January 18, 2006

Inhaled Saline Improves Cystic Fibrosis Lungs

By Karla Gale

NEW YORK (Reuters Health) - People with cystic fibrosis suffer from mucus build-up in the lungs that makes breathing difficult, but investigators now report that salt water can ease the condition.

Long-term inhaled saline with a 'hypertonic' salt concentration of 7 percent improves lung function and reduces pulmonary flare-ups in patients with cystic fibrosis, according to a report in this week's New England Journal of Medicine.

Short-term studies have suggested that hypertonic saline stimulates mucus clearance from the lungs and increases hydration of the airway surface in cystic fibrosis patients, the authors note.

On that basis, Dr. Peter T. P. Bye from the University of Sydney and colleagues in Australia conducted a 48-week study in which 162 patients were randomized to treatment with 7-percent saline or 0.9-percent (normal) saline.

The patients in the hypertonic saline group exhibited improved lung function during the first 4 weeks of treatment compared with patients given normal saline. Thereafter, lung function plateaued but remained better than the control group at all time points.

There were also fewer flare-ups requiring intravenous antibiotics in the hypertonic saline group and significantly fewer days on which they were absent from school or work.

Inhaled hypertonic saline "is an inexpensive, safe, additional therapy in patients with cystic fibrosis," Bye's team concludes.

In a related editorial, Dr. Felix Ratjen from the University of Toronto comments, "Hypertonic saline offers a new treatment strategy for patients and brings us closer to targeting the underlying abnormality, rather than the consequences of defective mucociliary clearance."

SOURCE: New England Journal of Medicine, January 19, 2006.