№6(6) 2023

DOI 10.37219/2528-8253-2023-6-54

Bezshapochny SB, Bondarenko RV
EFFECT OF PLATELET-RICH PLASMA AND QUERCETIN COMBINATION ON NASAL MUCOSAL DAMAGE
IN CHRONIC ATROPHIC RINITIS
Bezshapochny Sergey B
Poltava State Medical University
Professor of Department of Otorhinolaryngology with Ophthalmology
Doctor of Medical Sciences, Professor
Email: bezshapochny@ukr.net
ORCID ID: https://orcid.org/0000-0002-8726-2024
Scopus Author ID: 6603471609
Bondarenko Ruslan V
Poltava State Medical University
Department of Otorhinolaryngology with Ophthalmology
Postgraduate student
Email: motoman.110494@gmail.com
ORCID ID: https://orcid.org/0000-0002-8497-8123

Abstract

Actuality: Biological barriers play an important role in the functioning of the body, protecting it from external bacterial invasion, and preventing the access of immunocompetent cells to organs to which immunological tolerance has not been formed (brain, testicular tissue, lens of the eye, etc.). A change in the structure of the mucous membrane of the nose undoubtedly leads to a violation of its functioning. Atrophic rhinitis is a chronic pathological process characterized by the formation of thick dry crusts in the nasal cavity, which occurs as a result of progressive atrophy of the nasal mucosa and underlying bone.

The purpose of this work is to study the effect of the combination of plasma enriched with platelets (PRP) and quercetin on the content of markers of oxidative damage to biological polymers, the concentration of hydrogen sulfide and the intensity of collagenolysis in the nasal mucosa under conditions of chronic atrophic rhinitis.

Materials and methods: The study was conducted on 73 patients. Patients were divided into control (n=20) and experimental (n=53) groups. Patients from the experimental group were randomly divided into 2 subgroups: the standard therapy group, patients who received standard treatment according to the protocols for 28 days (n=29) and the PRP-therapy group with the use of quercetin, patients who received PRP injections and quercetin orally at a dose of 40 mg 3 times a day for 28 days against the background of standard therapy for chronic atrophic rhinitis (n=24). The content of free L-oxyproline, the concentration of malondialdehyde, the concentration of hydrogen sulfide (H2S), and the content of oxidatively modified proteins were studied in the nasal mucosa.

Results: The use of PRP therapy and quercetin in combination with standard therapy of chronic atrophic rhinitis led to a decrease in the content of malondialdehyde in the nasal mucosa by 57.75%, the content of oxidatively modified proteins after treatment decreased by 55.05% compared to the indicators before treatment. The concentration of free L-oxyproline in the nasal mucosa after usage of PRP therapy and quercetin in combination with standard therapy of chronic atrophic rhinitis was reduced by 53.02% compared to the values before treatment. The content of H2S in the nasal mucosa dropped by 61.02% compared to the values before treatment.

Conclusions: The use of a medical complex, which against the background of standard therapy of chronic atrophic rhinitis includes the use of PRP therapy and quercetin, increases the effectiveness of the treatment by reducing oxidative damage to lipids and proteins, reducing the breakdown of collagen and limiting the accumulation of H2S in the nasal mucosa.

Keywords: platelet-rich plasma, atrophic rhinitis, lipid peroxidation, L-oxyproline, hydrogen sulfide, quercetin.

