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Inhalation of dry-powder mannitol increases mucociliary clearance
E Daviskas1, S D Anderson, J D Brannan
1Dept of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Abstract:
Inhalation of hypertonic saline stimulates mucociliary clearance (MCC) in healthy subjects and those with obstructive lung disease. We investigated the effect of inhaling the osmotic agent mannitol on MCC. We used a dry-powder preparation of mannitol British Pharmacopea (BP) which was encapsulated and delivered using a Dinkihaler. MCC was measured for 75 min in six asthmatic and six healthy subjects on two occasions before and after the mannitol inhalation or its control, using 99mTc-sulphur colloid and a gamma camera. The inhaled dose of mannitol was 267+/-171 mg (mean+/-SD) and 400 mg and the percentage fall in forced expiratory volume in one second (FEV1) was 22+/-3 and 4+/-2% in the asthmatic and healthy subjects, respectively. The total clearance in the whole right lung for the 60 min from the start of inhalation of mannitol was greater by 263+/-11.9% in the asthmatic and 18.1+/-4.9% in the healthy subjects compared to the control. The total clearance over 75 min was 54.7+/-9.6% and 33.6+/-9.4% on the mannitol and control day (p<0.002), respectively, in the asthmatic subjects and 40.5+/-7.1% and 24.8+/-7.8% (p<0.002) in the healthy subjects. In conclusion, inhalation of dry-powder mannitol increases mucociliary clearance in asthmatic and healthy subjects and may benefit patients with abnormal mucociliary clearance.
Insights
Inhaling dry-powder mannitol significantly enhances mucociliary clearance (MCC) in both asthmatic and healthy individuals. This osmotic agent shows potential for improving lung health in those with impaired MCC.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Pharmacology
Background:
- Hypertonic saline inhalation is known to stimulate mucociliary clearance (MCC).
- The efficacy of osmotic agents like mannitol on MCC requires further investigation, particularly in specific patient populations.
Purpose of the Study:
- To evaluate the effect of inhaled dry-powder mannitol on mucociliary clearance in asthmatic and healthy subjects.
- To compare mannitol's impact on MCC against a control condition.
Main Methods:
- A dry-powder preparation of mannitol (BP) was delivered via a Dinkihaler.
- Mucociliary clearance was measured over 75 minutes using 99mTc-sulphur colloid and gamma camera imaging.
- Six asthmatic and six healthy subjects participated in a crossover study design.
Main Results:
- Inhaled mannitol significantly increased total lung clearance by 26.3% in asthmatic and 18.1% in healthy subjects compared to control.
- Over 75 minutes, total clearance was 54.7% with mannitol versus 33.6% for control in asthmatics (p<0.002).
- Healthy subjects showed clearance of 40.5% with mannitol versus 24.8% for control (p<0.002).
Conclusions:
- Inhalation of dry-powder mannitol effectively increases mucociliary clearance in both asthmatic and healthy individuals.
- Mannitol may offer therapeutic benefits for patients experiencing abnormal mucociliary clearance.
- The study highlights mannitol as a potential agent for enhancing airway clearance mechanisms.