmadaki amac›m›z, hafif ve orta fliddetteki akut rinosinüzitte mometazon furoat sprey ve oral bitkisel ilaç Sinupret'in birlikte kullan›m›n› mometazon furoat sprey monoterapisi ile karfl›lafl-t›rmakt›r.Yöntem: K›rk alt› akut rinosinüzitli hasta iki gruba ayr›ld›. Grup 1 (n=23) günde 3 kez Sinupret, 160 mg oral ve günde 2 kez mometazon furoat sprey 200 μg kulland›. Grup 2 (n=23) ise sadece 7 gün süreyle günde 2 kez mometazon furoat sprey 200 μg kulland›. Çal›flmada tedavi öncesi ve sonras› semptomlar ayr› ayr› (nazal obstrüksiyon, rinore, postnazal ak›nt›, fasiyal a¤r› koku bozuklu¤u), toplam semptom skoru ve endoskopik bulgular (mukoza ödemi ve mukoprülan sekresyon) de¤erlendirildi. Bulgular:Tedavi sonras› her iki tedavi grubundaki tüm klinik parametrelerde düzelme gözlendi (p<0.000). MFNS/Sinupret grubunda MFNS grubundan daha düflük toplam semptom skoru (p=0.002), burun t›kan›kl›¤› (p=0.001), burun ak›nt›s› (p=0.001), yüz a¤r›s› (p=0.001), koku bozuklu¤u (p=0.002), mukozal ödem (p=0.003) ve mukopürulan ak›nt› (p=0.001) oldu¤u gözlemlendi. MFNS/Sinupret grubunda hiç bir yan etki görülmezken, sadece MFNS grubunda 1 hastada hafif epistaksis ve 1 burun kurulu¤u gözlendi.Sonuç: Sonuçlar›m›z akut rinosinüzitte MFNS/Sinupret kombine tedavisinin semptomlar ve endoskopik bulgular üzerinde daha etkili oldu¤unu göstermifltir. MFNS monoterapisine k›yasla hiçbir advers olay bildirilmemifltir.Anahtar sözcükler: Glukokortikoidler, inflamasyon, t›bbi bitki, rinit, sinüzit. AbstractObjective: Herbal medicinal products have a well-established role in therapy of upper airway inflammations. Current evidence supports the use of intranasal corticosteroids for improvement in clinical symptoms of uncomplicated acute rhinosinusitis (ARS). We aimed to evaluate efficacy and safety of combined therapy by mometasone furoate nasal spray (MFNS) and oral herbal medicinal product Sinupret in comparison to MFNS monotherapy when treating mild to moderate ARS. Methods:Forty-six ARS patients were divided into two groups. Group 1 (n=23) received herbal drug Sinupret, 160 mg per os, three times daily and MFNS 200 μg twice daily for 7 days. Group 2 (n=23) received only MFNS 200 μg twice daily for 7 days. We assessed total symptom score (TSS), individual symptom scores for each symptom (nasal obstruction, rhinorrhea, postnasal drip, facial pain/pressure, impaired sense of smell) and endoscopic findings (mucosal edema, mucopurulent secretion), before and after treatment.Results: Significant improvement of all clinical parameters was found after both treatment modalities (p<0.000). We observed lower post-treatment TSS (p=0.002), nasal obstruction (p=0.001), rhinorrhea (p=0.001), facial pai...

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“…Adequate mucociliary clearance (MCC) is also dependent on the hydration state of the ASL as well as on ciliary beat frequency [4]. In chronic rhinosinusitis (CR), there is disruption in the Cl -transport which leads to dehydration of ASL and mucus stasis [5].…”

Section: Introductionmentioning

confidence: 99%

The Role of Airway Surface Liquid in the Primary Management of Rhinosinusitis

Hendrik¹,

Raubenheimer²

2013

J Interdiscipl Med Dent Sci

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Airway surface liquid forms part of the innate defence mechanism of the respiratory system, including the nasal and paranasal sinuses. Successful mucociliary clearance, which lies at the centre of this defence mechanism, involves the synchronized function of two structures, namely, the periciliary liquid layer and the mucus layer. The two structures have collectively been termed the 'two phase airway surface liquid' system. This system is kept hydrated through regulation of sodium and chloride transport. A well hydrated airway surface liquid that allows the periciliary liquid layer to extend over the height of the outstretched cilia keeping mucus away from the epithelia is considered to be essential for effective mucus clearance and sinonasal health. This mechanism assists in trapping and eliminating foreign particles and, together with antimicrobial peptides, maintains a sterile environment in the nasal and paranasal sinuses, which are continually exposed to microorganisms in the external environment. In diseases such as rhinosinusitis, the mucociliary clearance capacity is diminished; the first line of defence is disrupted allowing for bacterial invasion and infection. This manuscript explores the prospect of an alternative approach for the prophylaxis and primary management of rhinosinusitis based on the maintenance of a well hydrated airway surface liquid.

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The bioflavonoid compound, sinupret, stimulates transepithelial chloride transport in vitro and in vivo

Abstract: Sinupret strongly activates transepithelial Cl(-) secretion through a mechanism known to hydrate the ASL of respiratory epithelium. This is one means by which the medication is likely to exert therapeutic benefit.

Cited by 54 publications

References 21 publications

Acquired Cilia Dysfunction in Chronic Rhinosinusitis

Acquired Cilia Dysfunction in Chronic Rhinosinusitis

Efficacy and safety of combined treatment of acute rhinosinusitis by herbal medicinal product Sinupret and mometasone furoate nasal spray

The Role of Airway Surface Liquid in the Primary Management of Rhinosinusitis

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