The effectiveness of a Black Sea seawater-based remedy in irrigation therapy for chronic tonsillitis

Objective. To evaluate the clinical and immunological effectiveness of therapeutic and prophylactic irrigation using a Black Sea seawater-based product in healthy volunteers and patients with chronic tonsillopharyngitis.
Material and methods. The study included 50 participants aged 18–23 years, 25 participants with chronic tonsillopharyngitis (CTP) without exacerbation (studied group) and 25 healthy volunteers (comparison group). The study participants rinsed their oral cavity 3 times a day for 24 days using a Black Sea seawater-based product. At the initial stage (Day 1), on Day 12 and on Day 24 of the study, clinical examinations were conducted, and oral fluid (OF) samples were collected. The clinical methods of the study included investigator-assessed mesopharyngoscopy (TPA scale), subjective and objective symptom assessment using a questionnaire with validated scales (visual analogue scale of sore throat pain intensity STPIS, Likert scale). The concentrations of cytokines IL-1β, IL-6, IL-8, IL-4, and secretory immunoglobulin A (sIgA) in the collected OF were determined by enzyme immunoassay (Rayto RT-2100C analyzer, China) using appropriate test systems (Vector-Best LLC, Novosibirsk).
Results. In the studied group, chronic inflammation of the pharyngeal mucosa and palatine tonsils was clinically determined, which was confirmed by elevated levels of proinflammatory cytokines IL-1β, IL-6, IL-8, and decreased levels of sIgA in the OF compared with the indicators of healthy volunteers. Rapid and pronounced alleviation and/ or elimination of symptoms was observed in patients with CTP upon treatment and preventive measures, which was significantly reflected in the dynamics of clinical manifestations assessed by the investigator and patient, as well as in the convenience and good tolerability of the proposed protocol according to the Likert scale. Analysis of cytokine and sIgA levels in the study group on day 24 showed a decrease in IL-1β, IL-6, and IL-8 levels and an increase in sIgA concentration, which, however, did not reach the values observed in healthy volunteers. A positive effect of irrigation on the local immunity was also noted in healthy volunteers, in whom similar effects were found: an increase in sIgA and a decrease in the level of proinflammatory cytokines.
Conclusion. The results of the study clearly demonstrated that elimination-irrigation therapy using a Black Sea seawater-based remedy has a positive clinical, immunological, and protective effect due to a decrease in the antigen load, reducing the risk of developing or progressing inflammation in patients with CTP and healthy volunteers.
Key words: Black Sea seawater-based remedy, irrigation-elimination therapy, tonsillopharyngitis, oral fluid, cytokines, secretory immunoglobulin A
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. This study was conducted with financial support from the Kuban Scientific Foundation as part of Scientific Project No. N-24.1/2.