Efektivitas Pelargonium sidoides terhadap penurunan gejala rinosinusitis kronik alergi tanpa polip disertai gangguan tidur

Latar Belakang: Rinosinusitis kronik tanpa polip adalah inflamasi mukosa hidung dan sinus paranasal lebih dari 12 minggu. Etiologinya multifaktorial, terbanyak alergi. Gejala utamanya kongesti hidung, hidung berair, nyeri wajah, gangguan penciuman, dan menyebabkan gangguan tidur. Gangguan tidur disebabkan kongesti hidung dan peningkatan mediator inflamasi IL-1, IL-6, dan TNF-α. Tujuan: Membuktikan efektivitas terapi adjuvan rinosinusitis kronik alergi tanpa polip disertai gangguan tidur menggunakan ekstrak Pelargonium sidoides. Perbaikan gejala dan tanda klinis, serta penurunan kadar IL-1, IL-6, dan TNF- α sekret hidung sebagai indikator. Metode: Quasi-experimental open labelledpre and posttest design pada 20 sampel, dibagi menjadi dua kelompok. Kelompok pertama diterapi larutan cuci hidung NaCl isotonis, semprot hidung kortikosteroid dan ekstrak Pelargonium sidoides. Kelompok kedua (kontrol) tidak diberikan ekstrak Pelargonium sidoides. Gejala klinis dinilai dengan Total Nasal Score Symptoms (TNSS), Visual Analog Scale (VAS), dan nasoendoskopi. Kualitas hidup dengan Rhinoconjuntivitis Quality of Life Questionnaires (RQLQ), dan Sinonasal Outcame Test-20 (SNOT-20). Hasil: Penurunan skor Total Nasal Score Symptoms (TNSS) (p=0,001), Visual Analog Scale (VAS) hidung tersumbat (p=0.018), VAS hidung berair (p=0,02), VAS nyeri wajah (p=0,008),skor nasoendoskopi (p=0,03), dan Rhinoconjuntivitis Quality of Life Questionnaires (RQLQ) activity (p=0,003), sleep (p=0,001), non-nose/eye symptoms (p=0,005), dan emotional (p=0,01) pada kelompok perlakuan berbeda bermakna dibandingkan kelompok kontrol berdasarkan uji Mann-Whitney. Tidak ada perbedaan bermakna pada skor SNOT-20 (p=0,096), penurunan kadar IL-1 (p=0,529), IL-6 (p=0,529), dan TNF-α (p=0,971). Kesimpulan: ekstrak Pelargonium sidoides secara klinis efektif sebagai terapiadjuvan rinosinusitis kronik alergi tanpa polip disertai gangguan tidur, namun tidak didukung penurunan kadar IL-1, IL-6, dan TNF-α sekret hidung. Kata kunci: gangguan tidur, IL-1, IL-6, TNF-α, Pelargonium sidoides, rinosinusitis kronik alergi tanpa polip. ABSTRACTBackground: Chronic rhinosinusitis without nasal polyps is inflammation of the nasal and paranasal sinus mucosa that lasts more than 12 weeks. It has multifactorial etiologies, and allergy is the most common. Its main symptoms are nasal congestion, runny nose, facial pain, smell disturbance, and can cause sleep disturbances. Sleep disturbances caused by nasal congestion and increased of inflammatory mediators IL-1, IL-6, and TNF-α. Purpose: To prove effectiveness of Pelargonium sidoides extract as adjuvant therapy in allergic chronic rhinosinusitis without nasal polyps accompanied by sleep disturbances. The indicators are improvement of clinical signs and symptom, and decreased level of IL-1, IL-6, and TNF-α nasal secretions. Methods: Quasi-experimental design with 20 samples, dividedinto two groups. First group treated with isotonic nasal saline solution, corticosteroid nasal spray, and extract of Pelargonium sidoides. Second group (control) were not given extract of Pelargonium sidoides. Clinical symptoms were measured with TNSS, VAS, and nasoendoscopy. Qualityof Life measured by RQLQ and SNOT-20. Results: TNSS (p= 0.001), nasoendoscopy score, VAS nasal congestion (p=0,018), rinorrhea (p=0,02) facial pain (0,008), and improving RQLQ activity (p= 0.003), sleep (p=0.001), non-nose/eye symptoms (p=0,005), and emotional (p=0,01) in the treated group significanly difference compare to the control group based on Mann-Whitney tes. No significant difference in SNOT-20 score , and decreased levels of IL-1, IL-6, and TNF-α. Conclusion: Pelargonium sidoides extract can be used as adjuvant therapy of chronic allergic rhinosinusitis without nasal polyps with sleep disturbance, but not supported by decrease of IL-1, IL-6, and TNF-α.nasal secretion.Keywords: IL-1, IL-6, TNF-α, Pelargonium sidoides, allergic chronic rhinosinusitis without nasal polyps, sleep disturbance.

