[Acute and chronic rhinosinusitis age characteristics]

Area of Science:

• Otorhinolaryngology
• Immunology
• Pharmacology

Context:

• Rhinosinusitis is a common condition in both pediatric and adult populations, presenting distinct anatomical and etiological differences.
• Pediatric rhinosinusitis is often influenced by adenoid hypertrophy and viral infections, complicating diagnosis and treatment compared to adults.
• Adult rhinosinusitis is frequently linked to ostiomeatal complex occlusion.

Purpose:

• To evaluate the efficacy and safety of DysheLORz, a herbal preparation derived from Pelargonium sidoides roots, for treating acute and chronic rhinosinusitis (ARS and CRS) in children and adults.
• To elucidate the immunomodulatory mechanisms of Pelargonium sidoides in the context of rhinosinusitis treatment.
• To assess the direct antimicrobial effects of Pelargonium sidoides against common respiratory pathogens.

Summary:

• DysheLORz, based on Pelargonium sidoides, demonstrated high effectiveness and safety as monotherapy or adjunct treatment for ARS and CRS in both age groups.
• The herbal medicine exhibits broad immunomodulatory effects, including stimulating cytokine production (TNF-α, IL-1, IL-12, IFN-γ), enhancing macrophage and lymphocyte activity, and modulating chemokine synthesis.
• Pelargonium sidoides also possesses direct antimicrobial properties, inhibiting bacterial adhesion, stimulating phagocytosis, and exhibiting activity against key pathogens like Streptococcus pneumoniae and Staphylococcus aureus, while also inhibiting influenza virus.
• Additional benefits include increased ciliary beat frequency, enhanced antimicrobial peptide production, and reduced neutrophil activity at the inflammation site.

Impact:

• Provides a safe and effective therapeutic option for rhinosinusitis, particularly valuable for pediatric cases where conventional treatments may have limitations.
• Highlights the potential of phytomedicines in managing complex inflammatory conditions of the upper respiratory tract.
• Offers a mechanism-based understanding of how Pelargonium sidoides combats rhinosinusitis through combined immunomodulatory and antimicrobial actions.