Nasal potential measurements on the nasal floor and under the inferior turbinate: Does it matter?

Vermeulen, François; Proesmans, Marijke; Feyaerts, Nathalie; Boeck, K. De

doi:10.1002/ppul.21333

Cited by 15 publications

(14 citation statements)

References 20 publications

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“…Finally, testing the same subjects on different days with warmed or room temperature solutions showed differences of -15-20 mV in total chloride response, probably reflecting day-to-day variability rather than the different temperatures tested. The differences observed are in line with previous studies of day-to-day variability [2,12].…”

Section: Discussionsupporting

confidence: 82%

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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Section: Discussionsupporting

confidence: 82%

Influence of perfusate temperature on nasal potential difference

Bronsveld

Vermeulen²,

Sands³

et al. 2012

Eur Respir J

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“…NPD was measured with an end-hole Marquat® catheter under the IT instead of on the nasal floor, as suggested in the latest ECFS-NPD-SOP. Vermeulen et al demonstrated that measurements under the IT and the nasal floor have similar discriminative power for diagnostic use [16]. Therefore we believe this difference would not have changed our final conclusion.…”

Section: Discussionmentioning

confidence: 72%

“…We used 3 different criteria to discriminate between CF and non-CF, taking into account a total chloride response less than − 10 mV [12,15,16], and Sermet and Wilschanski composite scores as described in the original articles, being less than 0.27 for Ser score (developed with Abr method) and more than 0.7 for Wils score (developed with Ndl method) in the case of CF [17,18]. Previous papers have underlined the importance of taking into account the combined response on the different solutions, showing the ENaC-response on the Amilo solution and the net effect of chloride efflux due to passive (chloride-free solution) and active (cAMP-activated CFTR activity by isoproterenol) chloride transport [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…A NPD tracing was scored as CF if at least 2 of the 3 diagnostic criteria were fulfilled, namely: a total chloride response (ie. NPD-response after perfusion with solution #3 + #4, being Cl-Free and Iso) of less than − 10 mV [12,15,16], Wilschanski score = (e (total chloride response/Amilo response) ) N 0.7 (Wils score) [17] and Sermet score = [− 0.11(delta chloride free + Iso) − 0.05(Amilo response)] b 0.27 (Ser score) [18]. Otherwise, they were scored as non-CF.…”

Section: Methodsmentioning

confidence: 99%

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A semi-blinded study comparing 2 methods of measuring nasal potential difference: Subcutaneous needle versus dermal abrasion

Wachter

Schutter

Meulemans

et al. 2016

Journal of Cystic Fibrosis

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“…Other groups may measure the PD on the nasal floor, which is technically easier. Importantly, Vermeulen (2011) demonstrated that the 2 methods are comparable 16 .…”

Section: Modifications and Troubleshootingmentioning

confidence: 99%

Standardized Measurement of Nasal Membrane Transepithelial Potential Difference (NPD)

Solomon

Bronsveld

Hayes³

et al. 2018

JoVE

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We describe a standardized measurement of nasal potential difference (NPD). In this technique, cystic fibrosis transmembrane conductance regulator (CFTR) and the epithelial sodium channel (ENaC) function are monitored by the change in voltage across the nasal epithelium after the superfusion of solutions that modify ion channel activity. This is enabled by the measurement of the potential difference between the subcutaneous compartment and the airway epithelium in the nostril, utilizing a catheter in contact with the inferior nasal turbinate.The test allows the measurement of the stable baseline voltage and the successive net voltage changes after perfusion of 100 µM amiloride, an inhibitor of Na + reabsorption in Ringer's solution; a chloride-free solution containing amiloride to drive chloride secretion and 10 µM isoproterenol in a chloride-free solution with amiloride to stimulate the cyclic adenosine monophosphate (cAMP)-dependent chloride conductance related to CFTR.This technique has the advantage of demonstrating the electrophysiological properties of two key components establishing the hydration of the airway surface liquid of the respiratory epithelium, ENaC, and CFTR. Therefore, it is a useful research tool for phase 2 and proof of concept trials of agents that target CFTR and ENaC activity for the treatment of cystic fibrosis (CF) lung disease. It is also a key follow-up procedure to establish CFTR dysfunction when genetic testing and sweat testing are equivocal. Unlike sweat chloride, the test is relatively more time consuming and costly. It also requires operator training and expertise to conduct the test effectively. Inter-and intra-subject variability has been reported in this technique especially in young or uncooperative subjects. To assist with this concern, interpretation has been improved through a recently validated algorithm.

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Nasal potential measurements on the nasal floor and under the inferior turbinate: Does it matter?

Abstract: NPD measurements under the inferior turbinate and on the nasal floor have similar discriminative power for diagnostic use. Measurements under the turbinate result in a slightly higher proportion of interpretable tracings but sample size calculation slightly favors the nasal floor method.

Cited by 15 publications

References 20 publications

Influence of perfusate temperature on nasal potential difference

Influence of perfusate temperature on nasal potential difference

A semi-blinded study comparing 2 methods of measuring nasal potential difference: Subcutaneous needle versus dermal abrasion

Standardized Measurement of Nasal Membrane Transepithelial Potential Difference (NPD)

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