Impact of different chloride and glucose solutions on nasal potential difference

House, H.H.; Middleton, Peter G.

doi:10.1002/ppul.21032

Cited by 5 publications

(3 citation statements)

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“…These differences were highlighted as a cause of increased variability between sites in a multi‐center trial 12, so studies have now started to address specific details of the nasal PD. Boyle et al demonstrated that warmed solutions give larger isoproterenol responses 13, and we demonstrated that (0 mM) Cl gives significantly larger responses than (6 mM) Cl in non‐CF subjects, but glucose does not appear to alter nasal PD 14.…”

Section: Introductionsupporting

confidence: 48%

Measurement of airway ion transport assists the diagnosis of cystic fibrosis

Middleton

House

2010

Pediatric Pulmonology

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The nasal potential difference (PD) demonstrates the increased Na absorption and decreased Cl secretion typically found in cystic fibrosis (CF). It provides useful information for diagnostic purposes and measures the effect of new treatments on the ion transport defects found in CF. This study summarizes the nasal PD results in the respiratory tract of different groups of subjects, examines the responses in squamous epithelia and evaluates new ways to consider nasal PD results.Nasal PD was tested using the standard protocol of baseline, amiloride, low chloride, and isoproterenol solutions in 40 healthy non-CF volunteers, 46 CF subjects, and 78 subjects referred for investigation of possible CF. Nasal PD was also measured in the squamous epithelium at the anterior nares in six non-CF subjects.Baseline PD was elevated in the CF (47.5 (1.7) mV) compared with non-CF subjects: (14.0 (0.8) mV, P < 0.00001). Combined [Cl + Isop] responses were smaller in the CF (-0.1 (0.4) mV) compared with the non-CF subjects (26.2 (1.2) mV, P < 0.00001). In the diagnostic cohort 58 were given a non-CF diagnosis, 16 had CF confirmed, but 4 remained indeterminate. Separate consideration of Na and Cl transport was easily portrayed through X-Y plots. Finally, the nasal PD responses of squamous epithelium showed high baseline values, but little response to amiloride and low chloride solutions.The nasal PD provides useful information in the diagnostic algorithm of CF, and in the delineation of the two ion transport defects characteristically found in the respiratory epithelium. Avoidance of the squamous epithelium remains an important consideration for those performing and interpreting nasal PD responses.

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Section: Introductionsupporting

confidence: 48%

Measurement of airway ion transport assists the diagnosis of cystic fibrosis

Middleton

House

2010

Pediatric Pulmonology

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“…This parallels the recent demonstration that low-chloride responses with 0 mM versus 6 mM Cl -solutions gave an extra 2 mV response [10].…”

Section: Discussionsupporting

confidence: 67%

“…Six centres of the ECFS-DN Working Group participated. The perfusate temperature was changed during each step of the NPD protocol, using a similar design to a recent study comparing different chloride concentrations in the perfusate [10]. In a separate series of studies, a standard protocol was performed with either warmed or room temperature solutions, in the same subjects on different days.…”

Section: Introductionmentioning

confidence: 99%

Influence of perfusate temperature on nasal potential difference

Bronsveld

Vermeulen²,

Sands³

et al. 2012

Eur Respir J

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Nasal potential difference (NPD) quantifies abnormal ion transport in cystic fibrosis. It has gained acceptance as an outcome measure for the investigation of new therapies.To quantify the effect of solution temperature on NPD, we first examined the effect of switching from room temperature (20-25uC) to warmed (32-37uC) solutions and vice versa during each perfusion step. Secondly, standard protocols were repeated at both temperatures in the same subjects.Changing solution temperature did not alter NPD during perfusion with Ringer's solution (,1 mV) (p.0.1). During perfusion with zero chloride solution, changing from room temperature to warmed solutions tended to decrease absolute NPD (i.e. it became less negative) by 0.9 mV (p.0.1); changing from warmed to room temperature increased NPD by 2.1 mV (p,0.05). During isoprenaline perfusion, changing from room temperature to warmed solutions increased NPD by 1.5 mV (p,0.01) and from warmed to room temperature decreased NPD by 1.4 mV (p,0.05).For full protocols at room temperature or warmed in the same subjects, mean values were similar (n524). During warmed perfusion, group results for total chloride response had a larger standard deviation. As this increased variability will probably decrease the power of trials, this study suggests that solutions at room temperature should be recommended for the measurement of NPD. @ERSpublications This study recommends that perfusate solutions for measuring nasal potential difference should be at room temperature

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New clinical diagnostic procedures for cystic fibrosis in Europe

Boeck¹,

Derichs²,

Fajac³

et al. 2011

Journal of Cystic Fibrosis

102

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In the majority of cases, there is no difficulty in diagnosing Cystic Fibrosis (CF). However, there may be wide variation in signs and symptoms between individuals which encourage the scientific community to constantly improve the diagnostic tests available and develop better methods to come to a final diagnosis in patients with milder phenotypes. This paper is the result of discussions held at meetings of the European Cystic Fibrosis Society Diagnostic Network supported by EuroCareCF. CFTR bioassays in the nasal epithelium (nasal potential difference measurements) and the rectal mucosa (intestinal current measurements) are discussed in detail including efforts to standardize the techniques across Europe. New approaches to evaluate the sweat gland, future of genetic testing and methods on the horizon like CFTR expression in human leucocytes and erythrocytes are discussed briefly.

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Impact of different chloride and glucose solutions on nasal potential difference

Cited by 5 publications

References 14 publications

Measurement of airway ion transport assists the diagnosis of cystic fibrosis

Measurement of airway ion transport assists the diagnosis of cystic fibrosis

Influence of perfusate temperature on nasal potential difference

New clinical diagnostic procedures for cystic fibrosis in Europe

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