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Health-Related Quality of Life Impairment Among Patients With Severe Chronic Rhinosinusitis With Nasal Polyps in the SINUS-24 Trial

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2020.12.485 ◽

2021 ◽

Vol 147 (2) ◽

pp. AB133

Author(s):

Jorge Maspero ◽

Carl Philpott ◽

Peter Hellings ◽

Claire Hopkins ◽

Martin Wagenmann ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Let-7a-5p regulates the inflammatory response in chronic rhinosinusitis with nasal polyps

Diagnostic Pathology ◽

10.1186/s13000-021-01089-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jianwei Zhang ◽

Lei Han ◽

Feng Chen

Keyword(s):

Inflammatory Response ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Mapk Pathway ◽

Inhibitory Effect ◽

Luciferase Reporter ◽

Western Blot Assay ◽

Protein Levels ◽

Tnf Α

Abstract Background Let-7a-5p is demonstrated to be a tumor inhibitor in nasopharyngeal carcinoma. However, the role of let-7a-5p in chronic rhinosinusitis with nasal polyps (CRSwNP) has not been reported. This study is designed to determine the pattern of expression and role of let-7a-5p in CRSwNP. Methods The expression level of let-7a-5p, TNF-α, IL-1β, and IL-6 in CRSwNP tissues and cells were detected by RT-qPCR. Western blot assay was carried out to measure the protein expression of the Ras-MAPK pathway. Dual luciferase reporter assay and RNA pull-down assay were used to explore the relationship between let-7a-5p and IL-6. Results Let-7a-5p was significantly downregulated in CRSwNP tissues and cells. Moreover, the mRNA expression of TNF-α, IL-1β and IL-6 was increased in CRSwNP tissues, while let-7a-5p mimic inhibited the expression of TNF-α, IL-1β and IL-6. Besides that, let-7a-5p was negatively correlated with TNF-α, IL-1β and IL-6 in CRSwNP tissues. In our study, IL-6 was found to be a target gene of let-7a-5p. Additionally, let-7-5p mimic obviously reduced the protein levels of Ras, p-Raf1, p-MEK1 and p-ERK1/2, while IL-6 overexpression destroyed the inhibitory effect of let-7a-5p on the Ras-MAPK pathway in CRSwNP. Conclusion We demonstrated that let-7a-5p/IL-6 interaction regulated the inflammatory response through the Ras-MAPK pathway in CRSwNP.

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Mepolizumab Improves Health Related Quality of Life for Patients with Chronic Rhinosinusitis with Nasal Polyps: Data from the SYNAPSE study

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2020.12.458 ◽

2021 ◽

Vol 147 (2) ◽

pp. AB125

Author(s):

Stella Lee ◽

Maggie Tabberer ◽

Andrew Trigg ◽

Joseph Han ◽

Wytske Fokkens ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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The Comparison of Gabapentin and Amitriptilin Effectivity as Pain Therapy in Herniated Nucleus Pulposus

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v4i3.4738 ◽

2015 ◽

Vol 4 (3) ◽

pp. 225

Author(s):

Indriastuti Cahyaningsih ◽

Rina Handayani ◽

Setyaningsih Setyaningsih

Keyword(s):

Neuropathic Pain ◽

Nucleus Pulposus ◽

Statistical Difference ◽

Pain Therapy ◽

P Value ◽

Analog Scale ◽

Peripheral Neuropathic Pain ◽

Quasi Experimental ◽

Herniated Nucleus Pulposus

Herniated nucleus pulposus (HNP) is one of peripheral neuropathic pain. Although concensus guidelines for the treatment of neuropathic pain are based on the results of the RCT studies, there are still gaps in the literatures. This study aimed to compare the effectiveness and quality of life of gabapentin and amitriptyline for the treatment of pain in HNP. The method used a quasi experimental with consequtive sampling. This study included 30 patients in the gabapentin group and 26 patients in the amitriptyline group, and each group was evaluated for 1 month. Effectiveness was assessed using Visual Analogue Scale (VAS) every 2 weeks then analized by independent and paired sample t test. The results showed that the use of gabapentin and amitriptilin in 4 weeks showed the decrease of pain score measured by visual analog scale 3.70 ± 0.349 and 3.500 ± 0.34 although there was no statistical difference (p value = 0.704). To sum up, effectiveness of gabapentin and amitriptyline in the treatment of neuropathic pain did not have statistical difference.

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CLINICAL PROFILE OF CHRONIC RHINOSINUSITIS: A STUDY IN CENTRAL INDIA

10.36106/paripex/1809951 ◽

2021 ◽

pp. 104-106

Author(s):

Tanvi Rekhade ◽

A.Z. Nitnaware ◽

Seema Patel ◽

R.T. Pawar ◽

Ashish Keche

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Septum ◽

Nasal Polyps ◽

Central India ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Northern India ◽

Causative Factors

Chronic Rhinosinusitis (CRS) has heavy implications on the quality of life and has a prevalence of about 46.1 % in northern India with similar pattern across the country.This research has been undertaken to study the presentation and causative factors for CRS in central India. Data of 100 patients diagnosed as CRS was studied. Patients presented with nasal obstruction and nasal discharge at large. Nasal polyps were seen in 37% cases. The most common associated etiopathological factor was anatomical obstruction due to deviated nasal septum.

