Abstracts of selected publications

Chervinskaya A.V., Silber N.A., Alexandrov A.N. Halotherapy for treatment of bronchial asthma (abstract) // XIV World Congress of asthmology – Interasma 93, Israel. – 1993. – P. 59.

Halotherapy is a method of treatment under conditions of artificial salt cave microclimate. A therapeutic effect is stipulated by air-dispersed medium saturated with dry sodium chloride aerosol containing the dominating amount of 2 to 5-micron particles. Particle density (1-5 mg/m³) varies depending on the type and stage of the disease. The other factors – comfortable humidified temperature regime, the hypo bacterial and allergen-free environment saturated with air-ions enhance the therapeutic effect. Halotherapy treated 71 patients (25M, 46F, average 39.1±2.4 years) with various types of asthma. The drug treatment of 60% patients did not give the full effect. A control group of 15 patients (8M, 7F, average 38.4±1.5 years) received placebo. The Halotherapy course comprised of 10-20 daily one hour procedures. Treatment was conducted in a special room. No side effects were observed during Halotherapy. The clinical state of 85% patients with mild and moderate and 75% patients with severe asthma improved after Halotherapy. 47% of patients required fewer doses of drugs. The improvement in the clinical state of patients was accompanied by positive dynamics in lung function tests. The changes in control group parameters after Halotherapy were not statistically significant. Thus, the results of Halotherapy application demonstrated its efficacy.

Konovalov S.I., Chervinskaya A.V. Saline aerosol effect on pulmonary phagocyte system (abstract) // International symposium of speleotherapy. Solotvino-Ukraine, 1993.-P. 24.

Halotherapy – the treatment under conditions of artificially created salt-cave microclimate. Therapeutic influence is stipulated by aero dispersed medium saturated with dry sodium chloride aerosol containing the dominating amount of 2 to 5-micron particles. Further development of the method is offered by the application of the controlled therapeutic microclimate in a halochamber. Particles density from 1 to 7 mg/m³ was used. On the basis of various parameters of aero disperse environments using, we have developed criteria of prescribing the treatment with due regard for nosological forms of respiratory diseases, their pathogen city variants, and the degree of obstructive impairment. A differential approach to the prescription of method allowed reducing the frequency and manifestations of undesirable bronchospastic reactions during treatment. The feasibility of using halotherapy to treat otorhinolaryngologic diseases was substantiated. At the same time, it has been established that further research is needed to verify the prescription of the method for certain forms of respiratory diseases. Therefore, the application of controlled therapeutic microclimate of a halochamber improved the method of Halotherapy and brought it nearer to the up-to-date medical technology.

Chervinskaya A., Alexandrov A., Zilber N., Stepanova N. Effect of halotherapy in patients with bronchial asthma and allergic rhinitis (abstract). XV International Congress of Allergology and clinical immunology, Sweden, 1994. – P. 175.

Halotherapy – is a mode of treatment in a controlled air medium which simulates a natural salt cave microclimate. The main curative factor is dry sodium chloride aerosol with particles of 2 to 5 microns in size. Particles density (0.5-7 mg/m³) varies with the type of the disease. Other factors are comfortable temperature- humidity regime, the hypo bacterial and allergen-free air environment saturated with aero ions. 106 patients (pts) (59 – with allergic, 27 – with nonallergic bronchial asthma (BA) and 20 – with allergic rhinitis) were treated with Halotherapy. 15 pts of the control group were given a placebo. Halotherapy course consisted of 10-20 daily procedures of 1 hour. The clinical state of 85% pts with BA and 90% – with allergic rhinitis improved after Halotherapy. The results of Halotherapy did not depend on BA type. The positive dynamics of flow-volume loop parameters and a decrease of bronchial and nasal resistance measured by body plethysmography were observed. FVC and FEV1 initial values and the values of their changes during Halotherapy showed a significantly negative correlation – the more marked was the bronchial obstruction, the better were the results of therapy. The changes in control group parameters after Halotherapy were not statistically significant. The results of Halotherapy application demonstrated its efficacy.

Chervinskaya A., Alexandrov A., Strashnova O. Effect of dry sodium chloride aerosol in patients with bronchial asthma // Allergy & Immunology (Abstr. Interasma 95). – 1995. – V. 27, N. 7.- P. 221.

The effect of dry sodium chloride aerosol (DSCA) was evaluated in 125 patients (pts) with bronchial asthma (44 M, 81 F, mean age 34.3+2.5 years). 60% of pts received a base medication without full effect. The control group of 15 pts(8M, 7F, mean age 38.4+1.5 years) received placebo. Treatment was performed in a special room with salt-coated walls. The pts breathed quietly while reclining in chairs. DSCA containing the dominating amount of 2 to 5 microns particles was produced by a special nebulizer. The aerosol mass concentration (from 0.5 to 5 mg/m³) was prescribed according to the type of the disease. The DSCA course comprised 10-20 daily one hour procedures. Clinical symptoms analysis demonstrated that the number of asthma attacks decreased significantly. The cases with a cough occurred more rarely, cough became easier and more productive. Reduction in bronchodilators and inhaled corticosteroid consumption was an indicator of clinical benefit. The pts showed a significant increase in FVC, FEV1, PEF, FEF50 and a decrease of Raw by the end of the treatment. The changes in control group parameters after placebo were not statistically significant. The pts were examined 6 and 12 months after the DSCA course. The average duration of remission was 7.6+0.9 months.

