E. Daviskas et al., MUCOCILIARY CLEARANCE DURING AND AFTER ISOCAPNIC HYPERVENTILATION WITH DRY AIR IN THE PRESENCE OF FRUSEMIDE, The European respiratory journal, 9(4), 1996, pp. 716-724
We have previously shown that mucociliary clearance (MCC) decreased du
ring and increased after isocapnic hyperventilation (ISH) with dry air
, both in asthmatic and healthy subjects. Inhaled frusemide, an inhibi
tor of the Na+/K+/2Cl(-) and NaCl co-transporters on the basolateral m
embrane of the epithelial cell, prevents the airway narrowing provoked
by ISH with dry air, The co-transport system controls epithelial cell
volume and chloride secretion and, thus, frusemide has the potential
to modify the rate of recovery of periciliary fluid volume during and
after ISH with dry air, and hence affect MCC. Frusemide also blocks me
diator release from mast cells, which may also modify the increase in
MCC after ISH. Eleven asthmatic and 11 healthy subjects inhaled frusem
ide (35.7+/-0.44 mg) or its vehicle, from a Fisoneb(TM) ultrasonic neb
ulizer 30 min before ISH with dry air, on two separate occasions, MCC
was measured using Tc-99m-sulphur colloid and a gamma camera. Frusemid
e, compared to its vehicle, did not affect MCC during or 45 min after
ISH. However, in the presence of frusemide, the onset of the increase
of MCC after ISH was significantly delayed for approximately 10 min in
the whole right lung (p<0.002) and central region (p<0.01) in the ast
hmatic but not in the healthy subjects. These findings could be explai
ned by frusemide delaying the recovery of the periciliary fluid volume
after ISH with dry air and/or interfering with the stimulus that caus
es the increase in MCC in the asthmatic subjects after ISH.