title: Evaluation of ColdZyme® Mouth Spray on prevention of upper respiratory tract infections in a boy with primary immunodeficiency: a case report.
abstract: BACKGROUND
  Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. If left untreated, these infections may be fatal. Patients with primary antibody deficiencies are therefore given prophylactic immunoglobulin G replacement therapy. ColdZyme® Mouth Spray is a medical device intended to reduce the probability of catching a cold and/or can help shorten the duration of a cold, if used at an early stage of the infection, by forming a thin protective barrier on the pharyngeal mucous membrane. This is the first report of this kind in the literature.
  
  
  METHODS
  The parents of a 12-year-old white boy diagnosed as having common variable immunodeficiency voluntarily started to let their son use ColdZyme® Mouth Spray to reduce common cold infections if possible. Prior to using ColdZyme® Mouth Spray, he had recurrent microbial infections of his ears, sinuses, nose, bronchi, and lungs. He also frequently exhibited continuous rhinorrhea, fungal growth in his oral cavity, and gingivitis with wounds in his gums. As a consequence, his and his family's health-related quality of life was severely compromised. He commenced a twice-daily treatment (morning and evening) with ColdZyme® Mouth Spray; the weekly administration of immunoglobulin G (Hizentra®) for replacement therapy was continued throughout this period. Data were retrieved by using a daily diary about infections and symptoms. His guardians had recorded infection symptoms since he was diagnosed as having common variable immunodeficiency 10 years earlier to follow the effect of the immunoglobulin G treatment. Shortly after commencement of ColdZyme® Mouth Spray treatment, he experienced a marked improvement in symptoms and health-related quality of life. His continuous rhinorrhea disappeared, breathing through his nose was easier, oral fungal infection decreased, and wounds in his gum tissue healed for the first time in several years.
  
  
  CONCLUSIONS
  We observed that when ColdZyme® Mouth Spray was used to reduce common cold viral infection in a patient with common variable immunodeficiency on immunoglobulin G replacement therapy, secondary microbial and fungal infections in his oral cavity and oropharynx were also reduced. A controlled study is warranted to confirm the observed results.
authors: Enzymatica AB, Ideon Science Park, 223 70, Lund, Sweden. mats.clarsund@enzymatica.com.
authors: Mats
authors: M
authors: Clarsund
authors: Enzymatica AB, Ideon Science Park, 223 70, Lund, Sweden.
authors: Ulf
authors: U
authors: Blom
authors: The Unit for Clinical Nursing Research and Clinical Research in Immunotherapy, Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, 141 86, Stockholm, Sweden.
authors: Ann
authors: A
authors: Gardulf
mesh_terms: D000284:Administration, Oral; D002648:Child; D017074:Common Variable Immunodeficiency / Q000150:complications*; D005990:Glycerol / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D008297:Male; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D016896:Treatment Outcome; D014357:Trypsin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: C558471:Hizentra; D007074:Immunoglobulin G; D014357:Trypsin; D005990:Glycerol
keywords: ColdZyme® Mouth Spray; Common variable immunodeficiency; Quality of life; Respiratory tract infections; Subcutaneous immunoglobulin therapy