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Cystic Fibrosis: The Sense of Smell

American Journal of Rhinology and Allergy ◽

10.1177/1945892419870450 ◽

2019 ◽

Vol 34 (1) ◽

pp. 35-42 ◽

Cited By ~ 4

Author(s):

Antonella M. Di Lullo ◽

Paola Iacotucci ◽

Marika Comegna ◽

Felice Amato ◽

Pasquale Dolce ◽

...

Keyword(s):

Quality Of Life ◽

Cystic Fibrosis ◽

Facial Pain ◽

Nasal Polyps ◽

Nasal Congestion ◽

Nasal Discharge ◽

Upper Airways ◽

Multisystem Disease ◽

Mean Values

Background Cystic fibrosis (CF) is a multisystem disease that involves the upper airways with chronic rhinosinusitis (CRS) causing nasal congestion, rhinorrhea, mouth breathing, facial pain, and olfactory dysfunction. Twelve percent to 71% of CF patients report smelling alterations with an impact on nutrition and quality of life. Objectives The goal was to study olfaction performance in CF patients with CRS that worsens quality of life. Methods A total of 121 subjects were enrolled in this study. Seventy-one had CF and underwent ear, nose, and throat evaluation with nasal endoscopy, sinonasal outcome test 22 (SNOT-22), visual analog scale (VAS), and “Sniffin’ Sticks.” Fifty subjects were age-matched with healthy controls. Results All 71 CF patients were affected by CRS; 59 of 71 (83.1%) had CRS without nasal polyps and 12 of 71 (16.9%) had CRS with early nasal polyps. None of the 50 controls had CRS. Total SNOTT-22 mean values in the 71 CF patients were 38.10 ± 21.08 points. If considering only the 59 CF patients without nasal polyps, the SNOTT-22 mean value was 36.76 ± 21.52 points. Moreover, based on the VAS scores, the degree of nasal symptoms was classified as mild for facial pain, smell alteration, nasal discharge, and sneezing and resulted in moderate symptoms for nasal blockage and headache. Among the CF patients, 55 of 71 (76.5%) declared to be normosmic, while the smelling ability assessed by “Sniffin’ Sticks” showed that only 4 of 71 (5.63%) were normosmic, 58 (81.69%) were hyposmic, and 9 (12.68%) were anosmic. In the controls, 41(82%) were normosmic, 9 (18%) were hyposmic, and none were reported to be anosmic ( P < .001). Conclusions We confirm that most CF patients have a relevant olfactory impairment, although only a low percentage declares such alteration. A careful evaluation with simple and rapid tests helps to select the patients who may benefit from specific therapies.

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Evaluation of the effect of endoscopic partial middleturbinectomy surgery on the quality of life of patients with chronic rhinosinusitis and nasal polyps

Rhinology Journal ◽

10.4193/rhin19.258 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

M.M. Delarestaghi ◽

S. Rajaeih ◽

F.D. Firouzabadi ◽

M. Jamali ◽

M. Roomiani ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Polyps

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Nasal Polyposis: Insights in Epithelial-Mesenchymal Transition and Differentiation of Polyp Mesenchymal Stem Cells

International Journal of Molecular Sciences ◽

10.3390/ijms21186878 ◽

2020 ◽

Vol 21 (18) ◽

pp. 6878 ◽

Cited By ~ 1

Author(s):

Emanuela Chiarella ◽

Nicola Lombardo ◽

Nadia Lobello ◽

Annamaria Aloisio ◽

Teodoro Aragona ◽

...

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Inflammatory Process ◽

Nasal Polyposis ◽

Epithelial Mesenchymal Transition ◽

Nasal Congestion ◽

Alternative Source ◽

Mesenchymal Transition

Chronic rhinosinusitis is a common inflammatory disease of paranasal sinuses, which causes rhinorrhea, nasal congestion, and hyposmia. The genetic predisposition or the exposure to irritants can sustain the inflammatory response and the development of nasal polyposis. Nasal polyps are benign and teardrop-shaped growths that project in the nasal cavities, and originate from the ethmoid sinuses. This inflammatory process is associated with high expression of IL-4, IL-5 and IL-13 and IgE. Antibodies targeting these cytokines or receptors represent a therapeutic strategy in the treatment of nasal polyposis in combination with corticosteroids. The molecular pathogenesis of nasal polyps in chronic rhinosinusitis (CRS) patients is associated with remodeling transition, a process in which epithelial cells lose their typical phenotype, acquiring a mesenchymal-like aspect. TGFβ/SMAD, ERK, and Wnt/β-catenin pathways are altered during the nasal tissue remodeling. miRNA and inhibitor molecules targeting these signaling pathways are able to interfere with the process; which could lead to alternative therapies. Nasal polyps are an alternative source of mesenchymal stem cells, which can be isolated from surgical biopsies. A molecular understanding of the biology of PO-MSCs will contribute to the delineating inflammatory process underlying the development of nasal polyps.

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