Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis
Background Mucus dehydration and impaired mucus clearance are common features of cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). In CF, inhaled hypertonic saline (HS) improves lung function and produces sustained increases in mucociliary clearance (MCC). We hypothesised that a...
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doaj-a2c09a025f9e4512a342013db9b70f592020-11-25T03:55:47ZengEuropean Respiratory SocietyERJ Open Research2312-05412020-08-016310.1183/23120541.00269-202000269-2020Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitisWilliam D. Bennett0Ashley G. Henderson1Agathe Ceppe2Kirby L. Zeman3Jihong Wu4Christine Gladman5Fred Fuller6Stephen Gazda7Brian Button8Richard C. Boucher9Scott H. Donaldson10 Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Pulmonary and Critical Care Medicine, Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background Mucus dehydration and impaired mucus clearance are common features of cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). In CF, inhaled hypertonic saline (HS) improves lung function and produces sustained increases in mucociliary clearance (MCC). We hypothesised that administration of HS (7% NaCl) twice daily for 2 weeks would improve clinical outcomes and produce sustained increases in MCC in COPD subjects with a chronic bronchitis (CB) phenotype. Methods Twenty-two CB subjects completed a double-blinded, crossover study comparing inhaled HS to a hypotonic control solution (0.12% saline) administered via nebuliser twice daily for 2 weeks. Treatment order was randomised. During each treatment period, symptoms and spirometry were measured. MCC was measured at baseline, shortly after initial study agent administration, and approximately 12 h after the final dose. Results HS was safe and well tolerated but overall produced no significant improvements in spirometry or patient-reported outcomes. CB subjects had slower baseline MCC than healthy subjects. The MCC rates over 60 min (Ave60Clr) in CB subjects following 2 weeks of HS were not different from 0.12% saline but were slower than baseline (Ave60Clr was 9.1±6.3% at baseline versus 5.3±6.9% after HS; p<0.05). Subgroup analyses determined that subjects with residual baseline central lung clearance (14 subjects) had improved spirometry and symptoms following treatment with HS, but not 0.12% saline, treatment. Conclusions Inhaled HS appeared to be safe in a general CB population. A specific phenotypic subgroup may benefit from HS but requires additional study.http://openres.ersjournals.com/content/6/3/00269-2020.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
William D. Bennett Ashley G. Henderson Agathe Ceppe Kirby L. Zeman Jihong Wu Christine Gladman Fred Fuller Stephen Gazda Brian Button Richard C. Boucher Scott H. Donaldson |
spellingShingle |
William D. Bennett Ashley G. Henderson Agathe Ceppe Kirby L. Zeman Jihong Wu Christine Gladman Fred Fuller Stephen Gazda Brian Button Richard C. Boucher Scott H. Donaldson Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis ERJ Open Research |
author_facet |
William D. Bennett Ashley G. Henderson Agathe Ceppe Kirby L. Zeman Jihong Wu Christine Gladman Fred Fuller Stephen Gazda Brian Button Richard C. Boucher Scott H. Donaldson |
author_sort |
William D. Bennett |
title |
Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis |
title_short |
Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis |
title_full |
Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis |
title_fullStr |
Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis |
title_full_unstemmed |
Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis |
title_sort |
effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis |
publisher |
European Respiratory Society |
series |
ERJ Open Research |
issn |
2312-0541 |
publishDate |
2020-08-01 |
description |
Background
Mucus dehydration and impaired mucus clearance are common features of cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). In CF, inhaled hypertonic saline (HS) improves lung function and produces sustained increases in mucociliary clearance (MCC). We hypothesised that administration of HS (7% NaCl) twice daily for 2 weeks would improve clinical outcomes and produce sustained increases in MCC in COPD subjects with a chronic bronchitis (CB) phenotype.
Methods
Twenty-two CB subjects completed a double-blinded, crossover study comparing inhaled HS to a hypotonic control solution (0.12% saline) administered via nebuliser twice daily for 2 weeks. Treatment order was randomised. During each treatment period, symptoms and spirometry were measured. MCC was measured at baseline, shortly after initial study agent administration, and approximately 12 h after the final dose.
Results
HS was safe and well tolerated but overall produced no significant improvements in spirometry or patient-reported outcomes. CB subjects had slower baseline MCC than healthy subjects. The MCC rates over 60 min (Ave60Clr) in CB subjects following 2 weeks of HS were not different from 0.12% saline but were slower than baseline (Ave60Clr was 9.1±6.3% at baseline versus 5.3±6.9% after HS; p<0.05). Subgroup analyses determined that subjects with residual baseline central lung clearance (14 subjects) had improved spirometry and symptoms following treatment with HS, but not 0.12% saline, treatment.
Conclusions
Inhaled HS appeared to be safe in a general CB population. A specific phenotypic subgroup may benefit from HS but requires additional study. |
url |
http://openres.ersjournals.com/content/6/3/00269-2020.full |
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