Chest
Volume 107, Issue 3, March 1995, Pages 747-751
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Clinical Investigations: Miscellaneous: Articles
Effects of Guaifenesin on Nasal Mucociliary Clearance and Ciliary Beat Frequency in Healthy Volunteers

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Study objective

Mucociliary clearance is an important host defense function of the upper respiratory tract that requires the coordinated beating of cilia and results in the transport of mucus to the oropharynx. Guaifenesin is a commonly prescribed drug that is reported to improve the clearance of respiratory secretions. We hypothesized that guaifenesin increases nasal mucociliary clearance related to increases in ciliary beat frequency (CBF) and that a direct relationship exists between nasal CBF and nasal mucociliary clearance.

Design

Double-blind placebo-controlled crossover study.

Participants

Ten healthy volunteers with a previous history of sinus disease.

Interventions

Subjects received guaifenesin or placebo on days 1 to 7 or days 14 to 21.

Measurements and Results

In vivo saccharine transit time (STT) was measured by noting the time in minutes required for the subject to taste a saccharin particle placed on the inferior turbinate of the naris. The CBF was determined by video microscopy on ten separate groups of beating ciliated nasal mucosal cells obtained by brushing immediately after each STT determination. We found that there was no significant change between the guaifenesin- or placebo-treated groups from baseline values of STT (p=0.94) or CBF (p=0.46). Regression analysis demonstrated no relationship between STT and CBF for repeated measures within subjects (mean r2=0.18; mean p=0.66) and between STT and CBF when all paired measurements were combined across subjects (r2=0.47; p=0.46).

Conclusion

We conclude that guaifenesin exerts no measurable effect on in vivo nasal mucociliary clearance or ex vivo nasal ciliary motility in healthy volunteers with previous sinus disease. In addition, there appears to be no relationship between nasal STT measured in vivo and CBF measured ex vivo. The lack of correlation is most likely due to variations in CBF related to sampling artifacts introduced by the nasal brushing process.

Section snippets

Clinical Data

Subject Recruitment: The study protocol was approved by the Institutional Review Board at the University of Nebraska Medical Center prior to subject accrual. Ten healthy volunteers with a history of previous sinus problems were recruited through an advertisement to participate in the study. All subjects had no active sinus infection, nasal or sinus discharge, fevers, nasal stuffiness, or other active symptoms at the time of the study. Originally 12 subjects started the study, but one subject

Effect of Guaifenesin and Placebo on Saccharin Transit Time

The effect of guaifenesin was examined by STT. The baseline STT for individuals prior to guaifenesin and following 7 days on 2,000 mg/d was not significantly different (pre, 14.9 ± 1.2 min vs post, 14.1 ± 1.7 min; p=0.31; Fig 2, A). Similarly, there was no significant difference between the STT measured before and at the end of the placebo period of 7 days (pre, 16.8 ± 2.1 min vs post, 15.5 ± 1.2 min; p=0.28; Fig 2, B). When the change over seven days of treatment for guaifenesin was compared

Discussion

Our study examined the effect of guaifenesin on mucociliary clearance as measured in vivo by nasal STT and on ciliary motility as measured ex vivo by CBF. We found that guaifenesin had no significant effect on either of these measures of nasal mucociliary function. Our observation bolsters the experience in the literature in which few well designed studies have shown that guaifenesin promotes mucociliary clearance. Thomson and coworkers3 found that guaifenesin had a small but positive effect on

ACKNOWLEDGMENTS

The authors thank Proctor and Gamble for their sponsorship of this study. We also wish to acknowledge Kathryn May for her valuable technical assistance in performing the nasal brushings and CBF measurements and the nursing staff of the Otolaryngology Clinic for assisting in subject accrual and the nasal STT determinations.

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