Oxidative stress and dynamics of its patterns following therapeutic physical factors in complex therapy of vasomotor rhinitis

Belkina S.A.; Pelishenko T.G.; Nagornev S.N.

doi:https://doi.org/10.17116/rbpdpm2025203112

OBJECTIVE

To evaluate severity of oxidative stress and dynamics of lipid peroxidation in patients with VR undergoing postoperative therapy (pulsed low-intensity laser therapy in the infrared range and transcranial electrical stimulation) after cold plasma coblation.

MATERIAL AND METHODS

The study involved 137 patients with vasomotor rhinitis. All patients underwent cold plasma coblation of cavernous plexus of inferior turbinates. Basic postoperative therapy (BT) in all patients included irrigation of nasal cavity with saline solution and nasal cavity toilet. All patients were randomized into 4 groups. The first group (control, n=34) received only BT, the second group (comparison group 1, n=35) — BT and low-intensity laser therapy in the infrared range, the third group (comparison group 2, n=34) — transcranial electrical stimulation along with BT, the fourth group (main, n=34) — low-intensity laser radiation combined with transcranial stimulation. We assessed severity of oxidative stress considering serum primary and secondary lipid peroxidation products, as well as activity of antioxidant enzymes in erythrocytes. Quality of life in patients with VR was determined using the SNOT-22 questionnaire.

RESULTS

At baseline, high content of lipid peroxidation products under reduced activity of antioxidant enzymes in patients with vasomotor rhinitis indicates oxidative stress. Correlation analysis of oxidative stress and SNOT-22 scores additionally confirmed involvement of lipid peroxidation patterns in pathogenesis of vasomotor rhinitis. Low-intensity laser therapy and transcranial stimulation after cold plasma coblation decreased accumulation of peroxide metabolism products (more pronounced for low-intensity laser radiation). Maximum corrective effect on system of pro- and antioxidants was revealed for laser therapy combined with transcranial stimulation. An integrated physiotherapeutic approach contributed to significant decrease in concentration of lipid peroxidation products by 31—34% and increase in antioxidant enzymes by 33—69%.

CONCLUSION

Clear corrective effect on lipid peroxidation processes is observed for a complex of low-intensity laser therapy and transcranial stimulation. Significantly higher efficiency is based on phenomenon of potentiation following a combination of factors with different modalities and mechanisms for realizing their biological potential.

Keywords:

vasomotor rhinitis

low-intensity laser radiation

oxidative stress

transcranial stimulation

cold plasma coblation

correlation adaptometry

Authors:

Belkina S.A.

Clinical Hospital No. 1 of the Presidential Administration of the Russian Federation

ORCID: 0009-0000-9498-6031

Pelishenko T.G.

Clinical Hospital No. 1 of the Presidential Administration

ORCID: 0000-0001-6597-2167

Nagornev S.N.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-1190-1440

Received:

14.07.2025

Accepted:

23.08.2025

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References:

