Altering airway surface liquid volume: inhalation therapy with amiloride and hyperosmotic agents.
The thin layer of liquid lining the entire respiratory tract is the first line of defense against the continuous insult of inhaled bacteria and noxious chemicals. Many chronic obstructive diseases of the airway may reflect decreased airway surface liquid, which results from imbalances in ion transport and mucus production. Reduction in the thickness of airway surface liquid leads to reduced mucociliary clearance rates, causing mucus accumulation and infection in the airway. In this chapter, two inhalation therapies to replenish airway surface liquid and enhance mucociliary clearance are discussed: (1) aerosolized hyperosmotic agents; and (2) aerosolized sodium channel blockers. The advantages and disadvantages of each therapy are discussed, as well as future directions for improving airway surface liquid volume by inhalation pharmacotherapy.
Hirsh
Andrew J
AJ
Cystic Fibrosis/Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill NC 27599, USA. ajhirsh@parion.com
D000280:Administration, Inhalation; D000584:Amiloride / Q000008:administration & dosage / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D004848:Epithelium / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008353:Mannitol / Q000008:administration & dosage / Q000627:therapeutic use; D009079:Mucociliary Clearance / Q000187:drug effects; D009093:Mucus / Q000378:metabolism*; D009997:Osmotic Pressure; D012137:Respiratory System / Q000187:drug effects* / Q000503:physiopathology; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000627:therapeutic use; D026941:Sodium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*
D012462:Saline Solution, Hypertonic; D026941:Sodium Channel Blockers; D008353:Mannitol; D000584:Amiloride