Chest
Volume 135, Issue 1, January 2009, Pages 143-148
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Original Research
Over-the-Counter Cough Remedy
Vicks VapoRub Induces Mucin Secretion, Decreases Ciliary Beat Frequency, and Increases Tracheal Mucus Transport in the Ferret Trachea

https://doi.org/10.1378/chest.08-0095Get rights and content

Background

Vicks VapoRub (VVR) [Proctor and Gamble; Cincinnati, OH] is often used to relieve symptoms of chest congestion. We cared for a toddler in whom severe respiratory distress developed after VVR was applied directly under her nose. We hypothesized that VVR induced inflammation and adversely affected mucociliary function, and tested this hypothesis in an animal model of airway inflammation.

Methods

[1] Trachea specimens excised from 15 healthy ferrets were incubated in culture plates lined with 200 mg of VVR, and the mucin secretion was compared to those from controls without VVR. Tracheal mucociliary transport velocity (MCTV) was measured by timing the movement of 4 μL of mucus across the trachea. Ciliary beat frequency (CBF) was measured using video microscopy. [2] Anesthetized and intubated ferrets inhaled a placebo or VVR that was placed at the proximal end of the endotracheal tube. We evaluated both healthy ferrets and animals in which we first induced tracheal inflammation with bacterial endotoxin (a lipopolysaccharide [LPS]). Mucin secretion was measured using an enzyme-linked lectin assay, and lung water was measured by wet/dry weight ratios.

Results

[1] Mucin secretion was increased by 63% over the controls in the VVR in vitro group (p < 0.01). CBF was decreased by 35% (p < 0.05) in the VVR group. [2] Neither LPS nor VVR increased lung water, but LPS decreased MCTV in both normal airways (31%) and VVR-exposed airways (30%; p = 0.03), and VVR increased MCTV by 34% in LPS-inflamed airways (p = 0.002).

Conclusions

VVR stimulates mucin secretion and MCTV in the LPS-inflamed ferret airway. This set of findings is similar to the acute inflammatory stimulation observed with exposure to irritants, and may lead to mucus obstruction of small airways and increased nasal resistance.

Section snippets

Case Report

An 18-month-old previously healthy girl was brought to the emergency department (ED) by her grandparents. The grandmother stated that the girl had an upper respiratory infection but otherwise had been well until 2 h before coming to the ED when severe respiratory distress suddenly developed.

In the ED, the child was not interactive with her grandparents or the medical staff. She had wheezing and intercostal retractions. Her initial pulse oximetry saturation was 0.66 while breathing ambient air.

Animals

Unlike rodents, ferrets have an airway anatomy and cellular composition that is similar to humans and other carnivores, and have often been used to study airway inflammation and mucus secretion.3, 4 Adult ferrets (weight, 1.0 to 1.6 kg) were obtained from Marshall Farms (Rose, NY). This study was approved by the Wake Forest University Animal Care and Use Committee.

Study 1

As a requirement for Animal Care and Use Committee approval, we first studied the effects of VVR on tracheal mucin secretion,

Mucin Secretion

In vitro (study 1) VVR increased mucin secretion by 59% over baseline (n = 15; mean relative secretory index, 2.22 ± 1.17; p = 0.0012) [Fig 1].

In vivo (study 2) VVR increased mucin secretion in the normal airway (14%) and in the inflamed airway (7.8%), but this did not reach statistical significance. Mucin secretion was significantly increased by 67% in the group treated with LPS compared to the group not treated with LPS (p = 0.007), but VVR only slightly increased mucin secretion further (Fig

Discussion

Lunsford Richardson II and John Farris first compounded VVR in 1891 in Greensboro, NC, soon after buying the local W. C. Porter Drugstore. VVR was introduced in 1905 with the name Vick's Magic Croup Salve. The flu epidemic of 1918 increased VVR sales from $900,000 to $2.9 million in just 1 year. Procter & Gamble has since marketed VVR as, “The only thing more powerful than a mother's touch.”1

VVR is widely used to relieve symptoms of colds and congestion, but there are few data supporting a

References (28)

  • C Kishioka et al.

    Regulation of secretion from mucous and serous cells in the excised ferret trachea

    Respir Physiol

    (2001)
  • FB Sant'Ambrogio et al.

    Menthol in the upper airway depresses ventilation in newborn dogs

    Respir Physiol

    (1992)
  • SC Jordt et al.

    Lessons from pepper and peppermint: the molecular logic of thermal sensation

    Curr Opin Neurobiol

    (2003)
  • Protcor & Gamble

    Vicks VapoRub

  • A Burrow et al.

    The effects of camphor, eucalyptus and menthol vapour on nasal resistance to airflow and nasal sensation

    Acta Otolaryngol

    (1983)
  • K Okamoto et al.

    Secretory phospholipases A2 stimulate mucus secretion, induce airway inflammation, and produce secretory hyperresponsiveness to neutrophil elastase in the ferret trachea

    Am J Physiol Lung Cell Mol Physiol

    (2007)
  • F Faul et al.

    G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences

    Behav Res Methods

    (2007)
  • H Berger et al.

    Effect of VapoRub on the restlessness of children with acute bronchitis

    J Int Med Res

    (1978)
  • A Jaiwal

    Vick's VapoRub induced dermokerato conjunctivitis: a case report

    Indian J Ophthalmol

    (1989)
  • RL Ferrando et al.

    Bizarre behavior following the ingestion of levo-desoxyephedrine

    Drug Intell Clin Pharm

    (1988)
  • P Gattuso et al.

    Exogenous lipoid pneumonitis due to Vicks VapoRub inhalation diagnosed by fine needle aspiration cytology

    Cytopathology

    (1991)
  • M Schaller et al.

    Allergic airborne contact dermatitis from essential oils used in aromatherapy

    Clin Exp Dermatol

    (1995)
  • A Uc et al.

    Camphor hepatotoxicity

    South Med J

    (2000)
  • B McBride et al.

    A physiological stimulus to upper airway receptors in humans

    J Appl Physiol

    (1981)
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    The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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