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From the authors

Dept of Internal Medicine, Botnar Center for Clinical Research, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

We were pleased to learn that Mairbäurl et al. 1 recently confirmed our data on the effects of high altitude on nasal potential difference in high-altitude pulmonary oedema-prone subjects 2. This raises the important problem that their previous data may represent an artefact 3. We speculated that, among other factors, differences in the recording site used for nasal potential difference may have contributed to this artefact. Mairbäurl et al. 1 now speculate that nasal dryness and cold temperature, rather than improper location of the recording electrode, was the cause for this artefact, but fail to provide any direct experimental evidence for their speculation.

We have recently shown in mice that not only does a very close relationship between nasal and alveolar epithelial potential difference exist, but also, even more importantly, nasal potential difference is very closely correlated (r = 0.81) with alveolar fluid clearance 4. Moreover, and of paramount importance with regards to the translation of these findings into the clinical setting, in mice, nasal potential difference very reliably predicted propensity to develop experimental pulmonary oedema and time of resolution of pulmonary oedema in vivo 4. In high-altitude pulmonary oedema-prone humans, decreased nasal potential difference indicates that alveolar fluid clearance is impaired, and, consistent with this concept, stimulation of fluid clearance with the ß-adrenergic agonist salmeterol prevents pulmonary oedema during high-altitude exposure 5. Taken together, these data indicate that, when used properly by experienced investigators, nasal potential difference does reflect alveolar fluid clearance in both animals and humans.

REFERENCES

1. Mairbäurl H, Bärtsch P, Peth S, et al. Dexamethasone prevents high altitude pulmonary oedema without effects on nasal potential. Eur Respir J 2004;24: Suppl. 48 327s
2. Sartori C, Duplain H, Lepori M, et al. High altitude impairs the lung transepithelial sodium transport in HAPE-prone subjects. Eur Respir J 2004;23:916–920.[Abstract/Free Full Text]
3. Mairbäurl H, Weymann J, Mohrlein A, et al. Nasal epithelium potential difference at high altitude (4,559 m): evidence for secretion. Am J Respir Crit Care Med 2003;167:862–867.[Abstract/Free Full Text]
4. Egli M, Duplain H, Lepori M, et al. Defective respiratory amiloride sensitive sodium transport predisposes to pulmonary oedema and delays its resolution in mice. J Physiol 2004;560:857–865.[Abstract/Free Full Text]
5. Sartori C, Allemann Y, Duplain H, et al. Salmeterol for the prevention of high-altitude pulmonary edema. N Engl J Med 2002;346:1631–1636.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sartori, C. Articles by Scherrer, U. Search for Related Content PubMed Articles by Sartori, C. Articles by Scherrer, U.