Hypertonic saline has a prolonged effect on mucociliary clearance in adults with cystic fibrosis

Aaron T. Trimble, A. Whitney Brown, Beth L. Laube, Noah Lechtzin, Kirby L. Zeman, Jihong Wu, Agathe Ceppe, David Waltz, William D. Bennett, Scott H. Donaldson

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Inhaled hypertonic saline (HS) has been shown to increase mucociliary clearance (MCC) and improve clinical outcomes in adults and adolescents with cystic fibrosis (CF). However, in younger children with CF, a large study failed to demonstrate clinical benefits. This discrepancy could reflect pharmacodynamic differences in the MCC response to HS in different populations. We previously demonstrated the absence of a sustained effect of HS on MCC in healthy adults and in this study sought to characterize the durability of the MCC response to HS in adults with CF. Methods: At two study sites, MCC was measured in CF adults using gamma scintigraphy during three separate visits: at baseline, 15 min, and 4 h after a single dose of HS (7% NaCl, 4 mL). Particle clearance rates at these visits were used to assess the durability of the MCC response to HS. Results: The average 90-minute clearance rate measured 4 h after HS was significantly increased (21.81% ± 12.8) when compared to baseline (13.77% ± 8.7, p =.048) and showed no apparent slowing relative to the rate measured 15 min after HS. While not all subjects responded to HS, the acute response strongly predicted the sustained effect in these subjects (r = 0.896, p <.0001). Conclusions: These results suggest that, in contrast to healthy adults, a single dose of HS has a prolonged effect on MCC in adults with CF, which lasts at least 4 h. This may explain its clinical efficacy in this population.

Original languageEnglish (US)
Pages (from-to)650-656
Number of pages7
JournalJournal of Cystic Fibrosis
Volume17
Issue number5
DOIs
StatePublished - Sep 2018
Externally publishedYes

Keywords

  • Airway hydration
  • Hypertonic saline
  • Mucociliary clearance
  • Pharmacokinetics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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