Furosemide impairs nasal mucociliary clearance in humans

Abstract

Furosemide, a potent diuretic, affects ion and water movement across the respiratory epithelium. However, the effects of furosemide, as clinically used, on mucociliary clearance, a critical respiratory defense mechanism, are still lacking in humans. Fourteen young healthy subjects were assigned to three random interventions, spaced one-week apart: no intervention (control), oral furosemide (40mg), and furosemide+oral volume replacement (F+R). Nasal mucociliary clearance was assessed by saccharine test (STT), and mucus properties were in vitro evaluated by means of contact angle and transportability by sneeze. Urine output and osmolality were also evaluated. Urine output increased and reduced urine osmolality in furosemide and F+R compared to the control condition. STT remained stable in the control group. In contrast, STT increased significantly (40%) after furosemide and F+R. There were no changes in vitro mucus properties in all groups. In conclusion, furosemide prolongs STT in healthy young subjects. This effect is not prevented by fluid replacement, suggesting a direct effect of furosemide on the respiratory epithelium.

Aging, Diabetes, and Hypertension Are Associated With Decreased Nasal Mucociliary Clearance

“…8,[19][20][21][22][23][24] The saccharine transit test (STT) results were recorded in minutes, with times of Յ 12 min considered normal. [25][26][27][28][29][30][31][32] During the STT, the subjects were asked to maintain normal ventilation and to swallow freely but to avoid deep breaths, talking, coughing, sneezing, sniffi ng, eating, and moving. After 60 min, if the subject failed to taste saccharine, we repeated the STT the following day.…”

“…A mucus sample was collected using a soft brush placed gently in the opposite nostril from the side used during the STT. 22,25 The mucus sample was then removed from the brush, kept in a plastic tube, and stored at 2 70°C for later analysis. Airfl ow clearability was assessed using a machine designed to mimic the fl ow profi le of a natural sneeze.…”

“…Airfl ow clearability was quantifi ed by determining the mucus displacement in millimeters. 22,25 The contact angle of a sessile mucus droplet was measured using a stereo-microscope (Stemi 2000C; Carl Zeiss) connected to a camera (Axiocam HSC; Carl Zeiss) and to a microcomputer with an imaging program (Interactive AxionVison 4.7; Carl Zeiss). 33 Briefl y, a small sample of mucus was placed on a glass slide that had been treated previously with a sulphochromic solution to remove electrical charges and then washed several times with deionized water.…”

Efeitos da desobstrução rinofaríngea retrógada isolada e associada à instilação de soro fisiológico (0,9%NACL), sobre as propriedades do muco nasal, a celularidade e as citocinas em lavado nasal e sintomas nasais de motociclistas profissionais expostos à poluição da cidade de Belo Horizonte

“…A amostra de muco foi coletada com movimentos suaves por meio de um pincel macio na narina oposta à narina do TTS 94,95 . As amostras foram codificadas e armazenadas em tubo plástico e mantidas a -80ºC de temperatura para análise das propriedades físicas do muco.…”

“…Entre as propriedades do muco, a "wettabilidade" é a propriedade que todo fluido biológico possui de se espalhar quando colocado sobre uma superfície sólida (lâmina) 91,94,95 , e o ângulo mensurado (AC) é uma grandeza inversa dessa propriedade, quanto maior o ângulo, menor é a "wettabilidade" …”