3bound to the membrane (in that it resists washing out by the normal flow of secretions). A firmly bound effect was therefore sought by exposing normal red cells to saliva for 5 min, and then washing, before measuring ouabain-insensitive efflux. Table 2 shows that there was no difference between cells exposed to saliva and then washed, and cells not exposed to saliva. No firmly bound factor was demonstrated.The significance of humoral substances affecting membrane transport remains to be clarified. There does not appear to be any known hormone, for example, which could easily explain the above effect of saliva, whereas simple physical or physicochemical factors would seem to be excluded by the experimental controls. Modification of the cell membrane by uncharacterized circulating or secreted factors may have a bearing on transport processes in general, and possibly on the disturbance of CF in particular. However, the red cell model, as used in this study, has not confirmed that such a mechanism is important in CF.
CONCLUSIONIn a preliminary study, the red blood cells of patients with cystic fibrosis were found to show decreased ouabain-insensitive Na+ efflux. The ouabain-sensitive Na+ efflux, total Na+ efflux, and Na+ influx were found to be normal. This information was used to guide the choice of transport parameters in the main study. The effect of cystic fibrosis saliva on normal red cells was not significantly different from that of control saliva, but both Pediat. Res. 12: 3-6 (1978) normal saliva and cystic fibrosis saliva appear to contain a substance which accelerates Na+ transport in the red cell.