Mucociliary clearance in the airways.

Wanner, Adam; Salathe, Mathias; O’Riordan, Thomas G.

doi:10.1164/ajrccm.154.6.8970383

Cited by 652 publications

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“…The observed effect may be caused by an improvement in MC, the stimulation of cough or both. MC depends upon a successful relationship between three components: mucus, cilia and periciliary fluid [8].…”

Section: Discussionmentioning

confidence: 99%

“…Four per cent Ems salt produced an increase in the mucus clearance index as well as the cough clearance index compared to isotonic saline. Mucus is a complex non-Newtonian viscoelastic gel, containing 90± 95% water and 1±2% mucins [8]. Different intra-and intermolecular bonds are responsible for its netlike structure.…”

Section: Discussionmentioning

confidence: 99%

“…Owing to a lower percentage of ciliated cells, shorter cilia and slower beat frequency, MC is reduced in peripheral airways [8,10]. Higher peripheral deposition in one group would have resulted in underestimation of the effects of the intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Acceleration of ciliary beat frequency (CBF) in isolated cultured human ciliated cells observed via inverted phasecontrast microscope as well as reduction of sputum viscoelasticity in patients with cystic fibrosis and chronic bronchitis has been reported in vitro for Ems salt [6,7]. Both of these mechanisms would influence MC, which is determined by many factors: the quantity, components and viscosity of sputum, ciliary function and epithelial integrity [8]. An important role is played by the interaction between mucus viscosity, periciliary fluid and the ciliary apparatus [9].…”

mentioning

confidence: 99%

“…Cough can indicate dysfunction of these components, especially in chronic bronchitis, and may serve as a back-up system [10]. In this disease, hypertrophy of submucosal glands, an increased number of goblet cells and a reduction in the number of ciliated cells have been described histologically [8]; these could all account for a reduction in MC [8,10].…”

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Inhaled isotonic alkaline versus saline solution and radioaerosol clearance in chronic cough

et al. 2000

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Inhaled isotonic alkaline versus saline solution and radioaerosol clearance in chronic cough. P. Haidl, B. Scho Ènhofer, K. Siemon, D. Ko Èhler. #ERS Journals Ltd 2000. ABSTRACT: The aim of the present study was to test the influence of inhaled isotonic Ems salt (brine from the spa of Bad Ems, Germany) compared to isotonic saline on radioaerosol clearance (RC) in patients with chronic cough. Ems salt is an alkaline solution (pH 8.0±9.0) containing largely bicarbonate ions rather than the chloride ions present in isotonic saline (pH 6.4).RC was assessed with a radioaerosol technique using technetium-99m albumin in supine patients. After a 30-min baseline measurement of RC according to a single blind and randomized design, patients inhaled Ems salt (n=22, 20±77 yrs) or isotonic saline (n=21, 34±72 yrs) via a jet nebulizer (Pari Boy) for 10 min and were scanned for an additional 30 min.There was no difference between the two groups before intervention in terms of deposition pattern, lung function and baseline RC rate. After inhalation of Ems salt, the RC rate (1/t) improved significantly from 0.15 0.14 (mean SD) to 0.53 0.70 L . h -1 (p<0.005); no change was found after isotonic saline (0.13 0.13 to 0.08 0.09 L . h -1 , NS). Voluntary coughs performed after 60 min had no effect on the RC rate. However, in the Ems salt group, significantly more patients reported an inhalation induced cough. Compared to the Ems salt patients, who did not cough during and after inhalation, the RC rate in the cough group was enhanced significantly (0.10 0.12 versus 0.73 0.83, p=0.017), this effect being seen more frequently in females (p=0.003).It is concluded that Ems salt improves radioaerosol clearance significantly in patients with chronic cough. The underlying mechanism, regarding whether induced cough, increased water content in the mucus or enhanced ciliary beat frequency is the leading cause of Ems salt action, remains unclear.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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