Vazomotorny`j rinit: patogenez, diagnostika i principy` lecheniya (klinicheskie rekomendacii). Pod red AS Lopatina. M., 2014. Accessed August 07, 2025. (In Russ.). https://vazomotor_14.docx
Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, Dinakar C, Ellis AK, Finegold I, Golden DBK, Greenhawt MJ, Hagan JB, Horner CC, Khan DA, Lang DM, Larenas-Linnemann DES, Lieberman JA, Meltzer EO, Oppenheimer JJ, Rank MA, Shaker MS, Shaw JL, Steven GC, Stukus DR, Wang J; Chief Editor(s): Dykewicz MS, Wallace DV; Joint Task Force on Practice Parameters: Dinakar C, Ellis AK, Golden DBK, Greenhawt MJ, Horner CC, Khan DA, Lang DM, Lieberman JA, Oppenheimer JJ, Rank MA, Shaker MS, Stukus DR, Wang J; Workgroup Contributors: Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, Finegold I, Hagan JB, Larenas-Linnemann DES, Meltzer EO, Shaw JL, Steven GC. Rhinitis 2020: A practice parameter update. The Journal of Allergy and Clinical Immunology. 2020;146(4):721-767. https://doi.org/10.1016/j.jaci.2020.07.007
Settipane RA. Epidemiology of vasomotor rhinitis. World Allergy Organization Journal. 2009;2(6):115-118. https://doi.org/10.1097/WOX.0b013e3181ac91ae
Lopatin AS. Treatment of vasomotor rhinitis: international trends and Russian practice. Medicinskij sovet. 2012;11:83-87. (In Russ.).
van Rijswijk JB, Blom HM, Fokkens WJ. Idiopathic rhinitis, the ongoing quest. Allergy. 2005;60(12):1471-1481. https://doi.org/10.1111/j.1398-9995.2005.00975.x
Leader P, Geiger Z. Vasomotor Rhinitis. 2023. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
Smirnova OV, Goncharova NS. Characteristics of lipoperoxidation processes and antioxidant protection system factors in chronic rhinitis. Vestnik Otorinolaringologii. 2024;89(1):16-20. (In Russ.).
Smirnova OV, Goncharova NS. Influence of indicators of the system “lipid peroxidation-antioxidant protection” on the quality of life of patients with chronic rhinitis of different phenotypes. Byulleten` fiziologii i patologii dy`haniya. 2024;92:77-84. (In Russ.).
Kulyakin EV, Zatoloka PA, Semenov SA. Postnasal syndrome: etiology, clinic, diagnosis, treatment. Medicinskij zhurnal. 2020;1(71):10-18. (In Russ.).
Ciprandi G, Passali GC, Passali D. Vasomotor Rhinitis: an Italian survey in clinical practice. Acta Biomedca. 2022 16;93(6):e2022296. https://doi.org/10.23750/abm.v93i6.13218
Baroody FM, Gevaert P, Smith PK, Ziaie N, Bernstein JA. Nonallergic Rhinopathy: A Comprehensive Review of Classification, Diagnosis, and Treatment. Journal of Allergy and Clinical Immunology. In Practice. 2024;12(6):1436-1447. https://doi.org/10.1016/j.jaip.2024.03.009
Desai V, Sampieri G, Namavarian A, Lee JM. Cryoablation for the treatment of chronic rhinitis: a systematic review. Journal of Otolaryngology and Head and Neck Surgery. 2023 29;52(1):37. https://doi.org/10.1186/s40463-023-00645-6
Zarapkin GYu, Kravchuk AP, Ogorodnikov DS. Modern methods of surgical treatment of hypertrophic and vasomotor rhinitis. Rossijskaya rinologiya. 2021;29(1):31-36. (In Russ.).
Skorokhod AA, Tupikin DV. Traditional and innovative methods in otorhinolaryngology. Modern Science. 2020;2-2:238-242. (In Russ.).
Abdullah B, Singh S. Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies. International Journal of Environmental Research and Public Health. 2021 26;18(7):3441. https://doi.org/10.3390/ijerph18073441
Passali D, Loglisci M, Politi L, Passali GC, Kern E. Managing turbinate hypertrophy: coblation vs. radiofrequency treatment. European Archives of Oto-Rhino-Laryngology. 2016;273(6):1449-1453. https://doi.org/10.1007/s00405-015-3759-6
Svistushkin VM, Starostina SV, Toldanov AV. Possibilities of coblation in otorhinolaryngology: analytical review. European Archives of Oto-Rhino-Laryngology. 2022;279(4):1655-1662. https://doi.org/10.1007/s00405-021-07055-2
Mitrofanov VV, Shiman AG, Maksimov AV, Bezrukova EV. Physical methods of treatment of vasomotor rhinitis: a textbook. Fizioterapevt. 2008;5:29-49. (In Russ.).
Pustovit OM. Rehabilitation of rhinosurgical patients using physiotherapeutic methods of exposure. Sovremennaya nauka: aktual`ny`e problemy` teorii i praktiki. Seriya: Estestvenny`e i texnicheskie nauki. 2019;11:184-188. (In Russ.).
Pustovit OM, Nasedkin AN, Isaev EV, Chursinova YuV, Kuzmin MV. Photochromotherapy of patients after septoplasty and submucosal vasotomy of the lower nasal concha. Lazernaya medicina. 2017;21(2):21-25. (In Russ.).
Polyaeva M.Y. Endonasal electrophoresis in the complex treatment of nasal septum deformities and vasomotor rhinitis. Rossijskaya otorinolaringologiya. 2012;1(56):136-140. (In Russ.).
Volkovskaya AN, Zhaburina MV, Borzov EV. The effectiveness of low-intensity laser therapy in rhinosurgical patients. Glavvrach. 2022;11:47-50. (In Russ.).
Naumenko AN, Shustova TI, Naumenko NN, Konoplev OI, Shkabarova EV. The functional state of the ANS in patients with upper respiratory tract pathology in the pre- and postoperative periods. Rossijskaya otorinolaringologiya. 2008;6(37):91-94. (In Russ.).
Shustova TI, Naumenko AN. Transcranial electrical action in the treatment of patients with pathology of ENT organs. Aktual`ny`e voprosy` sovremennogo estestvoznaniya. 2008;6:85-89. (In Russ.).
