Hypertonic Saline in Treatment of Pulmonary Disease in Cystic Fibrosis

Figure 4

Schematic representation of the antimicrobial, immunomodulatory and mucolytic properties of HTS. (1) HTS draws water into the dehydated CF periciliary layer and improves mucus rheology and enhances mucociliary clearance. (2) LL-37, an antimicrobial protein that is inhibited by GAGs, is released by HTS via disruption of the electrostatic interaction between LL-37 and GAGs. (3) HTS liberates IL-8 from anionic matrices (GAGs) rendering the chemokine susceptible to proteolytic degradation by neutrophil elastase, thereby decreasing inflammation.