Chervinskaya A.V., Alexandrov A.N., Konovalov S.I. Application of dry rock salt aerosol in case of common cold // XVI Congress of the European Rhinologic Society. VII Congress of the International Rhinologic Society. Week of the Nose: Abstract Book.- 1996. – P. 104.

17 patients with common cold underwent dry rock salt aerosol (DRSA) therapy. DRSA with particles size of 1-5 microns and a high negative charge is the main curative factor of Halotherapy (HT). Density of aerosol depends on nosology, clinical features and FEV1 (0.5-1; 1-2; 3-5; 7-9 mg/m³). HT is drug-free method, which simulates natural salt cave microclimate. There were two ways of DRSA administration: in the room with the controlled air medium which is created with special equipment; the inhalation through nasal mask of individual inhalator. The method of Halotherapy was approved by the Russian Ministry of Public Health in 1990. It has been known that DRSA improves rheological properties of the airways contents, decreases edema of bronchial and nasal mucosa, it has a bactericidal action, enhances functioning of alveolar macrophages. Other factors are comfortable temperature and humidity, hypo bacterial and allergen-free air medium. The common cold patients’ condition was assessed by daily clinical observation, functional and cyto-bacteriological tests. In all cases we registered cold clinical symptoms disappear faster than in control group. The improvement in clinical state was accompanied by positive dynamics of laboratory tests.

Chervinskaya A., Norvaisas G., Pluskiene L., Noreikiene D. Halotherapy for rehabilitation of asthma patients in Russia and Litvania // Eur. J of Allergy and Clin. Immunol. suppl.- V.51.- № 30.- 1996. – P.39.

Halotherapy (HT) is a drug-free method which simulates natural salt cave microclimate. The controlled air medium is created in ordinary room with special equipment. The main curative factor is a dry sodium chloride aerosol with a density of 0.5 to 5 mg/m³, particles size of 1-5 microns and a high negative charge. Sodium chloride aerosol improves rheological properties of the bronchial contents, decreases edema of bronchial mucosa, it has an bactericidal action, enhances functioning of alveolar macrophages. Other factors are comfortable temperature and humidity, hypo-bacterial and allergen-free air medium.
The method of HT was approved by the Ministry of Public Health in 1990. To study the efficiency of Halotherapy, the data were collected from 15 Russian and 2 Lithuanian hospitals. We have evaluated the results of Halotherapy in 3,239 adults and children with the various types of asthma (2,320 from Russia, 919 from Lithuania). Physicians assessed the Halotherapy results by clinical symptoms and functional parameters dynamics. The course of Halotherapy (12-21 daily procedures) resulted in improvement of clinical state in 79% of asthma cases in adults and 89% in children. Patients showed positive dynamics of symptoms indicative of a better drain function of their airways. In the majority of cases, the number and intensity of asthma attacks decreased, which allowed to cancel or reduce the dosage of medication. The improvement in the clinical state was accompanied by positive dynamics of the lung function measurements. Long-term examination of patients (for one or more year) demonstrated the effect of Halotherapy on reduction in the frequency of exacerbations, reduction in chronic symptoms. Thus, Halotherapy can be used as a rehabilitation method for asthma management.

Chervinskaya A. Halotherapy for rehabilitation of pulmonary patients in Russia // The Europ. Respir. Journ.- V.10.- Suppl.25.-1997.- P.108.

Halotherapy (HT) is a mode of inhalation therapy with dry sodium chloride aerosol. The controlled air medium is created in an ordinary room with special equipment. The main curative factor is a dry sodium chloride aerosol with the particle size of 1-5 microns and high negative charge. Density of aerosol depends on nosology, clinical features and FEV1 (0.5-1; 1-2; 3-5; 7-9 mg/m³). Other factors are comfortable temperature and humidity, hypo-bacterial and allergen-free air medium. The method of Halotherapy was authorized by the Russian Ministry of Public Health in 1990. To study the efficiency of Halotherapy, the data was collected from 15 Russian hospitals (during 1991-1994). We have evaluated the results of Halotherapy in 4,780 adults and children with various types of pulmonary diseases. Halotherapy course consisted of 10-20 daily procedures of 1 hour. The Halotherapy results were assessed by physicians on the basis of clinical symptoms, functional parameters and the dosage of medication dynamics with the standard questionnaires use. Halotherapy resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% of severe asthma cases and 97% of chronic bronchitis and bronchiectasis. Long-term examination of patients (for one or more year) demonstrated the effect of Halotherapy on reduction in the frequency of exacerbations, reduction in chronic symptoms. Thus, Halotherapy can be used as a rehabilitation method for pulmonary diseases management.

Chervinskaya AV, Kvetnaya AS, Cherniaev AL, Apul’tsina ID, Amelina EL, Molodtsova VP, Faustova ME. Effect of halotherapy on the host defense of the respiratory tract // Ter. Arkh. – 2002. – N.3. – P. 48-52. (Червинская А.В., Кветная А.С., Черняев А.Л., Апульцина И.Д., Амелина Е.Л., Молодцова В.П., Фаустова М.Е. Влияние галоаэрозольной терапии на защитные свойства респираторного тракта // Терапевт. арх. – 2002. – Т. 74, № 3. – С.48-52.)

