title: Effect of inhalation of thermal water on airway inflammation in chronic obstructive pulmonary disease.
abstract: Thermal water inhalations have been traditionally used in the treatment of upper and lower chronic airway diseases. However, the benefit and the mechanism of this treatment have not been properly assessed. To determine whether inhaled salt-bromide-iodine thermal water improves lung function, quality of life and airway inflammation, 39 patients with chronic obstructive pulmonary disease (COPD) were randomly assigned to receive 2-weeks inhalation treatment with thermal water (active, no. = 20) or normal saline (control, no. = 19) in single blind. Lung volumes were measured, Saint George's respiratory questionnaire (SGRQ) was administered and induced sputum was performed before and after treatment. No changes in pre- and post-salbutamol lung volumes was observed after inhalation treatment in both groups. SGRQ score showed a significant improvement in active group compared with control group at the end of the trial. The concentration of total cells in induced sputum increased significantly in both active (P < 0.05) and control groups (P < 0.05). Inhalation of thermal water induced a small but significant decrease in percentages of sputum neutrophils (P < 0.01) and a parallel increase in macrophages (P < 0.01). In contrast, normal saline inhalation was not associated with changes in differential sputum cell counts. In conclusion, treatment with inhaled salt-bromide-iodine thermal water in COPD is associated with a reduced proportion of neutrophils in induced sputum suggesting that thermal water may have a mild anti-inflammatory effect on the airways. However, the short-term improvement in some components health-related quality of life was not related with changes in lung function or with the degree of airway inflammation.
authors.affiliation: Department of Environmental Medicine and Public Health, University of Padova, via Giustiniani, 2 35128 Padova (PD), Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pellegrini
authors.forename: Davide
authors.initials: D
authors.lastname: Fanin
authors.forename: Yohann
authors.initials: Y
authors.lastname: Nowicki
authors.forename: Gabriella
authors.initials: G
authors.lastname: Guarnieri
authors.forename: Anna
authors.initials: A
authors.lastname: Bordin
authors.forename: Diego
authors.initials: D
authors.lastname: Faggian
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Marina
authors.initials: M
authors.lastname: Saetta
authors.forename: Piero
authors.initials: P
authors.lastname: Maestrelli
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D001965:Bromides / Q000008:administration & dosage; D016535:Bronchial Hyperreactivity; D005080:Exercise Test; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007455:Iodine / Q000008:administration & dosage; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods*; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000008:administration & dosage; D018709:Statistics, Nonparametric; D014867:Water
chemical_list: D001965:Bromides; D014867:Water; D012965:Sodium Chloride; D007455:Iodine