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Hypertonic saline increases secretory and exudative responsiveness of human nasal airway in vivo

Depts of ¹ Otorhinolaryngology, Head & Neck Surgery and ² Clinical Pharmacology, University Hospital, Lund, and ³ Dept of Clinical Physiology, University Hospital, Malmö, Sweden

CORRESPONDENCE: L. Greiff, Dept of Otorhinolaryngology, Head & Neck Surgery, University Hospital, S-221 85, Lund, Sweden. Fax: 46 462110968. E-mail: lennart.greiff@skane.se

Keywords: airway, exudation, inflammation, methacholine, rhinitis, secretion

Received: November 16, 2001
Accepted August 6, 2002

The study was supported by the Swedish Medical Research Council and the Medical Faculty of Lund University.

Hypertonic saline (HS) is used in sputum induction studies. However, little is known about the physiological effects of HS on human airways in vivo. The present study takes advantage of the fact that the airway effects of topical challenges may be accurately examined in the readily accessible nasal airway. The present study specifically examines whether exposure to HS affects histamine challenge-induced exudation of plasma (₂-macroglobulin) and methacholine-induced secretion of mucin (fucose).

Isotonic saline and HS (27 and 45 g·L^–1), with and without concomitant histamine challenges, and with and without preceding methacholine challenges, were administered onto the nasal mucosa in 16 healthy subjects. Lavage fluid levels of ₂-macroglobulin and fucose were analysed.

Histamine produced a significant mucosal output of plasma (₂-macroglobulin). HS itself did not evoke exudation of ₂-macroglobulin, but it significantly increased the plasma exudation effect of histamine. Methacholine produced a significant nasal mucosal output of fucose. HS also increased the mucin secretion (fucose), and it enhanced the secretory effect of methacholine.

The authors concluded that hypertonic saline alone evokes mucinous secretion in human nasal airways in vivo and that it also enhances the exudative and secretory effects of histamine and methacholine, respectively. Through different mechanisms the HS exposure may also improve the recovery of soluble indices in human nasal airways. Whether or not the present findings are translatable to human bronchial airways remains to be examined.