Aim: Assessment of the efficacy of dry high-dispersive aerosol of sodium chloride – the main acting factor of halo-aerosol therapy – on defense system of the respiratory tract.
Material and methods: 188 patients with respiratory disease and at risk of pulmonary pathology received course of halo-aerosol therapy. 49 matched patients were given a placebo. The effect of the treatment was assessed by clinical, endoscope picture, cytomorphological and bacteriological characteristics of the bronchoalveolar lavage, contamination activity of the microflora, activity of local humoral immunity in pharyngeal brush-biopsies and saliva, rheological indices of the sputum.
Results: Dry aerosol of sodium chloride demonstrated anti-inflammatory activity in the respiratory tract, mucous regulatory action. It enhances drainage of the bronchi, activates alveolar macrophages, and improves biocenosis and local humoral immunity.
Conclusion: Haloaerosol therapy has positive effect on the host defense system, improves function of the respiratory tracts.

Chervinskaya A.V. Halotherapy of respiratory diseases. – Physiotherapy, balneology, and rehabilitation. – 2003. – N6. – P.8-15. (Червинская А.В. Галотерапия болезней органов дыхания // Физиотерапия, бальнеология и реабилитация. – 2003. – № 6. – С. 8-15.)

In the scientific review, the method of halotherapy simulating the parameters of salt speleo-clinic microclimate is described. The data concerning the development of method, principles, and advantages of halotherapy with a controlled microclimate of halo-chambers and halo-inhalation therapy with portable halo-inhalator are presented. Operative factors, pathophysiological foundations of therapeutic action of this method, particularities of symptom dynamics within the treatment course and factors of clinical pattern change with different pathologies are analyzed. Data of clinical efficiency and substantiation of method application for rehabilitation treatment in patients with bronchopulmonary pathology as a method of primary and secondary prevention of respiratory diseases for ENT and skin diseases as well as in persons with concomitant cardiac pathology were presented.

Korolev A.V., Tarasenko M.P., Filatova L.M., Kopileva O.D., Blokhin B.M. Rehàbilitation of children who have frequent and long-lasting colds and application of halotherapy and breathing gymnastics for their treatment. – Kremlin Medicine. Clinical Herald. – 2003. – N4. – P. 57-59. (Королев А.В., Тарасенко М.П., Филатова Л.М., Копылева О.Д., Блохин Б.М. Реабилитация часто и длительно болеющих детей с применением галотерапии и дыхательной гимнастики // Кремлевская медицина. – 2003. – №4. – С.57-59.)

Nowadays, development of techniques for treatment and rehabilitation of children who have frequent and long-lasting colds is quite actual 60 children with the discussed pathology have been examined and divided into three groups. A comparative analysis of the effectiveness of rehabilitation has been done. In one group a rehabilitation course included curative physical training, massage, swimming pool; in the other group- the same plus halotherapy; in the third group – everything mentioned above plus breathing gymnastics. Efficiency was evaluated by the function of external breathing. Results have shown that halotherapy improves parameters of the external breathing. Additional use of special equipment for breathing gymnastics considerably improves the efficiency of the prescribed therapy.

Chervinskaya A. V., Kvetnaya A. S. Therapeutical effects of the dry sodium chloride aerosol on physiological properties of the respiratory mucosa // Pulmonology. Supplement abstract book: 3rd Congress of European Region International Union against Tuberculosis and Lung Diseases (IUATLD).– 2004. – Res. 322.

Dry, fine-grained sodium chloride aerosol (halo-aerosol) is the primary factor of Halotherapy. The goal was to study therapeutical effects of halo-aerosol on the functional state of airway mucosa as well as on vitality and biological properties of microorganisms.
We used the standard S.pneumoniae strain as a test culture, which properties were studied in an experimental halo-aerosol chamber. Properties of the respiratory tract epithelium were studied using a model of larynx-pharyngeal epithelium cells obtained from 10 healthy persons before and after halo-aerosol inhalation. As the control substance, an aerosol of physiologic saline was used. Electrokinetic activity (EC) of epithelial cells and adhesive activity (adhesion index – AI) of S.pneumoniae were evaluated.
During the stay of S.pneumoniae strain in the halo-aerosol chamber, the colony-forming units (CFU) parameter was reduced with increasing of exposition period from 5 to 30 minutes (р<0.001). The survived microorganisms had decreased virulence and hyaluronidase activity.
After halo-inhalations an increase of the EC of the epithelial cells in the healthy persons was observed (before – 27.0±4.7%, after – 47.0±1,6%; р<0.01) as well as a decrease of AI in comparison with the initial one (29.3±4.3% и 8.3±4.1% correspondingly, р<0.01). The study indicated the adhesive activity of S.pneumoniae was the least intensive at a high level of EC cells (r=1.0).
As a result, it has been established that dry fine sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. Under the influence of halo-aerosol, an increase of the functional electrophysiological activity of the respiratory epithelial cells was observed as well as a rise of their colonization resistance.

Chervinskaya A. V. Respiratory hygiene with the dry sodium chloride aerosol // 14th Annual Congress of the European Respiratory Society, Glasgow, September 2004: Abstract Book.- 2004. – Ref. 2514.

