Chest
Original ResearchCystic FibrosisInhaled Mannitol Improves the Hydration and Surface Properties of Sputum in Patients With Cystic Fibrosis
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Subjects
Thirty-nine subjects with CF, clinically stable, from Australia and New Zealand were randomized, and 35 subjects completed both treatments of the study.7 Subjects were > 8 years old and had FEV1 between 41% and 91% predicted. Eligible subjects were premedicated with 400 μg of salbutamol prior to having an airway challenge with mannitol (Aridol; Pharmaxis Ltd; Frenchs Forest, NSW, Australia) following a standard protocol8 to exclude subjects with airway hyperresponsiveness to mannitol. Subjects
Results
There was no significant difference in the sputum properties between mannitol and placebo treatment at baseline and after a 2-week washout period. In addition, the order of treatment did not influence any of the sputum properties (ie, there was no carryover effect).
The solids content and surface properties of sputum were significantly reduced after a 2-week treatment with mannitol inhaled bid in patients with CF. This reduction was observed approximately 12 h after the last dose. The reduction
Discussion
Treatment with inhaled mannitol over 2 weeks improved the hydration and surface properties of sputum in patients with CF. The effect of mannitol on the sputum properties was evident for approximately 12 h after the end of the last treatment dose. This is the first in vivo study to show a sustained effect of mannitol on the sputum properties in CF. In addition, the reduction in solids content and surface properties correlated with the improvement in the lung function in these patients after 2
Acknowledgments
Author contributions: Dr Daviskas: contributed to the study design, measurement and analysis of sputum properties, interpretation of the findings, and writing the manuscript.
Dr Anderson: contributed to the study design, interpretation of the findings, and writing the manuscript.
Ms Jaques: contributed to the study design, interpretation of the findings, and writing the manuscript.
Dr Charlton: contributed to the study design, interpretation of the findings, and writing the manuscript.
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Funding/Support: This study was sponsored by Pharmaxis Ltd.
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