Chest
Clinical InvestigationsCYSTIC FIBROSISTargeting Aerosol Deposition in Patients With Cystic Fibrosis: Effects of Alterations in Particle Size and Inspiratory Flow Rate
Section snippets
Patient Characteristics
Nine patients (six men; three women), who had a documented sweatchloride value > 60 mEq/L by quantitative pilocarpine ionophoresisand one finding consistent with the clinical diagnosis of CF, participated in the study. Patients ranged in age from 21 to 47 years(mean ± SD age, 30 ± 8 years). FEV1, as apercent of predicted values, ranged between 25% and 124% for the ninepatients. Patients were receiving stable therapies for antibiotics, bronchodilators, recombinant human deoxyribonuclease,
Baseline FEV1 Values
Baseline FEV1 values, as a percent of predicted, for all nine patients on each of the four study days are shown in Table 1. Baseline FEV1 values on allfour study days were similar, averaging 65 ± 27%, 66 ± 28%,64 ± 28%, and 65 ± 27% for study days 1 through 4,respectively.
Aerosol Particle Size Characteristics
The average MMAD for the Pari nebulizer (n = 3) was3.68 ± 0.04 μm. Mean geometric SD averaged 3.01 ± 0.07. ThisMMAD was significantly larger than that of the Medicator nebulizer(n = 4), which averaged 1.01 ± 0.2 μm (p =
Discussion
To achieve a full therapeutic effect with any aerosolizedmedication, an adequate dose of drug must be deposited beyond theoropharynx. The distribution of drug within the lungs may also play arole in optimizing the effect of therapy. Aerosol particle size andinspiratory flow rate are two major determinants of deposition fractionand distribution of aerosol within the lungs. By varying these factors, it may be possible to develop methods for targeting the delivery of aerosolized medications to
ACKNOWLEDGMENT
The authors wish to thank Ta-Chun Lin, PhD, for histechnical assistance in performing these experiments, and LoisBrass-Ernst, RN, for her expertise in recruiting patients for thesestudies.
References (15)
- et al.
The efficacy of slow versus faster inhalation of cromolyn sodium in protecting against allergen challenge in patients with asthma
J Allergy Clin Immunol
(1998) - et al.
Homogeneity of bronchopulmonary distribution of99mTc aerosol in normal subjects and in cystic fibrosis patients
Chest
(1989) - et al.
Altered regulation of airway epithelial cell chloride channels in cystic fibrosis
Science
(1986) - et al.
Cl-channels in CF: lack of activation by protein kinase C and cAMP-dependent protein kinase
Science
(1989) - et al.
Cyclic AMP-dependent protein kinase opens chloride channels in normal but not cystic fibrosis airway epithelium
Nature
(1988) - et al.
Cystic fibrosis
Am J Respir Crit Care Med
(1996) - et al.
Pathology of cystic fibrosis: review of the literature and comparison with 146 autopsied cases
Perspect Pediatr Pathol
(1975)
Cited by (64)
Imaging regional lung function: A critical tool for developing inhaled antimicrobial therapies
2015, Advanced Drug Delivery ReviewsMethacholine delays pulmonary absorption of inhaled β<inf>2</inf>-agonists due to competition for organic cation/carnitine transporters
2012, Pulmonary Pharmacology and TherapeuticsDrug and light delivery strategies for photodynamic antimicrobial chemotherapy (PACT) of pulmonary pathogens: A pilot study
2011, Photodiagnosis and Photodynamic TherapyNebuliser systems for drug delivery in cystic fibrosis
2023, Cochrane Database of Systematic ReviewsEfficacy and Safety of Dry Powder Antibiotics: A Narrative Review
2023, Journal of Clinical Medicine
This work was supported in part by the CF Foundation's CF Gene TherapyCenter Pilot Projects Grant S879 and by the CF Foundation's CFTherapeutics Development Network Grant CFTDN ZEITLI98Y0.