A Supplement with Ribes Nigrum, Boswellia Serrata, Bromelain and Vitamin D to Stop Local Inflammation in Chronic Sinusitis: A Case-Control Study

Abstract

Although chronic sinusitis widely affects the adult population, the treatments currently used did not always satisfactorily solve the symptoms. Traditional therapy with steroids and antibiotics presents risks and benefits and the new drugs, i.e., monoclonal antibody, are valid solutions despite being quite expensive. Natural molecules could be a valid treatment that combines good efficacy and low price. We conducted a case -control study to evaluate the benefit of an oral supplement with Ribes nigrum, Boswellia serrata, Bromelain and Vitamin D on chronic sinusitis symptoms. 60 patients were randomly assigned to one of the three groups: control using nasal steroids only, treatment 1 using nasal steroid and 1 dose of the oral supplement for 30 days and treatment 2 in which patients used nasal steroid and two oral supplement doses daily for 15 days. Conditions of the nasal mucosa and a blood sample (WBC, IgE and CRP) were analyzed at T0, T1 (15 days after treatment) and T2 (30 days after treatment. Patients treated with the supplement improved their nasal findings (hyperemia of mucosa and rhinorrhea) with statistically significant differences from the control. Our preliminary data suggest that the addition of supplement containing Ribes nigrum, Boswellia serrata, Vitamin D and Bromelain to the traditional local therapy (nasal spray with cortisone) can be a supporting therapy to modulate the local inflammation in the nose in patients affected by chronic sinusitis.

Keywords: Boswellia; Vitamin D; chronic sinusitis; nasal hyperemia; rhinorrhea; treatment.

Figure 1

Clinical Findings. (A) Improvement in nasal hyperemia and rhinorrhea in TG1 comparing the baseline with T2, 30 days after. In this group, the supplement has been suspended at T1 (15 days after use). (B) Comparison of nasal findings in TG2 after 30 days of treatment (T2). (C) Results obtained in term of nasal improvement using exclusively nasal cortisone spray.

Figure 2

The images show the measurements of C-Reactive Protein (CRP) and IgE in TG1, TG2 and control group comparing the baseline with the end of the treatment. The vertical line indicates standard deviation.

Figure 3

The graph shows the results of the questionnaire. “**” indicates p < 0.01 and “*” p < 0.05. The vertical line shows standard deviation. We identified statistically significant differences in the treatment groups (Flog 1 and Flog 2) before and after treatment but none in the control group. The graph also shows the differences of questionnaire scores between treatment groups and control post-therapy.

Figure 4

Comparison of clinical aspects between the three groups in term of improvement at the end of the treatment. (A) shows the changes of the color of nasal mucosa (hyperemia) and (B) the improvement of nasal secretion (reduction of rhinorrhea) after treatments. “**” indicates p < 0.01.

Figure 5

Questionnaire used to screen the patients during the study and to evaluate the clinical variation obtained after the treatments.