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A modified technique for measurement of nasal transepithelial potential difference in infants
K W Southern1, P G Noone, D G Bosworth
1Institute of Child Health, University of Liverpool, Alder Hey Children's Hospital, Liverpool, United Kingdom.
Insights
A new modified nasal method accurately measures transepithelial potential difference (PD) in infants, aiding in cystic fibrosis (CF) diagnosis. This technique is well-tolerated and effective for distinguishing CF from normal respiratory epithelium in newborns.
Area of Science:
- Pediatric Medicine
- Respiratory Physiology
- Diagnostic Techniques
Background:
- Cystic Fibrosis (CF) diagnosis in infants relies on accurate physiological measurements.
- Nasal transepithelial potential difference (PD) is a key indicator of CF-related epithelial dysfunction.
- Established adult methods for nasal PD measurement require modification for infant application.
Purpose of the Study:
- To develop and validate a modified nasal transepithelial potential difference (PD) measurement technique for infants.
- To assess the feasibility and diagnostic utility of the modified method in identifying CF in infants.
- To compare the modified infant method with an established adult nasal PD protocol.
Main Methods:
- A modified nasal PD measurement protocol was developed using smaller catheter size, reduced flow rates, and shorter duration.
- The modified method was initially validated in adult volunteers, including those with CF.
- Nasal PD was subsequently measured in 13 infants with suspected CF, utilizing a 10(-4) mol/L amiloride concentration for sodium transport inhibition.
Main Results:
- The modified infant method yielded comparable recordings to the established adult method in volunteers.
- Two out of 13 infants exhibited PD values suggestive of CF, correlating with subsequent sweat tests and genetic analysis.
- Eleven infants demonstrated normal PD values, differentiating them from CF cases.
Conclusions:
- The modified nasal PD measurement technique is reliable and comparable to adult methods.
- The technique is well-tolerated in infants and effectively distinguishes between normal and CF-affected respiratory epithelium.
- This modified nasal PD method shows promise as a valuable diagnostic tool for cystic fibrosis in newborn infants.
Objective:
To establish a method for measuring nasal transepithelial potential difference (PD) in infants.
Study Design:
A modified infant method (smaller catheter size, reduced flow rates, and shorter protocol time) was compared with an established adult nasal PD method in 10 adult volunteers (4 with cystic fibrosis [CF]). Nasal PD was measured in 13 infants with a possible diagnosis of CF.
Results:
Recordings were similar for the established and the modified methods in adult volunteers. An amiloride concentration of 10(-4) mol/L was necessary for full inhibition of amiloride-sensitive sodium ion (Na(+)) transport. Of the 13 infants, 2 had PD values suggestive of CF (mean baseline PD, -50.1 mV and -31.4 mV; maximum baseline PD, -61 mV and -49 mV; change in PD after perfusion with zero chloride solution with isoprenaline and amiloride [DeltazeroCl(-)/Iso], -1 mV and +3.5 mV), and 11 had normal values (mean +/- SEM baseline PD, -13.2 +/- 1.0 mV; maximum baseline PD, -21.4 +/- 2.0; DeltazeroCl(-)/Iso, -15.3 +/- 1.9 mV). These results correlated with subsequent sweat test data, mutation analysis, and clinical outcome.
Conclusion:
Nasal PD measured with this modified method is comparable to that measured with an established adult method. The measurements were well tolerated in 13 infants and discriminated bioelectric profiles characteristic of normal and CF respiratory epithelium. This study supports the use of this modified nasal PD technique as a diagnostic test for CF in newborn infants.
