Acute inhalation of hypertonic saline does not improve mucociliary clearance in all children with cystic fibrosis
Open Access
- 6 September 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Pulmonary Medicine
- Vol. 11 (1), 45
- https://doi.org/10.1186/1471-2466-11-45
Abstract
Little is known of how mucociliary clearance (MCC) in children with cystic fibrosis (CF) and normal pulmonary function compares with healthy adults, or how an acute inhalation of 7% hypertonic saline (HS) aerosol affects MCC in these same children. We compared MCC in 12 children with CF and normal pulmonary function after an acute inhalation of 0.12% saline (placebo), or HS, admixed with the radioisotope 99 mtechnetium sulfur colloid in a double-blind, randomized, cross-over study. Mucociliary clearance on the placebo day in the children was also compared to MCC in 10 healthy, non-CF adults. Mucociliary clearance was quantified over a 90 min period, using gamma scintigraphy, and is reported as MCC at 60 min (MCC60) and 90 min (MCC90). Median [interquartile range] MCC60 and MCC90 in the children on the placebo visit were 15.4 [12.4-24.5]% and 19.3 [17.3-27.8%]%, respectively, which were similar to the adults with 17.8 [6.4-28.7]% and 29.6 [16.1-43.5]%, respectively. There was no significant improvement in MCC60 (2.2 [-6.2-11.8]%) or MCC90 (2.3 [-1.2-10.5]%) with HS, compared to placebo. In addition, 5/12 and 4/12 of the children showed a decrease in MCC60 and MCC90, respectively, after inhalation of HS. A post hoc subgroup analysis of the change in MCC90 after HS showed a significantly greater improvement in MCC in children with lower placebo MCC90 compared to those with higher placebo MCC90 (p = 0.045). These data suggest that percent MCC varies significantly between children with CF lung disease and normal pulmonary functions, with some children demonstrating MCC values within the normal range and others showing MCC values that are below normal values. In addition, although MCC did not improve in all children after inhalation of HS, improvement did occur in children with relatively low MCC values after placebo. This finding suggests that acute inhalation of hypertonic saline may benefit a subset of children with low MCC values. ClinicalTrials.gov: NCT01293084Keywords
This publication has 18 references indexed in Scilit:
- Pre‐Clinical Mouse Models of Primary and Metastatic Pleural Cancers of the Lung and Breast and the Use of Bioluminescent Imaging to Monitor Pleural Tumor BurdenCurrent Protocols in Pharmacology, 2011
- Hypertonic saline improves the LCI in paediatric patients with CF with normal lung functionThorax, 2010
- Denufosol: A review of studies with inhaled P2Y2 agonists that led to Phase 3Pulmonary Pharmacology & Therapeutics, 2008
- Chronic inhalation of nebulized levalbuterol does not increase mucociliary clearance in healthy subjectsPulmonary Pharmacology & Therapeutics, 2008
- Association between Pulmonary Function and Sputum Biomarkers in Cystic FibrosisAmerican Journal of Respiratory and Critical Care Medicine, 2007
- Evidence for airway surface dehydration as the initiating event in CF airway diseaseJournal of Internal Medicine, 2007
- Safety and use of sputum induction in children with cystic fibrosisPediatric Pulmonology, 2003
- Reduced Effect of Inhaled β2-Adrenergic Agonists on Lung Mucociliary Clearance in Patients With Cystic FibrosisSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1993
- The effect of aerosol distribution on airway responsiveness to inhaled methacholine in patients with asthmaJournal of Allergy and Clinical Immunology, 1992
- Effect of terbutaline on mucociliary clearance in asthmatic and healthy subjects after inhalation from a pressurised inhaler and a dry powder inhaler.Thorax, 1991