Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BACKGROUND Preliminary evidence suggests that regular inhalation of nebulised amiloride reduces sputum viscoelasticity, increases the clearance of sputum by mucociliary mechanisms and by coughing and reduces the rate of deterioration in lung function in patients with cystic fibrosis. These effects depend on adequate delivery of amiloride to the airways. This study was performed to quantify and compare pulmonary deposition of amiloride produced by two different nebuliser systems. METHODS The pulmonary deposition of nebulised amiloride (1 mg in 3 ml saline) was measured in eight patients with cystic fibrosis when given via a jet (System 22 with CR 60 compressor) and an ultrasonic (Fisoneb) nebuliser. Human serum albumin labelled with technectium-99m was used as an indirect marker for amiloride and its deposition in the lung was detected with a gamma camera. RESULTS Amiloride inhalation caused no side effects or changes in spirometric indices. The mean (SD) total pulmonary amiloride deposition was 57 (24) micrograms with the System 22 and 103 (53) micrograms with the Fisoneb nebuliser. Pulmonary deposition was completed more rapidly with the Fisoneb (4-5 minutes) than with the System 22 nebuliser (7-8 minutes) and the Fisoneb was preferred by the patients. CONCLUSIONS Both nebulisers appeared to deliver adequate amounts of amiloride to the lungs, but treatment with the Fisoneb nebuliser was quicker, more efficient, and more acceptable to the patients. Of the two nebulisers assessed, the Fisoneb would be preferred for clinical trials.
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PMID:Pulmonary deposition of nebulised amiloride in cystic fibrosis: comparison of two nebulisers. 175 18

Amiloride (AM) reduces mucociliary transport in the frog palate in vitro preparation, whereas in vivo inhalation of AM enhances mucociliary and cough clearance in cystic fibrosis patients. AM influences the bioelectric properties of the respiratory mucosa, and since electrical activity and ciliary activity are strictly related in the beating cell, an effect on ciliary function cannot be excluded. We have, therefore, investigated the effect of AM (10(-7) to 10(-3) M) in vitro on the ciliary activity of ten samples of healthy human bronchial epithelium at 37 degrees C. The baseline ciliary beat frequency was 13.7 +/- (SD) 1.0 Hz. At concentrations of AM of 10(-4) and 10(-3) M, small statistically significant (p less than 0.01) increases in ciliary beat frequency were recorded only after 1 min of exposure to the drug, with changes of +8.2 and +7.6%, respectively. We conclude that (1) AM affects the ciliary activity of the beating cell, but (2) because of the weakness and short duration of the effect, it is unlikely that AM plays a major role on mucociliary transport.
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PMID:Effect of amiloride on human bronchial ciliary activity in vitro. 235 94

Amiloride inhalation as treatment for cystic fibrosis (CF) lung disease has been shown in independent studies to increase mucus clearance by ciliary and/or cough action and to retard the decline in lung function. It is hypothesized that amiloride therapy decreases the excess sodium and water absorption that is a characteristic of CF airway epithelium and that it leads to an improvement in the rheologic properties of mucus favoring airway mucus clearance. The aim of this study was to investigate whether amiloride treatment (5 x 10(-3) M amiloride in one-third normal saline four times a day) would change sputum electrolyte composition in patients with CF after 25 wk of therapy as compared with placebo (one-third normal saline), and whether appropriate changes in sputum water content and rheologic properties would accompany any changes in electrolyte composition. Sputum samples were obtained from six patients with CF undergoing amiloride therapy, using the dental cotton protection technique to avoid salivary contamination. The samples were stored at -80 degrees C until analyzed. For electrolyte analyses an aliquot of the sputum (minimum, 30 mg) was analyzed with ion-selective electrodes for sodium and potassium, and a chloride meter was used to measure chloride content. Chronic (25-wk) amiloride therapy increased significantly the sputum sodium (94.8 +/- 16.4 to 121.4 +/- 15.4 mmol/L, p = 0.001) and chloride (64.4 +/- 11.8 to 77.2 +/- 8.0 mmol/L, p = 0.10) content when compared with 25 wk of saline treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Amiloride inhalation therapy in cystic fibrosis. Influence on ion content, hydration, and rheology of sputum. 811 99