Dry sodium chloride aerosol (DSCA) could be used as a method of respiratory hygiene for prevention of COPD. The aim was to study clinical and functional parameters of the persons with COPD risk on the application of the DSCA.
54 persons with exogenous risk factors of COPD were examined. They had a productive cough associated with smoking and/or exposure to industrial pollutants. The main group (MG) (26 males, 8 females, 43±2.4 yrs) was treated with the DSCA (14 procedures). Procedures (10 min daily) were given using inhaler Haloneb³, producing DSCA with the particle size of 1-5 μm and 0.8-1.2 mg/min density. The control group (CG) (15 males, 5 females, 46.5±2.8 yrs) received inhalation with room air.
After the procedures, the cough retained in 27% of the persons of MG and 91% – CG (p<0.001). Relief of a cough and improvement of sputum properties were remarked in the 88% of MG and 22% – CG (p<0.05). The significant decrease in the number prs with dry rales (15%-MG, 55%-CG, p<0.05) was observed as well. Significant increase of parameters FEF25 (p<0.05), FEF50 (p<0.01) FEF75 (p<0.05) was marked in MG. There were no significant changes in the average values of functional parameters in CG. Positive dynamics of the flow-volume indexes in 16 prs (47%) of MG was observed. That differed significantly from CG values (5%, p<0.01).
Respiratory symptoms and functional parameters of the prs with the risk of COPD had the significant changes under the action of DSCA. Relief of a cough, improvement of the sputum properties, positive dynamics of auscultatory finding and functional parameters demonstrated stimulation of bronchial drainage and sanitary acting of the DSCA.

Mokina N. A., Geppe N. A. Alternative methods at bronchial asthma of children // 14th Annual Congress of the European Respiratory Society, Glasgow, September 2004: Abstract Book.- 2004. – Ref. 1069.

The purpose: To estimate efficiency of halotherapy, physical training, massage at children with moderate bronchial asthma (BA).
Methods: The open randomized comparative study lasted 4 months. Base antiasthmatic therapy was carried out with combined medicine Seretide (50 mcg salmeterol and 100 mcg fluticasone). Three groups were generated: 30 patients, received only the basic therapy, the other two groups, each of 32 of children, except this, received for 2 weeks: 2nd group physical training and massage, 3-rd group halotherapy. The average age in the groups was accordingly: 9.5±0.5; 9.4±0.5; 9.5±0.3. The daytime and night displays of BA were estimated by the scale from 0 up to 3 numbers.
Results: The daytime and night symptoms were accordingly: 0.30±0.03 and 0.33±0.03 (Seretide group), 0.27±0.04 and 0.11±0.02 (Seretide + physical training + massage group), 0.16±0.04 and 0.15±0.04 (Seretide ± halotherapy group), p<0.05. Peak expiratory flow was higher in Seretide + halotherapy group (352±8 morning and 354±8 ml evening) and Seretide + physical training + massage: (347±3 morning and 347±3 ml evening), against 327±4 (morning) and 330±4 ml (evening) in Seretide group (p<0.05). The numbers of inhalations of salbutamol as needed were minimal per day in seretid+halotherapy group: 0.03±0.02, against 0.20±0.04 in Seretide + physical training + massage group and 0.39±0.04 in Seretide group, (p<0.05).
Conclusion: The application of halotherapy as well as physical training and massage on the background of the basic medicinal therapy in children with moderate BA renders to positive effect.

Lemko O. I., Lemko I. S., Kazankevich V. P., Reshetar D. V., Vatuh N. V., Meleha O. O., Slivko R. I. Some advances in COPD treatment and management// The Europ. Respir. Journ., -2004.-V.24: Suppl. 48. -85s.

The elaboration of the long-term programs of the COPD control is an important direction in the improvement of patients quality of life. The programs offered by us include rational bronchodilator therapy in combination with non-medicamental methods of treatment. One of such methods is speleotherapy (the treatment in of the rock salt mines microclimate) and its artificial analogs (Halotherapy). The rock salt aerosols improve the mucociliary clearance, they have antibacterial and anti-inflammatory influence and thus promote the reduction of broncho-obstruction.
123 patients with COPD of different stages have been investigated. The patients underwent complex examination, which included the research of pulmonary function tests (PFT), inflammation activity, immune reactivity, estimation of lipids peroxidation (POL) and antioxidant defense (AOD). The decrease of some unspecific defense factors, CD3- and CD4-cells independently of COPD stage was determined. But the number of B-lymphocytes, CD25- and CD71-cells was increased. The POL activation and AOD decrease have been observed. Two Halotherapy regimes (HR) with different aerosol characteristics were used. The special laser-optical system for monitoring of aerosol characteristics was carried out. Halotherapy has a positive influence on clinical COPD process, but significant increase of PFT-data and improvement of some immune indexes were found out only after HR-2. The improvement of AOD-data was observed after both HR. Besides that, the rise of sensitivity to bronchodilator therapy was noted.

Chervinskaya A.V., Biskys V. Aerosol respiratory hygiene as the main part of prevention of chronic obstructive pulmonary diseases (COPD) and health promotion for patients in hospitals // 14th International Conference on Health Promoting Hospitals, Palanga, Lithuania, May 2006, II-5.3.

