Preview

Meditsinskiy sovet = Medical Council

Advanced search

Potential of bioregulatory therapy in the treatment of patients with rhinitis medicamentosa

https://doi.org/10.21518/ms2024-495

Abstract

Chronic rhinitis is a common condition characterized by inflammation of the mucous membrane of the nose. It can lead to troublesome symptoms like itching, runny nose, nasal congestion, sneezing and irritation. Rhinitis can significantly lower the quality of life, have a detrimental effect on productivity and negatively affect social communications. Therefore, it is important to diagnose and treat this disease in due time. There are two main types of rhinitis: allergic rhinitis and non-allergic rhinitis. Non-allergic rhinitis refers to patients who have nasal symptoms, but skin tests do not show any allergic reactions. In this case, additional tests are necessary before making an accurate diagnosis. In turn, several subgroups of non-allergic rhinitis can be distinguished according to the causes and mechanisms of its development. The article discusses the features of the treatment of rhinitis medicamentosa. The use of different drugs can cause nasal symptoms, including nasal congestion. Rhinitis medicamentosa can be divided into two subgroups: rhinitis caused by adverse effects of systemic drugs and rhinitis due to overuse of antioedemic nasal therapy. Topically active vasoconstrictors are used to relieve nasal congestion caused by various reasons. However, the long-term use of such drugs can lead to the development of rhinitis medicamentosa and other adverse reactions. There are several hypotheses as to why rhinitis medicamentosa occurs. They include activation of beta-adrenergic receptors, the decreased production of presynaptic endogenous norepinephrine, and the development of tachyphylaxis. The overuse of topical nasal decongestants can bring on vicious cycle: the more frequently the patients use the drugs, the more likely thery are to get increased adverse effects. It is important to understand the potential risks and limitations of using topical nasal decongestants. If symptoms of nasal congestion or other adverse effects develop, it is necessary to consult a doctor to adjust the treatment.

About the Authors

S. A. Karpishchenko
Pavlov First Saint Petersburg State Medical University
Russian Federation

Sergey A. Karpishchenko - Dr. Sci. (Med.), Professor, Head of the Department of Otorhinolaryngology with Clinic.

6-8, Lev Tolstoy St., St Petersburg, 197022



O. M. Kolesnikova
Pavlov First Saint Petersburg State Medical University
Russian Federation

Olga M. Kolesnikova - Cand. Sci. (Med.), Associate Professor of the Department of Otorhinolaryngology with Clinic.

6-8, Lev Tolstoy St., St Petersburg, 197022



S. A. Alekseenko
St Petersburg Children’s Municipal Multi-specialty Clinical Center of High Medical Technology named after K.A. Rauhfus
Russian Federation

Svetlana Alekseenko - Dr. Sci. (Med.), Associate Professor, Head of the Otorhinolaryngology Department.

8, Ligovsky Ave., St Petersburg, 191036



References

1. Tran NP, Vickery J, Blaiss MS. Management of rhinitis: Allergic and non-allergic. Allergy Asthma Immunol Res. 2011;3(3):148-156. https://doi.org/10.4168/aair.2011.3.3.148.

2. Cemal Cingi C, Bayar Muluk N, Hanci D, Sahin E. Impacts of allergic rhinitis in social communication, quality of life and behaviours of the patients. J Allergy Disord Ther. 2015;2(1):1-3. https://doi.org/10.24966/ADT-749X/100002.

3. Small P, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol. 2011;7(Suppl. 1):S3. https://doi.org/10.1186/1710-1492-7-S1-S3.

4. Settipane RA, Kaliner MA. Nonallergic Rhinitis. Am J Rhinol Allergy. 2013;27(Suppl. 3):S48-S51. https://doi.org/10.2500/ajra.2013.27.3927.

5. Kaliner MA. Classification of Nonallergic Rhinitis Syndromes With a Focus on Vasomotor Rhinitis, Proposed to be Known henceforth as Nonallergic Rhinopathy. World Allergy Organ J. 2009;2(6):98-101. https://doi.org/10.1097/WOX.0b013e3181a9d55b.

