Combined nasal spray containing tuaminoheptane, acetylcysteine, and hyaluronic acid in the complex therapy for acute rhinosinusitis
DOI: 10.32364/2587-6821-2023-7-8-5
Aim: to assess the effect of hyaluronic acid on the clinical efficacy of a combination of tuaminoheptane and N-acetylcysteine and the functional activity of the nasal mucociliary apparatus in acute rhinosinusitis (ARS).
Patients and Methods: 60 adults aged 17–65 and 60 children aged 6–16 diagnosed with moderate ARS were enrolled. The study group received Drug 1 (a dosed spray for topical use containing tuaminoheptane, acetylcysteine, and sodium hyaluronate). The comparison group received Drug 2 containing tuaminoheptane and acetylcysteine. In addition, all patients received standard antibacterial therapy. Patients were examined at three control points. Visit 1 is an initial referral for subjective assessment of the severity of complaints using a 10-point visual analogue scale/VAS), assessment of symptoms by a specialist (0-3 points), and evaluation of the morphological structure of the mucosa and functional activity of the nasal mucociliary apparatus using video histomorphometry. Visit 2 occurred 5–7 days after starting treatment with a similar set of examinations. Visit 3 occurred on days 10–14 after treatment, and examinations included assessment of the severity of complaints and ARS symptoms.
Results: comparative analysis of changes in the severity of complaints and objective ARS signs in both age groups demonstrated that both drugs significantly reduced the severity of subjective complaints and ARS symptoms. However, Drug 1 demonstrated greater clinical efficacy. Both drugs were safe in both adults and children. Drug 1 containing hyaluronic acid had a positive effect on cell morphology and survival and on the activity of the nasal mucociliary apparatus.
Conclusions: a combined nasal spray containing sodium hyaluronate, tuaminoheptane, and N-acetylcysteine demonstrated higher clinical efficacy because of a positive effect on the nasal mucociliary apparatus and morphological characteristics of the nasal ciliated epithelium. Therefore, this preparation is recommended for practical use in adults and children.
Keywords: acute rhinosinusitis, hyaluronic acid, tuaminoheptane, acetylcysteine, mucociliary clearance, ciliated epithelium, decongestants, mucoactive therapy.
For citation: Ryazantsev S.V., Krivopalov A.A., Dvoryanchikov V.V., Alekseenko S., Kuzovkov V.E., Barashkova S.V., Tikhomirova E.K. Combined nasal spray containing tuaminoheptane, acetylcysteine, and hyaluronic acid in the complex therapy for acute rhinosinusitis. Russian Medical Inquiry. 2023;7(8):498–510 (in Russ.). DOI: 10.32364/2587-6821-2023-7-8-5.
About the authors:
Sergey V. Ryazantsev — Dr. Sc. (Med.), Professor, Deputy Director for Scientific Coordination Work, St. Petersburg Research Institute of Ear, Throat, Nose and Speech; 19, Bronnitskaya str., St. Petersburg, 190013, Russian Federation; ORCID iD 0000-0001-1710-3092.
Aleksandr A. Krivopalov — Dr. Sc. (Med.), Head of the Research Division of Upper Airway Disorders, St. Petersburg Research Institute of Ear, Throat, Nose and Speech; 19, Bronnitskaya str., St. Petersburg, 190013, Russian Federation; associate professor of the Department of Otorhinolaryngology, I.I. Mechnikov North-Western State Medical University; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0002-6047-4924.
Vladimir V. Dvoryanchikov — Dr. Sc. (Med.), Professor, Honorary Doctor of the Russian Federation, director, St. Petersburg Research Institute of Ear, Throat, Nose and Speech; 19, Bronnitskaya str., St. Petersburg, 190013, Russian Federation; ORCID iD 0000-0002-0925-7596.
Svetlana Alekseenko — Dr. Sc. (Med.), Associate Professor, leading researcher of the Research Division of Upper Airway Disorders, St. Petersburg Research Institute of Ear, Throat, Nose and Speech; 19, Bronnitskaya str., St. Petersburg, 190013, Russian Federation; associate professor of the Department of Otorhinolaryngology, I.I. Mechnikov North-Western State Medical University; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; Head of the Otorhinolaryngological Department, K.A. Raukhfus Children City Multidisciplinary Clinical Center of High Medical Technologies; 8, Ligovskiy av., St. Petersburg, 193036, Russian Federation; ORCID iD 0000-0002-3377-8711.
Vladislav E. Kuzovkov — Dr. Sc. (Med.), Deputy Director for Innovations, St. Petersburg Research Institute of Ear, Throat, Nose and Speech; 19, Bronnitskaya str., St. Petersburg, 190013, Russian Federation; ORCID iD 0000-0002-2581-4006.
Svetlana V. Barashkova — junior researcher of the Laboratory Diagnostic Research Division of Ear, St. Petersburg Research Institute of Ear, Throat, Nose and Speech; 19, Bronnitskaya str., St. Petersburg, 190013, Russian Federation; pathologist of the Pathology Department, K.A. Raukhfus Children City Multidisciplinary Clinical Center of High Medical Technologies; 8, Ligovskiy av., St. Petersburg, 193036, Russian Federation; ORCID iD 0000-0002-5618-4510.
Ekaterina K. Tikhomirova — C. Sc. (Med.), otorhinolaryngologist of the Otorhinolaryngological Department, K.A. Raukhfus Children City Multidisciplinary Clinical Center of High Medical Technologies; 8, Ligovskiy av., St. Petersburg, 193036, Russian Federation; ORCID iD 0000-0001-6952-6543.
Contact information: Svetlana Alekseenko, e-mail: svolga-lor@mail.ru.
Financial Disclosure: the publication is supported by Solopharm according to the internal policies and existing legislation of the Russian Federation.
There is no conflict of interest.
Received 20.07.2023.
Revised 14.08.2023.
Accepted 29.08.2023.
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