Mucociliary Clearance and Buffered Hypertonic Saline Solution

Talbot, A; Herr, Timothy M.; Parsons, David

doi:10.1097/00005537-199704000-00013

Cited by 248 publications

(230 citation statements)

References 9 publications

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“…Previous studies have confirmed the repeatability of the saccharin clearance technique in children and adults [20,36,44], and this test is in clinical use in the present authors9 institution. Sinonasal disease is uncommon in young CF children and, in line with others [45], the current authors did not show increased levels of the pro-inflammatory cytokine, IL-8, in nasal lavage samples.…”

Section: Discussionsupporting

confidence: 80%

Normal nasal mucociliary clearance in CF children: evidence against a CFTR‐related defect

McShane

Davies

Wodehouse³

et al. 2004

Eur Respir J

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Studies on mucociliary clearance (MCC) in cystic fibrosis (CF) have produced conflicting results. This study aimed to differentiate primary (ion transportrelated) from secondary (inflammatory) causes of delayed MCC in CF.Nasal MCC was measured in 50 children (CF, primary ciliary dyskinesia (PCD) and no respiratory disease). Nasal lavage fluid was analysed for interleukin (IL)-8 and tumour necrosis factor-a. Similar measurements were obtained in adult CF patients with and without chronic sinusitis (CS).Children with CF had neither delayed MCC nor increased levels of cytokines. Conversely, children with PCD had prolonged MCC times (all w30 min) and significantly raised levels of IL-8. CS-positive CF adults had significantly slower MCC than CS-negative subjects, but IL-8 levels were low and similar in both groups.Decreased airway surface liquid and delayed mucociliary clearance are the postulated primary mechanisms in cystic fibrosis. However, the current study reports that cystic fibrosis children have normal nasal mucociliary clearance. Abnormalities appeared in cystic fibrosis adults with symptoms of chronic sinus disease, suggesting a secondary rather than primary phenomenon. Studies to explore this mechanism in the distal, more sparsely-ciliated airways could aid an understanding of pathogenesis and the development of new treatments. Eur Respir J 2004; 24: 95-100.

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Section: Discussionsupporting

confidence: 80%

Normal nasal mucociliary clearance in CF children: evidence against a CFTR‐related defect

McShane

Davies

Wodehouse³

et al. 2004

Eur Respir J

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“…Irrigation with saline solution has recently become increasingly used in the treatment of rhinosinusitis [10]. Talbot et al determined that a buffered hypertonic saline nasal solution improved MC, but that physiological saline had no effect on MC [11]. Keojampa et al showed that both buffered hypertonic and physiological nasal solutions improved nasal MC [12].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Yasar¹,

Sutbeyaz²,

Sakat³

et al. 2017

Med-Science

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Mucociliary clearance (MC) is one of the main defense mechanisms of the nasal respiratory mucosa. The purpose of this study was to determine changes occurring nasal MC in patients with sinusitis, and how medical treatment affects changes in MC, and to identify an appropriate topical solution with positive effects on MC for use in the treatment of sinusitis by examining the effects of various topical solutions on MC. 60 patients diagnosed with rhinosinusitis at the ear, nose and throat clinic were included in this prospective study. Patients were randomly assigned into groups. Group 1 (n:10) received no topical treatment. Group 2 (n:10) was administered with fluticasone propionate, Group 3 (n:10) received mometasone furoate and Group 4 (n:10) received oxymetazoline. Group 5 (n:10) received isotonic sea water for nasal irrigation, while Group 6 (n:10) received isotonic Ringer's solution for nasal irrigation. Group 7 represented the control group (non-sinusitis). The saccharin test was used to determine nasal mucociliary clearance times. The saccharin test was performed before and on the 2nd week of treatment in all groups. Basal MCT and 2nd week MCT values were compared in all groups. When measurements performed 20 min and 14 days after administration of topical agents were compared with basal values, mean MCT values at 20 min. and 14 days were shorter in all groups compared to mean basal MCT values. However, the difference between 20-min, 14th day and basal MCT values was only statistically significant in the oxymetazoline and isotonic Ringer's solution groups (p<0.05). We think that oxymetazoline and isotonic Ringer's solution can be used as supportive therapy in the treatment of sinusitis since these produce a significant shortening of MCT.