The experts of WHO forecast the subsequent increase of COPD and asthma worldwide. Mainly it has been related to the deteriorative ecological situation. To stop this tendency, aerosol methods with physical factors are preferable because of physiological action without system side effects. Dry salt inhalation therapy has a long history in Europe since the 19th century. Nowadays there are a number of resorts are exploiting salt caves for patients with pulmonary diseases. Halotherapy (HT) is the result of adapting natural salt aerosol from salt caves to flexible usage in other locations. In addition to availability, the ability to deliver a specified different dose of dry rock salt represents a major advantage of Halotherapy over the treatment in natural salt caves. Over 15 years, numerous expert groups have worked on standardization of halo-chambers based on the accurate understanding of condition in salt caves. Halotherapy was sanctioned by Ministry of Public Health in Russia and Lithuania.
The efficiency of HT for the care of respiratory and allergic diseases, ENT-pathologies was proved by many scientists in controlled studies. The inclusion of Halotherapy into the rehabilitation course of pulmonary pathology patients (with asthma, COPD, bronchitis, pneumonia, and others) allows achieving the therapeutic effect by 82–95% of cases along with the most optimal use of pharmacotherapy. It has shown that the application of the Halotherapy assured 1.5-2 fold reduction of morbidity level in long-term observation.
Dry sodium chloride aerosol has a positive effect on the defense system of the respiratory tracts. It enhances mucociliary clearance in conjunction with normalization of bronchial microflora and immunological benefits. Data from prevention studies showed the high efficacy of dry salt aerosol in reducing the risk of common cold during the cold season. Halotherapy may be recommended for healthy persons and patients with chronic respiratory diseases before or during every cold period. Evaluation of respiratory symptoms, functional parameters, local immunity in persons with the risk factor of lung diseases, confirmed their significant changes under the action of Halotherapy. It can use as a sanitary method for respiratory airways.
We look at the positioning of dry sodium chloride aerosol with Halotherapy as the main component of respiratory hygiene for prevention of respiratory diseases, relief of environmental hazards and rehabilitation of chronic patients. As a consequence of clinical and mechanism acting understanding of Halotherapy, the concept of “maintaining bronchial health” appears to be helpful in health promotion activity of hospitals.

Chervinskaya Alina V. Respiratory Hygiene in Health Resort Medicine // 35th Congress of the International Society of Medical Hydrology & Climatology, Istanbul, June 6-10, 2006: Congress book. – 2006. – OP-2, P. 86.

WHO forecasts the subsequent increase of lung diseases worldwide, related to the deteriorative ecological situation. To stop this tendency, aerosol methods with physical factors are preferable. Adapting natural salt aerosol from salt caves for flexible and comfortable usage has to lead to Halotherapy and HaloSPA™ technology with dry sodium chloride aerosol (DSCA).
The aim of the study: Evaluation of the efficacy of DSCA on defense system of the respiratory tract and clinical state of the patients with respiratory diseases. 193 patients with pulmonary diseases and at risk of them received a course of DSCA (10-20 sessions daily 45-60 min each in the rooms, equipped with dry salt aerosol generators). 67 matched patients were given a placebo. The effect of the treatment was evaluated by clinical, functional, cytomorphological, bacteriological, immunological examinations, rheological indices of the sputum.
Results: DSCA enhanced drainage of the bronchi, activated alveolar macrophages, improved biocenosis and local humoral immunity. Procedures resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% of severe asthma cases and 97% of chronic bronchitis and bronchiectasis. The number of common cold cases during the cold season was reduced in half. Evaluation of respiratory symptoms and functional parameters by persons with the risk factor of lung diseases confirmed their significant changes under the action of DSCA.
Conclusion: We look at the positioning of DSCA as the main component of respiratory hygiene in Health Resort Medicine for prevention of respiratory diseases, as a relief of environmental hazards and rehabilitation of chronic patients.

Chervinskaya A. V. Effect of dry sodium chloride aerosol on the respiratory tract of tobacco smokers // The Europ. Respir. Journ.-Abstracts 16th ERS Annual Congress, Munich, Germany, September 2-6, 2006. – P. 106s-107s.

The aim was to study the influence of dry sodium chloride aerosol (DSCA) on the respiratory tract of tobacco smokers. 47 males were examined. They had a productive cough associated with smoking. The test group (TG) (24 male, 49.9±1.2 yrs; 27.0±1.7 pack/years) was treated with the DSCA (14 procedures). 20 procedures (10 min daily) were given using halo-inhaler Haloneb®, producing DSCA with the particle size of 1-5 μm and 0.5 mg/min density. The placebo group (PG) (23 male, 49.5±1.5 yrs; 27.9±2.3 pack/years) received inhalations with plain air.
88% of smokers of TG by the end of inhalation course reported easier and/or decreased a cough, changes in the character of sputum, which became lighter and clearer. Improvement in the character of sputum was noted only 22% volunteers of PG (p<0.001).
Cytobacteriologic study of brush biopsies taken from pharyngeal mucosa was carried out before and after procedures in both groups. It was determined that the infection index (II – % of epitheliocytes with adhered cells of S.pneumoniae) and adhesion index (AI – the mean number of microbial cells per one epitheliocyte) decreased significantly in the TG (II before – 28.1±5.8 and after – 7.8±2.7%, p<0.01; IA before – 45.4±11.3 and after – 13.9±6.3 microbe cells, p<0.01). The amount of IgA in epithelial cells of the oropharyngeal mucosa (estimated by the indirect method of fluorescent antibodies) increased significantly in the TG (before – 1.5±0.9 and after – 2.0±0.5, p<0.05). There were no significant changes in these indexes in the PG.
Conclusion: DSCA relieves the main symptoms ( the character of a cough and sputum), improves local defense mechanisms and resistance of mucous membranes of tobacco smokers owing to decreased colonization activity of pathogenic microbes.

Chervinskaya A. Halotherapy in controlled salt chamber microclimate for recovering medicine // Balneol. Pol. – 2007. – Vol. 49, N 2 (108). – P. 133-141.

