Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects
Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects
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DOI：
10.1183/09031936.96.09040725
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发表时间：
1996-04-01
影响因子：
24.3
通讯作者：
Bautovich, G
中科院分区：
文献类型：
--
作者：
Daviskas, E;Anderson, SD;Bautovich, G
气道表面液体（ASL）的高渗透压被认为是高通气诱发哮喘的刺激因素。我们以前发现，在干燥空气等二氧化碳过度通气（ISH）后，粘膜纤毛清除率（MCC）增加，我们认为这种增加与ASL的瞬时高渗透压有关。我们研究了增加ASL的渗透压对MCC的影响，用~（99 m）Tc-硫胶体、γ照相机和计算机分析法测定了12例哮喘患者和10例健康人的MCC。雾化的14.4%盐水的（平均值+/-SD）体积对于哮喘患者为2.2+/-1.2 mL，对于健康受试者为3.2+/-0.7 mL，这是：对于哮喘受试者和健康受试者，分别在5.4+/-1.3和6.4+/-0.7 min的时间段内递送体积。对14.4%生理盐水的气道反应在单独的访视中进行评估，哮喘患者的一秒用力呼气量（FEV（1））下降为22+/-4%，健康受试者为3+/-2%。与0.9%生理盐水和对照相比，高渗气雾剂增加了两组的MCC。在哮喘受试者中，14.4%生理盐水组1小时内整个右肺的MCC为68 ± 10%，0.9%生理盐水组为44 ± 14%，对照组为39 ± 13%。在健康受试者中，14.4%生理盐水组1小时内整个右肺的MCC为53+/-12%，0.9%生理盐水组为41+/-15%，对照组为36+/-13%.我们得出结论，哮喘和健康受试者气道表面液体渗透压的增加增加了粘液纤毛清除率。这些发现与我们之前的建议一致，即干燥空气等渗过度通气后粘膜纤毛清除率的增加是由于气道表面液体的瞬时高渗。
Hyperosmolarity of the airway surface liquid (ASL) has been proposed as the stimulus for hyperpnoea-induced asthma We found previously that mucociliary clearance (MCC) was increased after isocapnic hyperventilation (ISH) with dry air, and we proposed that the increase related to transient hyperosmolarity of the ASL, We investigated the effect of increasing the osmolarity of the ASL on MCC, by administering an aerosol of concentrated salt solution.MCC was measured using Tc-99m-sulphur colloid, gamma camera and computer analysis in 12 asthmatic and 10 healthy subjects on three separate days, involving administration of each of the following: 1) ultrasonically nebulized 14.4% saline; 2) ultrasonically nebulized 0.9% saline; and 3) no aerosol intervention (control).The (mean+/-SD) volume of nebulized 14.4% saline was 2.2+/-1.2 mL for asthmatics and 3.2+/-0.7 mL for healthy subjects, This:volume was delivered over a period of 5.4+/-1.3 and 6.4+/-0.7 min for asthmatic and healthy subjects, respectively. The airway response to 14.4% saline was assessed on a separate visit and the fall in forced expiratory volume in one second (FEV(1)) was 22+/-4% in the asthmatic and 3+/-2% in the healthy subjects. Compared to the MCC with the 0.9% saline and control, the hypertonic aerosol increased MCC in both groups. In asthmatic subjects, MCC of the whole right lung in 1 h was 68+/-10% with 14.4% saline vs 44+/-14% with 0.9% saline and 39+/-13% with control. In healthy subjects, MCC of the whole right lung in 1 h was 53+/-12% with 14.4% saline vs 41+/-15% with 0.9% saline and 36+/-13% with control.We conclude that an increase in osmolarity of the airway surface liquid increases mucociliary clearance both in asthmatic and healthy subjects. These findings are in keeping with our previous suggestion that the increase in mucociliary clearance after isotonic hyperventilation with dry air is due to a transient hyperosmolarity of the airway surface liquid.