Orekhova EM, Konchugova TV, Kulchitskaya DB, Korchazhkina NB, Egorova LA, Chuich NG. Modern approaches to the use of transcerebral magnetic therapy for arterial hypertension. Voprosy` kurortologii, fizioterapii i lechebnoj fizicheskoj kul`tury`. 2016;93(3):53-55. (In Russ.).
Kotenko KV, Korchazhkina NB, Eremin II, Nadelyaeva II, Mikhailova AA. Baza danny`x nauchny`x issledovanij po primeneniyu foto- i lazeroterapii pri lechenii posleoperacionny`x rubczov. Svidetel`stvo o registracii bazy` danny`x RU 2022622436, 06.10.2022. Zayavka №2022622380 ot 29.09.2022. (In Russ.).
Sheptiy OV, Kruglova LS, Korchazhkina NB, Kotenko KV, Yamenskov VV. Mechanisms of action of various lasers and differentiated indications for their use (Literature review). Vestnik novy`x medicinskix texnologij. E`lektronnoe izdanie. 2014;1:156. (In Russ.).
Patent na izobretenie RU 2587970 C1/27.06.2016. Dragan SP, Bogomolov AV, Razinkin SM, Korchazhkina NB, Erofeev GG, Ivashin VA. Sposob povy`sheniya funkcional`ny`x rezervov organizma. (In Russ.).
Korchazhkina NB, Rzhevsky VS. The effect of broadband electromagnetic therapy and low-frequency alternating electrostatic field on the severity of endogenous intoxication in patients with inflammatory diseases of the maxillofacial region. Voprosy` kurortologii, fizioterapii i lechebnoj fizicheskoj kul`tury`. 2022;99(3-2):107-108. (In Russ.).
Korchazhkina NB, Rzhevsky VS. The use of physiotherapy methods in the early rehabilitation period after surgical interventions in patients with inflammatory diseases of the maxillofacial region. Hirurgiya. Zhurnal im. N.I. Pirogova. 2022;2:5-10. (In Russ.). https://doi.org/10.17116/hirurgia20220215
Korchazhkina NB, Mikhailova AA, Kolgaeva DI, Kovalev SA, Rzhevsky VS. Justification for the inclusion of pulsed low-frequency electrostatic massage in comprehensive treatment and rehabilitation programs. Fizioterapiya, bal`neologiya i reabilitaciya. 2019;18(3):191-194. (In Russ.). https://doi.org/10.17816/1681-3456-2019-18-3-191-194
Korchina TYa, Korchin VI. The relationship between elemental status and indicators of oxidative metabolism in residents of the Khanty-Mansiysk Autonomous Okrug with substandard water treatment. Zdorov’e naseleniya i sreda obitaniya. 2022;30(4):14-21. (In Russ.). https://doi.org/10.35627/2219-5238/2022-30-4-14-21
Sies H, Berndt C, Jones DP. Oxidative Stress. Annual Review of Biochemistry. 2017;86:715-748. https://doi.org/10.1146/annurev-biochem-061516-045037
Rasulova MT, Ganizhonov PH, Khomidchonova ShH, Odilov XA. Stress and its effect on the state of the mucous membrane of the digestive tract: morphological and functional changes (literature review). Consilium Medicum. 2024;26(5):286-291. https://doi.org/10.26442/20751753.2024.5.202671
Kulyakin EV, Krishtopova MA, Zatoloka PA, Semenov SA. Linguistic adaptation and confirmation of the validity of the SNOT-22 rus questionnaire for assessing the quality of life of patients with postnasal syndrome with vasomotor rhinitis. Medicinskij zhurnal. 2021;1(75):132-137. (In Russ.).
Kulyakin EV. Assessment of the quality of life of patients with postnasal syndrome with vasomotor rhinitis before and after surgical treatment. Medicinskij zhurnal. 2022;3(81):88-93. (In Russ.).
Koryagin FN, Pelishenko TG, Nagornev SN. Dynamics of the clinical condition of patients with polypous rhinosinusitis during complex therapy using physical factors and dupilumab. Fizioterapevt. 2025;21(3):77-89. (In Russ.).
Dugieva MZ, Kotenko KV. Activity of lipoperoxidation processes in patients with prolonged postoperative pain syndrome against the background of combined use of low-intensity infrared laser therapy when exposed to the thymus region and pantovegin electrophoresis. Saratovskij nauchno-medicinskij zhurnal. 2013;9(4):831-835. (In Russ.).
Moskvin SV. Osnovy` lazernoj terapii. Seriya «E`ffektivnaya lazernaya terapiya». T.1. M. — Tver`: OOO «Izdatel`stvo «Triada»; 2016. (In Russ.).
Balaeva MR, Nagornev SN, Remizova AA. Dynamics of markers of oxidative stress and cytokine content in patients with peri-implantitis with the combined use of mesodiencephalic modulation and ozone therapy. Fizioterapiya, bal`neologiya i reabilitaciya. 2023;22(4):261-272. (In Russ.). https://doi.org/10.17816/rjpbr627063
Tsukarzi EE. Neuromodulating therapy in post-traumatic stress disorder: the use of transcranial magnetic stimulation and transcranial electrical stimulation. Rossijskij psixiatricheskij zhurnal. 2025;1:25-30. (In Russ.).
Gorban AN, Smirnova EV. The effect of group stress and correlation adaptometry. 2018. (In Russ.). Accessed August 05, 2025. (In Russ.). https://adaptometry.narod.ru/Index.htm
Smirnova EV. Matematicheskoe modelirovanie adaptacii k e`kstremal`ny`m usloviyam, e`ffekt gruppovogo stressa i korrelyacionnaya adaptometriya: dis. … d-ra fiz.-mat. nauk. Krasnoyarsk, 2000. (In Russ.).
Metaorganizm. Stress i adaptaciya. Monografiya. Pod red. A.L. Burmistrovoj. Chelyabinsk: Izdatel`stvo Chelyabinskogo gosudarstvennogo universiteta; 2019. (In Russ.).