Hypertonic Saline in Treatment of Pulmonary Disease in Cystic Fibrosis

Table 1

The reported effects of hypertonic saline on infection and inflammation.

HTS treatment	Patients sample or cells	Effect after HTS	Reference
7% HTS	Patients with CF	Higher FEV1 and FVC, less pulmonary exacerbations	Elkins et al. 2006 [24]
3% HTS	Sputum of patients with CF	Surfactant protein A increased; neutrophil counts, Staphylococcus aureus and non-mucoid Pseudomonas slightly decreased.	Aitken et al. 2003 [54]
Hypertonic medium	Human bronchial gland cells from CF and healthy controls (isolated from brushings)	Increased NaCl increased IL-8, but higher in CF cells (NF-κB pathway activated)	Tabary et al. 2000 [55]
Hyperosmolarity (NaCl or mannitol, up to 6x normal)	Human bronchial epithelial cells	Increased IL-8 release via p38 and JNK pathway	Hashimoto et al. 1999 [56]
4.5% HTS	Exhaled breath condensate of patients with asthma or COPD and healthy controls	Greater IL-6 and TNF-alpha concentration, lower pH.	Carpagnano et al. 2005 [57]
Hypertonic medium	Peripheral blood neutrophils	HTS inhibited neutrophil priming of respiratory burst by LTB4 and arachidonic acid	Lee et al. 2011 [58]
Hypertonic medium	Peripheral blood mononuclear cells	Reduced LPS induced mTOR pathway activation in HTS treated cells	Schaeffer et al. 2010 [59]
7% HTS	Bronchial samples	Increased antioxidant levels in BAL fluid	Gould et al. 2010 [60]
7% HTS	Sputum from patients with CF	Decreased IL-8 concentration in sputum after HTS	Reeves et al. 2011 [23]
7% HTS	Sputum from patients with CF	LL-37 complexation to GAGs was decreased after HTS and antimicrobial properties of sputa restored	Bergsson et al. 2009 [21]
2–7% HTS in culture medium	Pseudomonas strain PA01 and mucoid strain FRD1	Reduced motility and growth of all strains tested	Havasi et al. 2008 [22]
0–0.8 M NaCl added to medium	Pseudomonas strain PA01 and mucA mutant	MucA mutant less resistant to osmotic stress	Behrends et al. 2010 [67]