Albuterol improves impaired mucociliary clearance after lung transplantation.
BACKGROUND
Previous studies have shown that mucociliary clearance (MCC) is diminished after lung transplantation. However, it is unknown how early this deficit occurs after transplantation, or whether the abnormality can be improved by pharmacologic means. We hypothesized that impairment of MCC is evident soon after lung transplantation and that the defect in MCC can be improved by inhaled beta(2)-adrenergic receptor agonists.


METHODS
MCC and cough clearance (CC) were quantified in seven patients at 76 +/- 48 days (mean +/- standard deviation) after lung transplantation (baseline visit) and again 1 week later after an acute inhalation of albuterol. MCC was also determined once in four healthy subjects. To measure MCC, volunteers inhaled 99m-technetium-sulfur colloid aerosol, followed by gamma-camera imaging of their lungs for 76 minutes.


RESULTS
Baseline MCC was significantly reduced in transplant patients, compared with healthy subjects, averaging 8.9 +/- 7.3% and 20.9 +/- 15.1%, respectively (p = 0.05). CC was not affected by transplantation. Acute inhalation of albuterol significantly improved MCC in transplant patients (31.9 +/- 21.9%) compared with baseline values (p < 0.05).


CONCLUSIONS
MCC is diminished within a few months after transplantation. However, the response to albuterol suggests that the deficit is not static and can be improved with inhalation of a beta(2)-adrenergic receptor agonist.
Laube
Beth L
BL
Eudowood Division of Pediatric Respiratory Sciences, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-2533, USA.
Karmazyn
Yauel J
YJ
Orens
Jonathan B
JB
Mogayzel
Peter J
PJ
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D000420:Albuterol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000187:drug effects*; D011183:Postoperative Complications / Q000188:drug therapy
D000318:Adrenergic beta-Agonists; D000420:Albuterol