The review presents the method of halotherapy which models the microclimate parameters of salt speleoclinics. It gives historical data on the method development, principles and advantages of Halotherapy using controlled microclimate. The influence of the main curing factor – the dry, fine-grained sodium chloride aerosol, and pathophysiological basis of curing effect of the halotherapy method is under review in the article. The article describes the method of controlled halotherapy and its technology, that is the halo-complex equipped with a controlled halogenerator.
Data on clinical efficacy and the grounds for the method used in the recovering treatment for bronchopulmonary and otorhinolaryngologic pathologies, skin diseases and combined cardiovascular pathology, as well as preventive measures against respiratory diseases, are cited. Efficacy of Halotherapy in treatment and recovery of children is under review. Foundations for perspective usage of halotherapy in all kinds of medical and recovering establishments are given.
Key words: halotherapy, speleotherapy, drug-free method, salt room, salt cave, salt chamber, halochamber, halo-complex, halogenerator, dry sodium chloride aerosol, respiratory diseases.

Chervinskaya A. Mechanism of action of the dry sodium chloride aerosol and its clinical efficiency in prophylaxis and rehabilitation // Balneol. Pol. – 2007. – Vol. 49, N 3 (109). – P. 197.

Introduction: Dry sodium chloride aerosol is the main curative factor of treatment in the natural salt caves – speleotherapy. Halotherapy (HT) has been developed from speleotherapy. Curative effect of is caused by an air medium saturated with dry sodium chloride aerosol with predominance amount of particles of 1 to 5 microns in size and a certain density range. Halotherapy is carried out on the premises equipped with medical devices – dry salt aerosol generators and control devices.
It has been known that nebulized sodium chloride solution is used for therapeutic and diagnostic purposes. There is little doubt that inhalation of isotonic saline does not produce any evident therapeutic effects. Aerosolized hypertonic saline influences on impaired mucociliary clearance, but it is not used for therapy because can provoke bronchospasm in patients with asthma and even in healthy persons. Hypertonic and hypotonic solutions are used to diagnose bronchial hyperreactivity. Because physical properties of dry sodium chloride differ from nebulized solution, its therapeutic effect differs as well.
The aim: assessment of the efficacy of the dry fine sodium chloride aerosol (halo-aerosol) on defense system of the respiratory tract and clinical state of the patients with respiratory diseases.
Material and methods: 193 patients with respiratory disease and at risk of pulmonary pathology received course of Halotherapy. 67 matched patients were given a placebo. The effect of the treatment was assessed by clinical and functional parameters dynamics, endoscope picture, cytomorphological and bacteriological characteristics of the bronchoalveolar lavage, contamination activity of the microflora, activity of local humoral immunity in pharyngeal brush-biopsies and saliva, rheological indices of the sputum. The course of Halotherapy consisted of 10-20 daily 1-hour procedures.
Results: It has been established that dry fine sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. Under the influence of dry salt aerosol, an increase of the functional electrophysiological activity of the respiratory epithelial cells was observed as well as a rise of their colonization resistance. Dry aerosol of sodium chloride demonstrated anti-inflammatory activity in the respiratory tract, muco-regulating action. It enhances drainage of the bronchi, activates alveolar macrophages, and improves biocenosis and local humoral immunity. Halotherapy resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% of severe asthma cases and 97% of chronic bronchitis and bronchiectasis. Patients showed positive dynamics of symptoms indicative of a better drain function of their airways. In the majority of cases, the number and intensity of asthma attacks decreased, which allowed reducing the dosage of medication. The improvement in the clinical state was accompanied by positive dynamics of the lung function measurements. None of the pts complained of the bad condition during Halotherapy procedures. Long-term examination of patients (for one or more year) demonstrated the effect of Halotherapy on reduction in the frequency of exacerbations, reduction in chronic symptoms. The changes in control group parameters after placebo were not statistically significant.
Evaluation of respiratory symptoms and functional parameters in persons with the risk factor of COPD confirmed their significant changes under the action of Halotherapy. Relief of a cough in combination with improvement of sputum properties, positive dynamics of auscultatory finding and functional parameters demonstrated stimulation of bronchial drainage and sanitary acting of Halotherapy.
Conclusion: Dry sodium chloride aerosol has positive effect on the defense system and function status of the respiratory tracts. Clinical efficacy of Halotherapy in prophylaxis and rehabilitation of respiratory patients is based on the medicating action of dry sodium chloride aerosol.

Chervinskaya Alina. Halotherapy in health resort medicine// 36th Congress of the International Society of Medical Hydrology & Climatology. Abstracts book. – Porto, 2008. – P. 29-30.

The paper presents the method of halotherapy which models the microclimate parameters of salt speleo-clinics. It gives historical data on the method development, principles and advantages of halotherapy using controlled microclimate. The influence of the main curing factor — the dry, fine-grained sodium chloride aerosol, and pathophysiological basis of curing effect of the halotherapy method is under review in the paper. The paper describes the method of controlled halo­therapy and its technology, that is the halo-complex equipped with a controlling halogenerator. Scientific grounds for action mechanism, proven clinical effi­ciency verified by research on standards of evidence-based medicine and practical application in various fields of public health determine broad prospect of the method in rehabilitation, sanatoria and health resorts and preventive medicine. Data on clinical efficacy and the grounds for the method used in the recovering treatment for bronchopulmonary and otorhinolaryngologic pathologies, skin diseases and combined cardiovascular pathology, as well as preventive mea­sures against respiratory diseases, are cited. Efficacy of Halotherapy in treatment and recovery of children is under review. Foundations for perspective usage of Halotherapy in all kinds of medical and recovering establishments are given.

Chervinskaya A. Dry sodium chloride aerosol against acute respiratory viral infections// The Europ. Respir. Journal, – 2009. – 34: Suppl. 53. – 401s.

