Objectives. The safety and efficacy of ectoine nasal spray and ectoine nasal spray with dexpanthenol in the treatment of rhinitis sicca were evaluated in two studies. Design and Methods. Two noninterventional observational studies were performed to evaluate the efficacy and safety of a nasal spray containing ectoine (study 1) and ectoine/dexpanthenol (study 2) over a period of two weeks including comparable numbers of patients suffering from rhinitis sicca anterior. Patients and physicians were asked to rate the efficacy in reducing symptoms and the tolerability over the treatment phase. Results. The treatment in both studies resulted in a clinical and statistical significant reduction of the main diagnosis parameters, nasal airway obstruction, and crust formation. There was also a significant reduction in the secondary diagnosis parameters in both studies. Importantly, the tolerability was very good. During the whole observational study, neither patients nor doctors stopped the medication due to unwanted effects. Conclusion. Rhinitis sicca could be successfully treated with a nasal spray containing ectoine and a nasal spray combining ectoine with dexpanthenol. The combination of both substances led to slight advantages. 1. Introduction Rhinitis sicca or generally speaking dry nose is a rather frequent problem involving many people. The term “dry nose” has not yet been uniformly defined [1]. Otolaryngologists often use the terms “rhinitis sicca” or “dry rhinitis,” although no clear definition exists. Many symptoms during dry nose could be encountered ranging from subjective sensation of the dry nose and itching up to mild burning, nasal obstruction, crusting associated with unpleasant smell, epistaxis, and diminished sense of smell. Rhinitis sicca anterior means a chronic inflammation in the region of the anterior part of the nose, affecting the anterior and caudal septum and/or the corresponding lateral nasal vestibule. Mechanical as well as environmental irritations lead to crust formation. In rare cases, patients suffer from a slight stench due to bacterial colonization of the crust formations. The treatment of rhinitis sicca involves mainly elimination of promoting factors, moistening, sufficient daily drinking amount, cleansing of the crusts, care of the mucosa and inhibition of possible infections, or in rare cases the elimination of overlarge endonasal space [1]. The main treatment for rhinitis sicca consists of humidification of the nose, especially the mucus, focusing in a real wash-out of possible inflammatory triggers and application of a
References
[1]
T. Hildenbrand, R. K. Weber, and D. Brehmer, “Rhinitis sicca, dry nose and atrophic rhinitis: a review of the literature,” European Archives of Oto-Rhino-Laryngology, vol. 268, no. 1, pp. 17–26, 2011.
[2]
C. L. Brown and S. M. Graham, “Nasal irrigations: good or bad?” Current Opinion in Otolaryngology & Head and Neck Surgery, vol. 12, no. 1, pp. 9–13, 2004.
[3]
O. Michel, “Nasenspülung bei rhinosinusitis,” Laryngo-Rhino-Otologie, vol. 85, no. 6, pp. 448–458, 2006.
[4]
W. M. Boek, N. Kele？, K. Graamans, and E. H. Huizing, “Physiologic and hypertonic saline solutions impair ciliary activity in vitro,” Laryngoscope, vol. 109, no. 3, pp. 396–399, 1999.
[5]
A. R. Talbot, T. M. Herr, and D. S. Parsons, “Mucociliary clearance and buffered hypertonic saline solution,” Laryngoscope, vol. 107, no. 4, pp. 500–503, 1997.
[6]
M. Miwa, N. Nakajima, M. Matsunaga, and K. Watanabe, “Measurement of water loss in human nasal mucosa,” American Journal of Rhinology, vol. 20, no. 5, pp. 453–455, 2006.
[7]
A. Neher, M. Gst？ttner, M. Thaurer, P. Augustijns, M. Reinelt, and W. Schobersberger, “Influence of essential and fatty oils on ciliary beat frequency of human nasal epithelial cells,” American Journal of Rhinology, vol. 22, no. 2, pp. 130–134, 2008.
[8]
W. Kehrl and U. Sonnemann, “Dexpanthenol-nasenspray als wirksames therapieprinzip zur behandlung der rhinitis sicca anterior,” Laryngo-Rhino-Otologie, vol. 77, no. 9, pp. 506–512, 1998.
[9]
M. Dohil, “Natural ingredients in atopic dermatitis and other inflammatory skin disease,” Journal of Drugs in Dermatology, vol. 12, supplement 9, pp. S128–S132, 2011.
