Articles

Evaluation of PHR160 Spray Effect on Improvement of Lung Function, Asthma Severity and Exacerbation in Severe Asthmatic Patients

Abstract

Pinen Hydronoplacton Ribonucleic acid (PHR160) medicine contains compounds that can be useful in the recovery of respiratory patients. The aim of this study was to determine the effect of PHR spray on improving lung function, severity and asthma attacks in patients with severe asthma. This study is a pioneering interventional study (pilot study) conducted during the years 2021-2022 on patients with severe asthma resistant to treatment who referred to the lung clinic of Imam Khomeini, Golestan Hospitals and the private practice of lung specialists of this academic center. The study includes two groups of patients with asthma, both groups were given the usual treatment according to the stage of the disease, in addition, the intervention group was given two puffs of PHR spray every eight hours, and the control group was given a placebo spray with the same dose. Before and after the intervention, GSK 2002 questionnaire, six-minute walk distance (6MWD) and spirometry tests were completed. Among of 60 patients, 27 (45%) were male. The mean age of the patients was 44.33±6.94 years. Based on findings, the forced vital capacity (FVC) and forced expiratory flow between 25% and 75% (FEF 25-75%) were significantly better in the intervention group than the control group (P<0.001 and P=0.019, respectively), but there was a statistically remarkable difference between the two groups in terms of forced expiratory volume (FEV1) and FEV1/FVC (P=0.505, P=0.575, respectively). In addition, the GSK questionnaire score in the intervention group was higher than the control group (P<0.001), however there is no significant difference between the two intervention groups in terms of the 6MWD test and the number of exacerbation (P=0.114 and P=0.09, respectively). It is generally concluded that PHR160 spray can lead to improvement of spirometry parameters and severity of disease in severe asthma patients by affecting small airways.

1. Hammad H, Lambrecht BN. The basic immunology of asthma. Cell 2021;184:1469-85.
2. Cevhertas L, Ogulur I, Maurer DJ, Burla D, Ding M, Jansen K, et al. Advances and recent developments in asthma in 2020. Allergy 2020;75:3124-46.
3. Lambrecht BN, Hammad H. The immunology of asthma. Nat Immunol 2015;16:45-56.
4. Eileen W, Wechsler ME, Tran TN, Heaney LG, Jones RC, Menzies-Gow AN, et al. Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR). Chest 2020;157:790-804.
5. Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014;43:343-73.
6. Settipane RA, Kreindler JL, Chung Y, Tkacz J. Evaluating direct costs and productivity losses of patients with asthma receiving GINA 4/5 therapy in the United States. Ann Allergy Asthma Immunol 2019;123:564-72. e3.
7. Brusselle GG, Koppelman GH. Biologic therapies for severe asthma. N Engl J Med 2022;386:157-71.
8. Vosooghi S, Mahmoudabady M, Neamati A, Aghababa H. Preventive effects of hydroalcoholic extract of saffron on hematological parameters of experimental asthmatic rats. Avicenna J Phytomed 2013;3:279-87.
9. Boskabady MH, Farkhondeh T. Antiinflammatory, antioxidant, and immunomodulatory effects of Crocus sativus L. and its main constituents. Phytother Res 2016;30:1072-94.
10. Matucci A, Maggi E, Vultaggio A. Eosinophils, the IL-5/IL-5Rα axis, and the biologic effects of benralizumab in severe asthma. Respir Med 2019;160:105819.
11. Boskabady M, Tabatabaee A, Byrami G. The effect of the extract of Crocus sativus and its constituent safranal, on lung pathology and lung inflammation of ovalbumin sensitized guinea-pigs. Phytomedicine 2012;19:904-11.
12. Zilaee M, Hosseini SA, Jafarirad S, Abolnezhadian F, Cheraghian B, Namjoyan F, et al. An evaluation of the effects of saffron supplementation on the asthma clinical symptoms and asthma severity in patients with mild and moderate persistent allergic asthma: a double-blind, randomized placebo-controlled trial. Respir Res 2019;20:1-11.
13. Cheng H, An X. Cold stimuli, hot topic: An updated review on the biological activity of menthol in relation to inflammation. Front Immunol 2022;13:1023746.
14. Juergens UR. Anti-inflammatory properties of the monoterpene 1.8-cineole: current evidence for co-medication in inflammatory airway diseases. Drug Res (Stuttg) 2014;64:638-46.
15. Wendell SG, Baffi C, Holguin F. Fatty acids, inflammation, and asthma. J Allergy Clin Immunol 2014;133:1255-64.
16. Zhao JV, Schooling CM. The role of linoleic acid in asthma and inflammatory markers: a Mendelian randomization study. Am J Clin Nutr 2019;110:685-90.
17. Jnanesha A, Ashish K, Vanitha T. Variation in the yield and chemical composition of eucalyptus species (Nilagiri) under different agro climatic condition of India. Int J Herbal Med 2019;7:4-7.
18. Boskabady Ma, Aslani M. Relaxant effect of Crocus sativus (saffron) on guinea‐pig tracheal chains and its possible mechanisms. J Pharm Pharmacol 2006;58:1385-90.
19. Xiong Y, Wang J, Yu H, Zhang X, Miao C. Anti-asthma potential of crocin and its effect on MAPK signaling pathway in a murine model of allergic airway disease. Immunopharmacol Immunotoxicol 2015;37:236-43.
20. Yosri H, Elkashef WF, Said E, Gameil NM. Crocin modulates IL-4/IL-13 signaling and ameliorates experimentally induced allergic airway asthma in a murine model. Int Immunopharmacol 2017;50:305-12.
21. Bukhari SI, Pattnaik B, Rayees S, Kaul S, Dhar MK. Safranal of Crocus sativus L. inhibits inducible nitric oxide synthase and attenuates asthma in a mouse model of asthma. Phytother Res 2015;29:617-27.
22. Gholamnezhad Z, Koushyar H, Byrami G, Boskabady MH. The extract of Crocus sativus and its constituent safranal, affect serum levels of endothelin and total protein in sensitized guinea pigs. Iran J Basic Med Sci 2013;16:1022-26.
23. Lertnimitphun P, Zhang W, Fu W, Yang B, Zheng C, Yuan M, et al. Safranal Alleviated OVA-Induced Asthma Model and Inhibits Mast Cell Activation. Front Immunol 2021;12:585595.
24. Hosseini SA, Zilaee M, Shoushtari MH, Ghasemi Dehcheshmeh M. An evaluation of the effect of saffron supplementation on the antibody titer to heat-shock protein (HSP) 70, hsCRP and spirometry test in patients with mild and moderate persistent allergic asthma: A triple-blind, randomized placebo-controlled trial. Respir Med 2018;145:28-34.
25. MacRedmond R, Dorscheid DR. Conjugated linoleic acid (CLA): is it time to supplement asthma therapy? Pulm Pharmacol Ther 2011;24:540-8.
26. Millqvist E, Ternesten-Hasséus E, Bende M. Inhalation of menthol reduces capsaicin cough sensitivity and influences inspiratory flows in chronic cough. Respir Med 2013;107:433-8.
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IssueVol 61 No 11 (2023) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v61i11.16080
Keywords
Asthma Sever asthma Spirometry volume Six-minute walk distance (6MWD)
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How to Cite
1.
Dargahi-Malamir M, Borsi SH, Mehraban Z, Kianizadeh F, Mohsenikia H. Evaluation of PHR160 Spray Effect on Improvement of Lung Function, Asthma Severity and Exacerbation in Severe Asthmatic Patients. Acta Med Iran. 2024;61(11):685-690.