Mucociliary clearance (MCC), the process in which airway mucus together with substances trapped within are moved out of the lungs, is an important defence mechanism of the human body. Drugs may alter this process, such that it is necessary to know the effect of the drugs on MCC. Indeed, agents stimulating MCC may be used therapeutically in respiratory medicine, especially in patients suspected of having an impairment of their mucociliary transport system. In contrast, caution should be taken with drugs depressing MCC as an undesired side-effect, independently of their therapeutic indication. Since cough clearance (CC) serves as a back-up system when MCC fails, the influence of drugs must be examined not only on MCC but also on CC. Ultimately, the clinical repercussions of alterations in mucus transport induced by drug administration must be studied. Tertiary ammonium compounds (anticholinergics), aspirin, anaesthetic agents and benzodiazepines have been shown to be capable of depressing the mucociliary transport system. Cholinergics, methylxanthines, sodium cromoglycate, hypertonic saline, saline as well as water aerosol have been shown to increase MCC. Adrenergic antagonists, guaifenesin, S-carboxymethylcysteine, sodium 2-mercapto-ethane sulphonate and frusemide have been reported not to alter the mucociliary transport significantly. Amiloride, uridine 5'-triphosphate (UTP), quaternary ammonium compounds (anticholinergics), adrenergic agonists, corticosteroids, recombinant human deoxyribonuclease (rhDNase), N-acetylcysteine, bromhexine and ambroxol have been reported either not to change or to augment MCC. Indirect data suggest that surfactant as well as antibiotics may improve the mucociliary transport system. As for the influence of drugs on CC, amiloride and rhDNase have been demonstrated to increase the effectiveness of cough. A trend towards an improved CC was noted after treatment with adrenergic agonists. The anticholinergic agent ipratropium bromide, which is a quaternary ammonium compound, has been suggested to decrease CC significantly. Bromhexine, ambroxol and neutral saline seemed not to alter CC, either positively or negatively. Finally, treatment with either amiloride, recombinant human deoxyribonuclease, bromhexine, ambroxol, N-acetylcysteine, S-carboxymethylcysteine or hypertonic saline has been suggested as a possible cause of clinical improvement in patients, such as the experience of dyspnoea, the case of expectoration or the frequency of infective exacerbations. Other agents did not show a clinical benefit.
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PMID:Effects of drugs on mucus clearance. 1051 29

Unmyelinated C-fibers endings lye beneath the epithelial layer and release neuropeptides which regulate baseline transepithelial potential difference (PD) and changes of transepithelial potential difference during mechanical stimulation (dPD). Ambroxol can suppress reflexes such as the cough or the corneal reflex which are connected to stimulation of C fibre endings. The study aimed to estimate the influence of ambroxol (ABX) and capsaicin (CAPSA) on PD and dPD in isolated rabbit bladder. The experiments were carried out on 26 bladder specimens of. 2 cm2 surface area each, obtained from 13 rabbits. Ussing apparatus was used. Procedure used for stimulation of sensory receptor involved directing stream onto epithelium. A stimulus lasted 30s, ejecting the 2.5 ml fluid. Amiloride and bumetanide were used to estimate of ionic currents. Each significant reaction was repeated at least 10 times on various specimens. PD ranged between 5 and 10 mV in different experimental conditions. Mechanical stimulation of isolated bladder wall caused increasing dPD about 2 mV defined as hyperpolarization. Application of ABX to the stimulation fluid decreased the hyperpolarization in comparison with control stimulation under conditions of inhibited chloride ion transport. Application of CAPSA to the stimulation fluid decreased the hyperpolarization in comparison with control stimulation under conditions of inhibited sodium ion transport. ABX and CAPSA had no influence on PD after mechanical stimulation. ABX as well as CAPSA influence on transepithelial ion transport pathways in bladder epithelium is dependent on sensory stimulation. ABX can be suspected to suppress bladder contractions.
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PMID:The influence of ambroxol and capsaicin on the isolated rabbit bladder wall. 1645 89