[10]
E. A. Galinski and A. Oren, “Isolation and structure determination of a novel compatible solute from the moderately halophilic purple sulfur bacterium Ectothiorhodospira marismortui,” European Journal of Biochemistry, vol. 198, no. 3, pp. 593–598, 1991.
[11]
T. Arakawa and S. N. Timasheff, “The stabilization of proteins by osmolytes,” Biophysical Journal, vol. 47, no. 3, pp. 411–414, 1985.
[12]
J. Smiatek, R. K. Harishchandra, O. Rubner, H.-J. Galla, and A. Heuer, “Properties of compatible solutes in aqueous solution,” Biophysical Chemistry, vol. 160, no. 1, pp. 62–68, 2012.
[13]
J. Buenger and H. Driller, “Ectoin: an effective natural substance to prevent UVA-induced premature photoaging,” Skin Pharmacology and Physiology, vol. 17, no. 5, pp. 232–237, 2004.
[14]
U. Sydlik, I. Gallitz, C. Albrecht, J. Abel, J. Krutmann, and K. Unfried, “The compatible solute ectoine protects against nanoparticle-induced neutrophilic lung inflammation,” American Journal of Respiratory and Critical Care Medicine, vol. 180, no. 1, pp. 29–35, 2009.
[15]
R. Graf, S. Anzali, J. Buenger, F. Pfluecker, and H. Driller, “The multifunctional role of ectoine as a natural cell protectant,” Clinics in Dermatology, vol. 26, no. 4, pp. 326–333, 2008.
[16]
K. Unfried, U. Sydlik, H. Peuschel, C. Albrecht, A. Bilstein, and J. Krutmann, “The compatible solute ectoine prevents neutrophilic lung inflammation induced by environmental model nanoparticles in vivo,” Toxicology Letters, vol. 196, p. S67, 2010.
[17]
A. Marini, K. Reinelt, J. Krutmann, and A. Bilstein, “Ectoine-containing cream in the treatment of mild to moderate atopic dermatitis: a randomised, comparator-controlled, intra-individual double-blind, multi-center trial,” Skin Pharmacology and Physiology, vol. 27, pp. 57–65, 2014.
[18]
A. Eichel, J. Wittig, K. Sha-Hosseini, and R. M？sges, “A prospective, controlledstudy of SNS01 (ectoine nasal spray) compared to BNO-101 (phytotherapeutic dragées) in patients with acute rhinosinusitis,” Current Medical Research and Opinion, vol. 29, no. 7, pp. 739–746, 2013.
[19]
M. B？hm, A. Michels, and R. M？sges, “Pharmaotherapie: therapeutischer stand der allergischen rhinits,” Forum HNO, vol. 14, pp. 156–161, 2012.
[20]
A. Salapatek, M. Bates, A. Bilstein, and D. Patel, “Ectoin, a novel, non-drug, extremophile-based device, relieves allergic rhinoconjunctivitis symptoms in patients in an environmental exposure chamber model,” The Journal of Allergy and Clinical Immunology, vol. 127, supplement 2, p. 202, 2011.
[21]
C. Hahn, M. B？hm, S. Allekotte, and R. M？sges, “Tolerability and effects on quality of life of liposomal nasal spray treatment compared to nasal ointment containing dexpanthenol or isotonic NaCl spray in patients with rhinitis sicca,” European Archives of Oto-Rhino-Laryngology, vol. 270, no. 9, pp. 2465–2472, 2013.
[22]
W. Kehrl and U. Sonnemann, “Dexpanthenol nasal spray as an effective therapeutic principle for treatment of rhinitis sicca anteriory,” Laryngo-Rhino-Otologie, vol. 77, no. 9, pp. 506–512, 1998.
[23]
J. Bünger, J. Degwert, and H. Driller, “The protective function of compatible solute ectoin on the skin cells and its biomolecules with respect to UV-ratiation, immunosupression and membrane damage,” IFSCC Magazine, vol. 4, no. 2, pp. 1–6, 2001.
[24]
U. Heinrich, B. Garbe, and H. Tronnier, “In vivo assessment of ectoin: a randomized, vehicle-controlled clinical trial,” Skin Pharmacology and Physiology, vol. 20, no. 4, pp. 211–218, 2007.
[25]
H. Peuschel, U. Sydlik, S. Grether-Beck et al., “Carbon nanoparticles induce ceramide- and lipid raft-dependent signalling in lung epithelial cells: a target for a preventive strategy against environmentally-induced lung inflammation,” Particle and Fibre Toxicology, vol. 9, article 48, 2012.