6. Agnihotri NT, McGrath KG. Allergic and nonallergic rhinitis. Allergy Asthma Proc. 2019;40(6):376-379. https://doi.org/10.2500/aap.2019.40.4251.

7. Alromaih S, Alsagaf L, Aloraini N, Alrasheed A, Alroqi A, Aloulah M et al. DrugInduced Rhinitis: Narrative Review. Ear Nose Throat J. 2022;1455613221141214. https://doi.org/10.1177/01455613221141214.

8. Hellings PW, Klimek L, Cingi C, Agache I, Akdis C, Bachert C et al. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2017;72(11):1657-1665. https://doi.org/10.1111/all.13200.

9. Liva GA, Karatzanis AD, Prokopakis EP. Review of Rhinitis: Classification, Types, Pathophysiology. J Clin Med. 2021;10(14):3183. https://doi.org/10.3390/jcm10143183.

10. Varghese M, Glaum MC, Lockey RF. Drug-induced rhinitis. Clin Exp Allergy. 2010;40(3):381-384. https://doi.org/10.1111/j.1365-2222.2009.03450.x.

11. Pinargote P, Guillen D, Guarderas JC. ACE inhibitors: upper respiratory symptoms. BMJ Case Rep. 2014;2014:bcr2014205462. https://doi.org/10.1136/bcr-2014-205462.

12. Wahid NWB, Shermetaro C. Rhinitis Medicamentosa In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://pubmed.ncbi. nlm.nih.gov/30855902/.

13. Malm L, Anggard L. Vasoconstrictors. In: Mygind N, Naclerio RM (eds.). Allergic and non-allergic rhinitis. Clinical aspects. 1st ed. Copenhagen: Munksgaard; 1993, pp. 95-100. Available at: https://archive.org/details/allergicnonaller0000unse/page/n5/mode/2up.

14. Karpishchenko SA, Kolesnikova OM. Pros and cons of nasal decongestants. Pediatrics. Consilium Medicum. 2016;(3):31-36. (In Russ.) Available at: https://omnidoctor.ru/upload/iblock/958/9583c8bad29d42bcd02e93038a 0a9da2.pdf.

15. Sutrisna В, Frerichs RR, Reingold AL. Randomised, controlled trial of effectiveness of ampicillin in mild acute respiratory infections in Indonesian children. Lancet. 1991;338(8765):471-474. https://doi.org/10.1016/01406736(91)90544-y.

16. Passali D, Salerni L, Passali GC, Passali FM, Bellussi L. Nasal decongestants in the treatment of chronic nasal obstruction: efficacy and safety of use. Expert Opin Drug Saf. 2006;5(6):783-790. https://doi.org/10.1517/14740338.5.6.783.

17. Колесникова ОМ. Роль вазомоторной формы дисфункции эндотелия в патогенезе вазомоторного и аллергического ринитов: автореф. дис канд. мед. наук: 14.00.04, 14.00.16. СПб.; 2008. 10 с. Режим доступа: https://new-disser.ru/_avtoreferats/01004068137.pdf.

18. Lacroix JS. Adrenergic and nonadrenergic mechanisms in sympathetic vascular control of the nasal mucosa. Acta Physiol Scand Suppl. 1989;581:1-63. Available at: https://pubmed.ncbi.nlm.nih.gov/2568728/.

19. Graf P. Rhinitis medicamentosa: a review of causes and treatment. Treat Respir Med. 2005;4(1):21-29. https://doi.org/10.2165/00151829-200504010-00003.

20. Graf P, Hallen H. Effect on the nasal mucosaof long-term treatment with oxymetasoline, bensalconium chloride, and placebo nasal sprays. Laryngoscope. 1996;106(5):605-609. https://doi.org/10.1097/00005537199605000-00016.

21. Lockey RF. Rhinitis medicamentosa and the stuffy nose. J Allergy Clin Immunol. 2006;118(5):1017-1018. https://doi.org/10.1016/j.jaci.2006.06.018.

22. Ramey JT, Bailen E, Lockey RF. Rhinitis medicamentosa. J Investig Allergol Clin Immunol. 2006;16(3):148-155. Available at: https://www.jiaci.org/Summary/vol16-issue3-num52.