References

  1. Mishra A, Kawatra R, Gola M. Interventions for atrophic rhinitis. Cochrane Database Syst Rev. 2012; (2): CD008280. doi: 10.1002/14651858.CD008280.pub2.
  2. Liva GA, Karatzanis AD, Prokopakis EP. Review of Rhinitis: Classification, Types, Pathophysiology. J Clin Med. 2021; 10(14): 3183. doi: 10.3390/jcm10143183.
  3. Zhu S, Li X, Dang B, Wu F, Wang C, Lin C. Lycium Barbarum polysaccharide protects HaCaT cells from PM2.5-induced apoptosis via inhibiting oxidative stress, ER stress and autophagy. Redox Rep. 2022;27(1):32-44. doi: 10.1080/13510002.2022.2036507.
  4. Mihalj H, Butković J, Tokić S, Štefanić M, Kizivat T, Bujak M, Baus Lončar M, Mihalj M. Expression of Oxidative Stress and Inflammation-Related Genes in Nasal Mucosa and Nasal Polyps from Patients with Chronic Rhinosinusitis. Int J Mol Sci. 2022;23(10):5521. doi: 10.3390/ijms23105521.
  5. Tai J, Shin JM, Park J, Han M, Kim TH. Oxidative Stress and Antioxidants in Chronic Rhinosinusitis with Nasal Polyps. Antioxidants (Basel). 2023;12(1):195. doi: 10.3390/antiox12010195.
  6. Kostenko V, Akimov O, Gutnik O, Kostenko H, Kostenko V, Romantseva T, Morhun Y, Nazarenko S, Taran O. Modulation of redox-sensitive transcription factors with polyphenols as pathogenetically grounded approach in therapy of systemic inflammatory response. Heliyon. 2023;9(5):e15551. doi: 10.1016/j.heliyon.2023.e15551.
  7. Kim DH, Lee MH, Lee J, Song EA, Kim SW, Kim SW. Platelet-Rich Plasma Injection in Patients with Atrophic Rhinitis. ORL J Otorhinolaryngol Relat Spec. 2021;83(2):104-111. doi: 10.1159/000513099.
  8. Akimov OYe, Mischenko AV, Kostenko VO. Influence of combined nitrate and fluoride intoxication on connective tissue disorders in rats gastric mucosa. Archives of Balkan Medical Union. 2019;54(3):417-422. doi: 10.31688/ABMU.2019.54.3.03.
  9. Mykytenko AO, Akimov OY, Neporada KS. Influence of lipopolysaccharide on the development of oxidative-nitrosative stress in the liver of rats under conditions of chronic alcohol intoxication. Fiziol Zh. 2022;68(2):29-35. doi: 10.15407/fz68.02.029.
  10. Beregova TV, Neporada KS, Skrypnyk M, Falalyeyeva TM, Zholobak NM, Shcherbakov OB, Spivak MY, Bubnov RV. Efficacy of nanoceria for periodontal tissues alteration in glutamate-induced obese rats-multidisciplinary considerations for personalized dentistry and prevention. EPMA J. 2017 Mar 14;8(1):43-49. doi: 10.1007/s13167-017-0085-7.
  11. Qi W, Qi W, Xiong D, Long M. Quercetin: Its Antioxidant Mechanism, Antibacterial Properties and Potential Application in Prevention and Control of Toxipathy. Molecules. 2022;27(19):6545. doi: 10.3390/molecules27196545.
  12. Deepika, Maurya PK. Health Benefits of Quercetin in Age-Related Diseases. Molecules. 2022;27(8):2498. doi: 10.3390/molecules27082498.
  13. Oneto P, Etulain J. PRP in wound healing applications. Platelets. 2021;32(2):189-199. doi: 10.1080/09537104.2020.1849605.
  14. Tognoloni A, Bartolini D, Pepe M, Di Meo A, Porcellato I, Guidoni K, Galli F, Chiaradia E. Platelets Rich Plasma Increases Antioxidant Defenses of Tenocytes via Nrf2 Signal Pathway. Int J Mol Sci. 2023;24(17):13299. doi: 10.3390/ijms241713299.
  15. Murphy B, Bhattacharya R, Mukherjee P. Hydrogen sulfide signaling in mitochondria and disease. FASEB J. 2019 Dec;33(12):13098-13125. doi: 10.1096/fj.201901304R.
  16. Yassin-Kassab A, Bhargava P, Tibbetts RJ, Griggs ZH, Peterson EI, Craig JR. Comparison of bacterial maxillary sinus cultures between odontogenic sinusitis and chronic rhinosinusitis. Int Forum Allergy Rhinol. 2021 Jan;11(1):40-47. doi: 10.1002/alr.22627.
  17. Lin W, Xie L, Zhou L, Zheng J, Zhai W, Lin D. Effects of platelet-rich plasma on subchondral bone marrow edema and biomarkers in synovial fluid of knee osteoarthritis. Knee. 2023 Jun;42:161-169. doi: 10.1016/j.knee.2023.03.002.
  18. Huynh CB, Nagaarudkumaran N, Kalyaanamoorthy S, Ngo W. In Silico and In Vitro Approach for Validating the Inhibition of Matrix Metalloproteinase-9 by Quercetin. Eye Contact Lens. 2023;49(5):193-198. doi: 10.1097/ICL.0000000000000982.
  19. Lee SJ, Lee AY, Pak SW, Kim WI, Yang YG, Lim JO, Chae SW, Cho YK, Kim JC, Moon BC, Seo YS, Shin IS. Protective effects of Angelica decursiva Franchet & Savatier on allergic responses through enhancement of Nrf2 and suppression of NF-kB/MMP-9 in ovalbumin-exposed mice. J Ethnopharmacol. 2024 Jan 10;318(Pt A):116863. doi: 10.1016/j.jep.2023.116863.
  20. Sul OJ, Ra SW. Quercetin Prevents LPS-Induced Oxidative Stress and Inflammation by Modulating NOX2/ROS/NF-kB in Lung Epithelial Cells. Molecules. 2021 Nov 17;26(22):6949. doi: 10.3390/molecules26226949.