Background and aims Acute respiratory viral infections account for 90% of all infectious disorders and conditions in children. The variety and multiplicity of infectious agents, which constantly interact with the mucous membrane of the respiratory tract (on average an urban dweller inhales at least 10⁴–10⁵ of different types of microorganisms while breathing) suggests a complex setting for local protection of the respiratory tract. BNO 1030 phyto-immunomodulator (Bionorica AG, Germany) is one of the mild immunomodulating drugs, representing a fixed dose combination of 7 active ingredients extracted from medicinal plants (marshmallow root (Althaeae radix), chamomile flower (Matricariae flos), horsetail herb (Equiseti herba), walnut leaves (Juglandis folium), yarrow herb (Millefolii herba), oak bark (Quercus cortex), and dandelion herb (Taraxaci herba)).

Conduct a clinical and immunological study on therapeutic efficacy with BNO 1030 phyto-immunomodulator in children (3 to 14 years of age) prone to frequent acute respiratory infections (ARI) in intercurrent period and with a view to emergency prevention.

Methods Immunological level of serum Ig A, Ig M, Ig G; sCD14; TLR4 expression

Results Significant reduction in the multiplicity of the ARI by 2.3-fold during the year and duration of single respiratory episodes by 2.5±0.2 days. In children with the recurrent bronchitis at risk – clinical improvement due to reduction of the multiplicity of both acute bronchitis episodes by 1.3-fold during the year, and the multiplicity of the ARI episodes by 2.1-fold, on average. There was a significant increase in concentration of sCD14 and the TLR4 expression level remained unchanged against the background of treatment with BNO 1030.

Conclusions In view of the clinical data, it can be assumed that the immunomodulatory effect of Imupret is about increasing (stimulation) of production of the sCD14 molecule responsible for prevention of interaction between PAMP and mCD14, and upregulation of the TLR4 macroorganism. The effect of the BNO 1030 is based on its anti-inflammatory properties provided by the molecular mechanism responsible for sCD14 production.