title: Preclinical evaluation of Luffa operculata Cogn. and its main active principle in the treatment of bacterial rhinosinusitis.
abstract: BACKGROUND
  The prevalence of rhinosinusitis is quite high. Despite the widespread use of antibiotics for rhinosinusitis, there are other forms of treatment, including phytotherapy. One of the most widely used herbal medicines for treatment of rhinosinusitis is Luffa operculata.
  
  
  OBJECTIVE
  This study aimed to evaluate the efficacy of topical nasal solution of the aqueous extract of L. operculata, determining the toxicity to its use and identifying the active principles presented in the aqueous extract. The secondary objective was to evaluate the action of active principles on bacteria commonly involved in acute rhino sinusitis.
  
  
  METHODS
  The study was conducted in experimental model of sinusitis. Three different concentrations of L. operculata were used as local treatment of rhino sinusitis. The results were compared with those observed in control groups that received nasal saline solution. Histological examination of the liver, kidney, spleen, myocardium, brain and lungs of all animals evaluated the toxicity of L. operculata. The aqueous extract used was subjected to chromatographic analysis and an active principle was isolated and tested for in vitro inhibition of bacterial colonies usually found in rhino sinusitis.
  
  
  RESULTS
  Intranasal treatment of sinusitis with L. operculata showed better clinical evolution than control group. Statistically significant difference (p>0.10) between the treated group and the control group was observed in the histologic evaluation for inflammatory pattern. The aqueous extract of L. operculata used presented a predominance of 2,3-dicafeoilglicaric acid, a substance not yet described in the literature. There was a significant difference in bacterial growth of Streptococcus pyogenes on blood-agar plates when under the influence of both the aqueous extract and the active substance.
  
  
  CONCLUSIONS
  Topical nasal solution of the aqueous extract of L. operculata is effective compared to the application of saline solution for the treatment of bacterial rhinosinusitis in an experimental model. L. operculata determined in vitro inhibition of growth of S. pyogenes.
authors.affiliation: Santa Casa de São Paulo, São Paulo, SP, Brazil. Electronic address: leosilva@uol.com.br.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Silva
authors.affiliation: Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo, SP, Brazil.
authors.forename: Henrique Olival
authors.initials: HO
authors.lastname: Costa
authors.affiliation: Instituto de Ciências Avançadas em Otorrinolaringologia (ICAO), São Paulo, SP, Brazil.
authors.forename: Flávia Coelho de
authors.initials: FC
authors.lastname: Souza
authors.affiliation: Universidade 9 de Julho (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Elaine Monteiro Cardoso
authors.initials: EM
authors.lastname: Lopes
authors.affiliation: Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo, SP, Brazil.
authors.forename: Suely Mitoi Ykko
authors.initials: SM
authors.lastname: Ueda
keywords: Luffa; Microbiologia; Microbiology; Sinusite; Sinusitis; Streptococcus pyogenes; Terapêutica; Therapeutics