Aim of the study: The main objective was to estimate the preventing efficacy of inhaled dry sodium chloride aerosol (DSCA) against acute respiratory viral infection (ARVI).
Objects and methods: 160 persons were recruited from personnel of an industrial enterprise through special questionnaire. They were randomized into 2 groups – test group (TG) (19 males, 61 females, 47.4±8.0 yrs) and control group (CG) (22 males, 58 females, 48.8±11.6 yrs). The persons of the TG were undertaken with inhalations (10 min) using Haloneb® halo-inhaler, producing DSCA with the particle size of 1-5 μm and 0.8-1.2 mg/min density flow. The CG received 10 min inhalations with plain air. Each subject was given two inhalations a week during 12 weeks. A physician regularly examined the subjects of both groups for possible ARVI.
Results. For three months observation, there were only 14 cases of ARVI and 104 days marked by symptoms of ARVI in the TG. In the CG there were 55 cases of ARVI and 585 days of symptoms. TG subjects were affected by ARVI four times less frequently than CG subjects, and the number of days marked by symptoms of ARVI was 5.6 times less. Analysis of incidences of ARVI showed that they occurred in 60% of subjects with risk factors of COPD in CG subjects against 18% of subjects with risk factors in the TG (p<0.01). On the whole, 13 subjects (16%) developed ARVI in the TG against 50 subjects (63%) in the CG (p<0.001).
Conclusions: Inhalations of DSCA, consisting of two weekly procedures for 12 weeks are an effective preventing measure against ARVI.

Chervinskaya A.V., Kvetnaya A.S. Effect of the dry sodium chloride aerosol on physiological properties of S.pneumoniae and the mucosa epithelium at the experiment // Research Practical Journal “Clinical Laboratory Consilium.” – 2009. – №3 (28). – P.72-77. (Червинская А,В., Кветная А.С., Корженевская Т.Б. Влияние сухого высокодисперсного аэрозоля хлорида натрия на физиологические свойства Streptococcus Pneumoniae, персистирующего на слизистой ларингофарингеального эпетелия, в эксперименте //Научно-практический журнал “Клинико-лабораторный консилиум”. – 2009. – №3 (28). – С.72-77.)

Background: The dry aerosol of sodium chloride with a predominant fraction of respirable particles is the main factor of action of the inhalation therapy which was given the name of Halotherapy. The goal of this work was to study effects of the dry, fine-grained sodium chloride aerosol on the functional state of mucosal epithelium as well as on vital capability and biological properties of microorganisms.
Methods: As a test culture, we used the standard S.pneumoniae strain, whose properties were studied in an experimental aerosol chamber. Properties of the respiratory tract epithelium were studied using a model of pharyngeal epithelium cells obtained from 10 healthy volunteers before and after inhalation of the dry sodium chloride aerosol. As a control, an aerosol of 0.9% sodium chloride solution was used.
Results: It has been established that the dry, fine-grained sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. After exposition to the aerosol, there was observed an increase of the functional electrophysiological activity of the epithelial cells and a rise of their colonization resistance.
Keywords: Dry sodium chloride aerosol, inhalations, halotherapy, respiratory diseases, microorganisms, mucosa epithelium.

Ponikowska I, Latour T., Czerwinskaja A., Chojnowski J. Investigation of physical-chemical properties of dry salt aerosol in artificial caves // Balneol. Pol. – 2009.– N 2 (116). – P. 92-99. (Ponikowska I, Latour T., Czerwinskaja A., Chojnowski J. Badania właściwości fizyczno-chemicznych suchego aerozolu solnego w komorze naziemnej //Balneol. Pol. – 2009. – N 2 (116). – P. 92-99.)

Treatment in natural salt caves (speleotherapy) has been known for years. In Poland, numerous artificial salt caves have been constructed during the last few years that were supposed to be a good alternative for natural salt chambers. Still, in artificial caves, it was impossible to reach such levels of salt aerosol that would bring medical effect. Consequently, they cannot be treated as “medical equipment.” However, artificial salt caves can be used in medical treatment provided that special salt aerosol demonstrating certain medical parameters is introduced.
The aim of the research was to examine physical and chemical properties of the high-dispersive dry salt aerosol of specific concentration that is produced by a generator. The microclimate of the caves was checked together with the size of aerosol particles and its concentration. This investigation, treated as primary work, enabled to select the salt that has the greatest medical value to be a source of aerosol produced by the nebulizer that is additionally enriched with iodine. The examination of the size of particles generated by the apparatus showed that 98 percent of aerosol particles are 1-5 µm making them reach to pulmonary alveoli. The concentration of aerosol was examined in various conditions and places within the cave. It was 4.42-6.03 NaCl mg/m³ on average. It was stated that sodium chloride absorption during one procedure came to 13 mg NaCl on average, which means it was a tiny amount of salt that was absorbed by a human organism. It should be speculated that such amount of sodium chloride does not have any negative influence on the patient.
Examination of the microclimate of artificial caves shows that dry salt aerosol concentration came to 10-15 mg/m³, humidity – to 60 percent, air temperature – to 20-24 degrees Celsius, procedure duration – 45 minutes. These results we will be later adopted in the treatment of patients with COPD.
Key words: salt caves, concentration of aerosol.

Chervinskaya Alina. Efficacy of halotherapy in asthma patients//Press Therm Climat/ 37th world congress of the International Society of Medical Hydrology and Climatology, Paris 2010 “Medical Hydrology and Balneology: from molecules to society,” June 23th to 26th 2010. – 2010. – V.147. – P.45-47.