23. Varricchio A, Capasso M, De Lucia A, Avvisati F, Varricchio AM, Bettoncelli G, Ciprandi G. Intranasal flunisolide treatment in patients with non-allergic rhinitis. Int J Immunopathol Pharmacol. 2011;24(2):401-409. https://doi.org/10.1177/039463201102400213.

24. Shelenkova VV. Drug-induced rhinitis: Questions and answers. Meditsinskiy Sovet. 2017;(8):112-115. (In Russ.) https://doi.org/10.21518/2079701X-2017-8-112-115.

25. Allen DB. Systemic effects of intranasal steroids: an endocrinologist’s perspective. J Allergy Clin Immunol. 2000;106(4 Suppl.):S179-S190. https://doi.org/10.1067/mai.2000.110038.

26. Jacobs R, Lieberman P, Kent E, Silvey M, Locantore N, Philpot EE. Weather temperature-sensitive vasomotor rhinitis may be refractory to intranasal corticosteroid treatment. Allergy Asthma Proc. 2009;30(2):120-127. https://doi.org/10.2500/aap.2009.30.3206.

27. Blom HM, Godthelp T, Fokkens WJ, KleinJan A, Mulder PG, Rijntjes E. The effect of nasal steroid aqueous spray on nasal complaint scores and cellular infiltrates in the nasal mucosa of patients with nonallergic, noninfectious perennial rhinitis. J Allergy Clin Immunol. 1997;100(6 Pt 1):739-747. https://doi.org/10.1016/s0091-6749(97)70267-7.

28. Lundblad L, Sipila P, Farstad T, Drozdziewicz D. Mometasone furoate nasal spray in the treatment of perennial non-allergic rhinitis: a nordic, multicenter, randomized, double-blind, placebo-controlled study. Acta Otolaryngol. 2001;121(4):505-509. Available at: https://pubmed.ncbi.nlm.nih.gov/11508513/.

29. Konnert BD, Maiwald J. Therapy of chronic drug-induced and vasomotor rhinopathies experience with the use of a biological nasal spray. Biologicheskaya Meditsina. 1997;(1):23-28. (In Russ.) Available at: https://www.arnebia.ru/cgi-bin/download.cgi?id_dnl=965.

30. Sprenger F. Rhinitis-Behandlung. Eine Studie mit Euphorbium-compositumNasentropfen-(Heel-) Dosierspray ohne Treibgas. Z Allgemeinmed. 1984;60:1164-1168.

31. Heine H. Zum antiviralen Wirkmechanismus von Euphorbium compositum S. Biol Med. 2001;30:209-210.

32. Glatthaar-Saalmuller B, Fallier-Becker P. Antiviralaction of Euphorbium compositum and its components. Forsch Komplementarmed Klass Naturheilkd. 2001;8(4):207-212. https://doi.org/10.1159/000057223.

33. Schmolz M, Weiser M. Wirkungen eines Antihomotoxikums auf das Immunsystem des Menschen. Biol Med. 2001;30:132-135.

34. Scalia RA, Dolci JE, Ueda SM, Sassagawa SM. In vitro antimicrobial activity of Luffa operculata. Braz J Otorhinolaryngol. 2015;81(4):422-430. https://doi.org/10.1016/j.bjorl.2014.07.015.

35. Silva L, Costa HO, Souza FC, Lopes EM, Ueda SM. Preclinical evaluation of Luffa operculata Cogn. and its main active principle in the treatment of bacterial rhinosinusitis. Braz J Otorhinolaryngol. 2016;84(1):82-88. https://doi.org/10.1016/j.bjorl.2016.11.004.

36. Karpishchenko SA, Kolesnikova OM. Bioregulatory therapy in the treatment of acute and chronic rhinitis. RMJ. 2018;10(2):75-78. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Bioregulyacionnaya_terapiya_v_lechenii_ostryh_i_hronicheskih_rinitov/.


Review

For citations:


Karpishchenko SA, Kolesnikova OM, Alekseenko SA. Potential of bioregulatory therapy in the treatment of patients with rhinitis medicamentosa. Meditsinskiy sovet = Medical Council. 2024;(18):133-138. (In Russ.) https://doi.org/10.21518/ms2024-495

Views: 129


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)