Abstract

Rhinosinusitis is a prevalent disorder with a severe impact on the health-related quality of life. Saponins of Cyclamen europaeum exert a clinically proven curative effect on rhinosinusitis symptoms when instilled into the nasal cavity, however, more extensive preclinical assessment is required to better characterize the efficacy of this botanical extract. This work evaluates the potential use of a natural freeze-dried extract of C. europaeum given as topical nasal administration. Permeation experiment on porcine nasal mucosa was performed with Franz diffusion cells. Experiments in rabbits were performed to test for any toxicological, hematological, biochemical or histological evidence of systemic action. No theoretical levels of saponins were found in the receptor chamber of Franz diffusion cells. Hematological data did not show significant differences between control and experimental animals (p > 0.05). Histological studies also showed that enhanced secretory activity in response to intranasal administration was not accompanied by any visible signs of injury. An examination of the brain, lungs, liver, kidneys, spleen, and gastrointestinal organs did not reveal any abnormality. The absence of mucosal permeation of saponins and negligible probability of C. europaeum saponins absorption in the course of a therapeutic application was demonstrated.

Highlights

  • In recent years, rhinosinusitis (RS) has become a major health problem, and its incidence is steadily increasing around the world with associated health-system costs

  • Saponins of Cyclamen europaeum exert a clinically proven curative effect on rhinosinusitis symptoms when instilled into the nasal cavity, more extensive preclinical assessment is required to better characterize the efficacy of this botanical extract

  • Histological studies showed that enhanced secretory activity in response to intranasal administration was not accompanied by any visible signs of injury

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Summary

Introduction

Rhinosinusitis (RS) has become a major health problem, and its incidence is steadily increasing around the world with associated health-system costs. It is thought that 75% of patients with acute RS take antibiotics unnecessarily [3]. The literature shows little evidence of the effectiveness of such treatments and alternative therapies are required. In this context, the freeze-dried natural fluid extract of the Cyclamen europaeum plant delivered intranasally is thought to have beneficial effects in relieving congestion by facilitating nasal drainage, and it has an anti-inflammatory effect. C. europaeum treatment significantly reduced sinus opacification in patients with acute rhinosinusitis (ARS) [6]. A high percentage of curative outcomes has been shown in several clinical trials using C. europaeum, demonstrating its effectiveness in the symptomatic treatment of ARS [8]

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