Inexpensive Breakthrough Treatment for Cystic Fibrosis Involving Salt Water

January 18th 2006

Scott Donaldson

Scientists may have discovered a breakthrough treatment for cystic fibrosis (CF). The treatment is inexpensive, safe and easy to do. According to researchers at the University of North Carolina, by inhaling a saltwater aerosol solution at least twice a day for between 10 and 15 minutes, patients should be able to avoid a “significant part of the damage the disease causes to their lungs”.

The new saline water treatments appear to promote the “clearance of the naturally occurring mucus the body uses to trap harmful bacteria, viruses and other foreign particles.” The solution may produce a “water layer” in the lungs promoting the removal.

It now appears the surfaces of the lungs of CF patients are dehydrated. Healthy people have a 5 to 10 micron thick, coating of water in the lungs that helps lubricate the open areas of the lungs. By restoring hydration with the hypertonic saline solution, you are treating the “basic cause of this disease”.

Since respiratory failure is the leading cause of death in CF patients, this finding is very important. According to Dr. Scott H Donaldson, assistant professor of Medicine, "We are very excited that this simple and inexpensive therapy turned out to be so effective and well-tolerated in patients with CF."

Cystic fibrosis is the leading fatal genetic illness among whites, and effects 1 in 2,500 children born. About one in five babies with CF are diagnosed at birth. This happens when their gut becomes blocked by extra thick meconium (a black tar-like bowel contents that all babies pass soon after birth). Some children with CF don’t put weight on because their pancreas is not producing enzymes that help digest fat. Typically the stools contain the extra fat and are oily and very smelly.

Patients with CF will also symptoms involving the lungs. In a healthy person there is a constant flow of mucus over the air passages in the lungs. This is an important process to remove debris and bacteria. Cystic fibrosis will cause the mucus to become excessively sticky. Bacteria can then grow in this environment.

Current therapy includes daily vigorous massages to help loosen the sticky mucus. If an infection occurs it is important to treat it quickly with antibiotics. It is important for people with CF to be vaccinated against the flu and pneumococcus to prevent chest infections.

"Sustained Improvement in Mucus Clearance and Lung Function in Cystic Fibrosis with Hypertonic Saline" will be published in the January 19 issue of the New England Journal of Medicine (NEJM). The research was carried out at the University of North Carolina at Chapel Hill School of Medicine and UNC Hospitals. This week's NEJM also includes a report by Australian researchers who followed 164 patients receiving a similar treatment for nearly one year, as well as an editorial about the two studies.