Introduction: The experts of WHO forecast the subsequent increase of allergy and asthma on worldwide. Mainly it has been related to the deteriorative ecologic situation. To stop this tendency, aerosol methods with physical factors are preferable because of physiological action without system side effects.
Dry salt inhalation therapy has a long history in Europe since the 19th century. Nowadays there are a number of resorts are exploiting salt caves for patients with pulmonary diseases. Halotherapy (HT) is the result of adapting natural salt aerosol from salt caves to flexible usage in other locations. Curative effect of Halotherapy is caused by an air medium saturated with dry sodium chloride aerosol (DSCA) with predominance amount of particles of 1 to 5 µm in size and of a specific density range. HT is carried out on the premises equipped with medical facilities – dry salt aerosol generators (halogenerators) and control devices.
Over 15 years, numerous expert groups have worked on standardization of halo-chambers based on the correct understanding of condition in salt caves. In addition to availability, the ability to deliver a specified different dose of DSCA represents a major advantage of Halotherapy over the treatment in natural salt caves. Ministry of Public Health approved Halotherapy in Russia and Lithuania.
Material and methods:The randomized placebo study has lasted for 12 months. Controlled Halotherapy was evaluated in 115 patients (pts) with asthma (37 males, 78 females, mean age 41.2+2.2 years). 60% of pts received a base medication without a full effect. DSCA with the dominating amount of 1 to 5 µm particles was produced by halogenerator ASA-01.3 (Aeromed Ltd.). Treatment was performed in a special room with salt-coated walls. The pts breathed normally while reclining in the chairs. The DSCA course comprised 15-20 daily one hour procedures. The duration of each course and density of the aerosol environment (from 1 to 5 mg/m³) depend on clinical features of asthma and functional parameters. The control group of 95 pts (30 males, 65 females, mean age 39.4+1.5 years) received a placebo. Placebo course consisted of 15 procedures of a musical psycho-suggestive program in the same room with salt-coated walls, but halogenerator did not produce DSCA.
Results: During Halotherapy, most of the pts showed positive dynamics of symptoms indicative of a better drain function of their airways: sputum secretion alleviated, it became less viscous and more mucosal, coughing relieved, and the auscultative picture of the lungs altered. By the end of the course of Halotherapy, the number of asthma attacks decreased significantly as compared to the initial ones (94 and 56%, p<0.01). The number of severe asthma attacks controlled by combined medication also decreased (24% and 3%, p<0.01). After Halotherapy, inhaled corticosteroids were discontinued in 5% of pts. In 40% of pts, it was possible to reduce the dose. Those were the cases when inhaled corticosteroids were prescribed as anti-inflammatory agents. Dynamics of beta-agonists usage was positive as well. Reduction or cancellation in medication usage was an indicator of Halotherapy clinical benefit. None of the pts complained of the bad condition during Halotherapy procedures. The pts showed a significant increase in FVC, FEV1, PEF, FEF50 and a decrease of Raw by the end of the treatment. HT resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% of severe asthma cases. The pts were examined 6 and 12 months after Halotherapy course. The average duration of remission was 7.6+0.9 months.
The inclusion of Halotherapy into the rehabilitation course of asthma pts allowed achieving the therapeutic effect in 82–95% of cases along with the most optimal use of pharmacotherapy. It has shown that the application of the Halotherapy assured 1.5-2 fold reduction of morbidity level in long-term observation. The changes of the majority of the clinical and functional parameters in the control group were less statistically as compared to the Halotherapy group’s ones.
Conclusion: The application of Halotherapy on the background of the essential medicinal therapy in pts with asthma renders to positive influence on the clinical and lung functional parameters. The results of Halotherapy application demonstrate its efficacy.
We look at the positioning of dry sodium chloride aerosol with controlled Halotherapy as a component of rehabilitation programs for asthma pts.

Chervinskaya A., Ponikowska I. Halotherapy for treatment of patients with chronic obstructive pulmonary diseases// Acta Balneologica. – 2011. – LIII, N3 (125). – P.190.

Aim of the study: The main objective was to estimate the efficacy of inhaled dry sodium chloride aerosol (DSCA) in rehabilitation therapy (RT) of patients with COPD.
Objects and methods: It was double-blind placebo study. 72 patients (pts) with the moderate and mild stage of COPD were recruited. They were randomized into 2 groups – interventional group (IG) (21 m, 18 f, 60.3±10.8 yrs) and control group (CG) (22 m, 11 f, 58.5±8.9 yrs). All patients received RT: daily procedures of chest massage, light radiation, physical exercises. Pts of IG were treated with the DSCA (45 min twice a day for 14 days). DSCA containing particles with the size of 1-5 µm and level of mass concentration in the room of 10-15 mg/m³ was produced by halogenerator GDA-01.17 (Halomed UAB, Lithuania). CG received placebo (inhalations with room air) instead of DSCA. Clinical, functional parameters and measures of health-related quality of life (HRQL) by SF-16 and LCQ (10 items) were estimated after RT procedures and in 3 months.
Results: Improvements of clinical symptom scores were observed in the both groups after the course of RT (p<0.05), but in 3 months positive effect was noticed only in IG (before – 13.8±5.4, after RT – 9.1±4.9, in 3 months – 9.6±4.3, p<0.05). Measures of LCQ were changed significantly after RT only in pts of IG, received DSCA (35.2±5.2 and 52.4±6.3, p<0.05). Positive changes in physical functioning measures were observed (SF-16) in IG and CG groups after RT, but they have been kept till three months only in IG.
Conclusions: Application of inhalations of DSCA on the background of the RT in pts with COPD renders to positive effect.

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