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“…Esta solução era hipertônica em relação aos componentes do muco, apresentando osmolaridade de 474mOsm/l. Assim como resultados de trabalhos recentes 4,11,14,16,21 , os dados deste estudo sugerem que a hipertonicidade seja uma característica desejável para as soluções a serem usadas para irrigação intranasal.…”

Section: Discussionunclassified

“…Trabalhos recentes mostraram diminuição do batimento ciliar de fragmentos de mucosa criopreservada de seio esfenoidal de humanos 26 e de traquéia de embrião de galinha 27 , ao serem expostos a esta solução. Estes resultados talvez possam explicar os resultados clínicos pouco favoráveis, em relação ao clearance mucociliar, obtidos por diversos autores ao utilizarem a solução salina a 0,9% para irrigação intranasal em pacientes sem história de doença nasossinusal significante 11,14 , pacientes com rinossinusite aguda bacteriana 16 e em período pós-operatório de septoplastia 12. No entanto, alguns autores não observaram alterações epiteliais semelhantes às encontradas neste estudo, ao avaliarem grupos-controle tratados com solução salina a 0,9% 18,20 , o que poderia ser explicado pelo pequeno número de indivíduos da amostra 20 .…”

Section: Discussionunclassified

“…Os benefícios e a eficácia da irrigação nasal têm sido comprovados por diversos estudos clínicos, porém a maioria destes trabalhos se baseia no teste de sacarina como forma de avaliar a eficácia da solução em estudo 11,[14][15][16] . Podemos observar que não existem evidências sobre os efeitos locais deste procedimento, ou seja, pouco se sabe sobre os efeitos na mucosa nasal, causados pelo uso das diferentes soluções para lavagem nasal 9 .…”

Section: Introductionunclassified

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Irrigação intranasal: avaliação dos efeitos do uso de soluções hidroeletrolíticas na mucosa de ratos

Viertler

Testa

Morgado

et al. 2003

Rev. Bras. Otorrinolaringol.

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A irrrigação intranasal tem grande importância como terapia adjuvante de doenças nasossinusais. Entretanto, faltam estudos que avaliem as alterações histológicas que as diferentes soluções utilizadas podem causar na mucosa do nariz. Objetivo: Analisar os aspectos histológicos da mucosa nasal de ratos após irrigação local com diferentes soluções hidroeletrolíticas. Forma de estudo: Experimental. Material e Método: 120 ratos Wistar foram divididos igualmente em 4 grupos. O grupo número 1 recebeu solução salina a 0,9%. Os grupos 2 e 3 receberam soluções contendo Cloreto de Sódio associado a Cloreto de Potássio e Glicose, em diferentes concentrações. O grupo 4 foi o grupo controle. Duas vezes ao dia, 0,1ml (2 gotas) das soluções foram aplicados na narina esquerda dos ratos, através de uma seringa. Metade dos animais de cada grupo foi sacrificado após a primeira semana e a metade restante após a quarta semana de tratamento. Os fragmentos de mucosa obtidos foram processados e estudados em microscopia óptica, utilizando a hematoxilina e eosina. Resultados: Pôde-se observar que a infiltração de células inflamatórias foi estatisticamente mais intensa no grupo 2, em 1 e 4 semanas de administração das soluções (p≤0,05), quando comparada ao grupo controle. A formação de glândulas intraepiteliais foi estatisticamente mais evidente no grupo 1, quando comparada aos grupos 3 e 4 (p≤0,05). Conclusão: A solução salina hipertônica testada causou a menor reação tecidual na mucosa nasal de ratos quando comparada ao grupo controle. Não foram encontradas vantagens na utilização da solução salina a 0,9% em comparação com o uso das demais soluções em estudo.

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Mucociliary Clearance and Buffered Hypertonic Saline Solution

Cited by 248 publications

References 9 publications

Normal nasal mucociliary clearance in CF children: evidence against a CFTR‐related defect

Normal nasal mucociliary clearance in CF children: evidence against a CFTR‐related defect

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Irrigação intranasal: avaliação dos efeitos do uso de soluções hidroeletrolíticas na mucosa de ratos

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