Impact of Platelet-Rich Plasma on Injuried Nasal Mucosa in Chronic Atrophic Rhinitis

Abstract

Relevance. The mucous membrane of the nasal cavity is a natural biological barrier that protects the upper respiratory tract from infection. Chronic atrophic rhinitis is characterized by a triad of symptoms and signs, which include progressive atrophy of the nasal mucosa, the formation of crusts and a characteristic unpleasant odor. A promising tool for the pathogenetic therapy of chronic atrophic rhinitis can include the use of platelet-rich plasma injections (PRP therapy).
 The purpose of this study is to investigate the effect of platelet-rich plasma on the content of markers of oxidative damage to biological polymers, the concentration of hydrogen sulfide, and the intensity of collagenolysis in the nasal mucosa under chronic atrophic rhinitis.
 Materials and methods. The study involved 68 patients, categorized into control (n=20) and experimental (n=48) groups. Within the experimental group, patients were randomly assigned to two subgroups: the standard therapy group (n=29) received conventional treatment as per protocols for 28 days, and the PRP therapy group (n=19) received PRP injections alongside standard therapy for chronic atrophic rhinitis over the same duration. The content of free L-oxyproline, the concentration of malondialdehyde, the concentration of hydrogen sulfide (H2S), and the content of oxidatively modified proteins were studied in the nasal mucosa.
 Results. PRP therapy included to the standard treatment for chronic atrophic rhinitis resulted in a significant 42.67% decrease in malondialdehyde content in the nasal mucosa compared to pre-treatment values. The presence of oxidatively modified proteins post-treatment, following the standard therapeutic regimen with the addition of PRP therapy, decreased by 39.25% compared to pre-treatment levels. The concentration of free L-oxyproline in the nasal mucosa, under standard treatment combined with PRP therapy, exhibited a reduction of 38.28% compared to pre-treatment values. Furthermore, the content of hydrogen sulfide (H2S) in the nasal mucosa decreased by 82.27% compared to pre-treatment levels.
 Conclusions. The integration of PRP therapy with standard treatment for chronic atrophic rhinitis enhances treatment efficacy by mitigating oxidative damage to lipids and proteins, reducing collagen breakdown, and limiting the accumulation of H2S in the nasal mucosa.