title: A new paradigm in respiratory hygiene: modulating respiratory secretions to contain cough bioaerosol without affecting mucus clearance.
abstract: BACKGROUND
  Several strategies and devices have been designed to protect health care providers from acquiring transmissible respiratory diseases while providing care. In modulating the physical characteristics of the respiratory secretions to minimize the aerosolization that facilitates transmission of airborne diseases, a fundamental premise is that the prototype drugs have no adverse effect on the first line of respiratory defense, clearance of mucus by ciliary action.
  
  
  METHODS
  To assess and demonstrate the primary mechanism of our mucomodulators (XLs), we have built our evidence moving from basic laboratory studies to an ex-vivo model and then to an in-vivo large animal model. We exposed anesthetized dogs without hypersecretion to different dose concentrations of aerosolized XL "B", XL "D" and XL "S". We assessed: cardio-respiratory pattern, tracheal mucus clearance, airway patency, and mucus viscoelastic changes.
  
  
  RESULTS
  Exposure of frog palate mucus to XLs did not affect the clearance of mucus by ciliary action. Dogs maintained normal cardio-respiratory pattern with XL administration. Tracheal mucociliary clearance in anesthetized dogs indicated a sustained 40% mean increase. Tracheal mucus showed increased filance, and there was no mucus retention in the airways.
  
  
  CONCLUSIONS
  The ex-vivo frog palate and the in-vivo mammalian models used in this study, appear to be appropriate and complement each other to better assess the effects that our mucomodulators exert on the mucociliary clearance defence mechanism. The physiological function of the mucociliary apparatus was not negatively affected in any of the two epithelial models. Airway mucus crosslinked by mucomodulators is better cleared from an intact airway and normally functioning respiratory system, either due to enhanced interaction with cilia or airflow-dependent mechanisms. Data obtained in this study allow us to assure that we have complied with the fundamental requirement criteria established in the initial phase of developing the concept of mucomodulation: Can we modulate the physical characteristics of the respiratory secretions to reduce aerosolization without affecting normal mucociliary clearance function, or even better improving it?
authors: University of Alberta Pulmonary Research Group, Edmonton, Canada. g.zayas@ualberta.ca
authors: Gustavo
authors: G
authors: Zayas
authors: Juan C
authors: JC
authors: Valle
authors: Mauricio
authors: M
authors: Alonso
authors: Henry
authors: H
authors: Alfaro
authors: Daniel
authors: D
authors: Vega
authors: Gloria
authors: G
authors: Bonilla
authors: Miguel
authors: M
authors: Reyes
authors: Malcolm
authors: M
authors: King
mesh_terms: D000336:Aerosols; D000818:Animals; D001001:Anura; D002923:Cilia; D003371:Cough; D004285:Dogs; D005260:Female; D006920:Hygiene; D008297:Male; D009079:Mucociliary Clearance / Q000502:physiology*; D009093:Mucus; D010159:Palate; D020545:Respiratory Mucosa / Q000737:chemistry* / Q000502:physiology*; D012140:Respiratory Tract Diseases / Q000517:prevention & control*; D014132:Trachea / Q000502:physiology; D014783:Viscosity
chemical_list: D000336:Aerosols
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