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Mannitol cystic fibrosis

Chunxia Liu, Ling Lin, Zhengwei Huang, Qiaoli Wu, Junhuang Jiang, Li Lv, Xiaoxia Yu, Guilan Quan, Guocheng Li, Chuanbin Wu
Non-cystic fibrosis bronchiectasis (NCFB) is a chronic respiratory disease associated with the high morbidity and mortality. Long-term intermittent therapy by inhalable antibiotics has recently emerged as an effective approach for NCFB treatment. However, the effective delivery of antibiotics to the lung requires administering a high dose to the site of infection. Herein, we investigated the novel inhalable silk-based microparticles as a promising approach to deliver high-payload ciprofloxacin (CIP) for NCFB therapy...
January 23, 2019: AAPS PharmSciTech
Emma Warren, Kristen Morgan, Toby J Toward, Matthias Schwenkglenks, Joanna Leadbetter
BACKGROUND: Inhaled mannitol (Bronchitol® ) is licensed in Australia as a safe and efficacious addition to best supportive care in patients with cystic fibrosis. OBJECTIVE: The objective of this study was to assess the cost effectiveness of inhaled mannitol (in addition to best supportive care) in the Australian setting from the perspective of a government-funded national healthcare system. METHODS: A probabilistic patient-level simulation Markov model estimated life-time costs and outcomes of mannitol when added to best supportive care, compared with best supportive care alone in patients aged 6 years and older...
January 22, 2019: PharmacoEconomics
Peter Wark, Vanessa M McDonald
BACKGROUND: Impaired mucociliary clearance characterises lung disease in cystic fibrosis (CF). Hypertonic saline enhances mucociliary clearance and may lessen the destructive inflammatory process in the airways. This is an update of a previously published review. OBJECTIVES: To investigate efficacy and tolerability of treatment with nebulised hypertonic saline on people with CF compared to placebo and or other treatments that enhance mucociliary clearance. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register, comprising references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings...
September 27, 2018: Cochrane Database of Systematic Reviews
Connie Yang, Mark Montgomery
BACKGROUND: Dornase alfa is currently used as a mucolytic to treat pulmonary disease (the major cause of morbidity and mortality) in cystic fibrosis. It reduces mucus viscosity in the lungs, promoting improved clearance of secretions. This is an update of a previously published review. OBJECTIVES: To determine whether the use of dornase alfa in cystic fibrosis is associated with improved mortality and morbidity compared to placebo or other medications that improve airway clearance, and to identify any adverse events associated with its use...
September 6, 2018: Cochrane Database of Systematic Reviews
Stephanie Van Biervliet, Bruno Hauser, Stijn Verhulst, Hedwig Stepman, Joris Delanghe, Jean-Pol Warzee, Bruno Pot, Tom Vandewiele, Michael Wilschanski
BACKGROUND: A potential positive effect of probiotics in cystic fibrosis (CF) on fecal calprotectin (FCP), pulmonary exacerbations and weight has been described in small controlled trials. METHODS: A double-blind multicenter cross-over study (2 × 4 m) was performed looking at abdominal pain, nutritional status, pulmonary function, pulmonary exacerbation, FCP and lactulose/mannitol gut permeability test. Patients kept a diary with daily scoring of abdominal pain, stool frequency and consistency as well as treatment changes...
October 2018: Clinical Nutrition ESPEN
Simone K Visser, Peter Bye, Lucy Morgan
Once neglected in research and underappreciated in practice, there is renewed interest in bronchiectasis unrelated to cystic fibrosis. Bronchiectasis is a chronic lung disease characterised by chronic cough, sputum production and recurrent pulmonary exacerbations. It is diagnosed radiologically on high resolution computed tomography chest scan by bronchial dilatation (wider than the accompanying artery). The causes of bronchiectasis are diverse and include previous respiratory tract infections, chronic obstructive pulmonary disease, asthma, immunodeficiency and connective tissue diseases...
August 20, 2018: Medical Journal of Australia
The-Thien Tran, Celine Vidaillac, Hong Yu, Valerie F L Yong, Dan Roizman, Ravishankar Chandrasekaran, Albert Y H Lim, Teck Boon Low, Gan Liang Tan, John A Abisheganaden, Mariko Siyue Koh, Jeanette Teo, Sanjay H Chotirmall, Kunn Hadinoto
Non-cystic fibrosis bronchiectasis (NCFB) characterized by permanent bronchial dilatation and recurrent infections has been clinically managed by long-term intermittent inhaled antibiotic therapy among other treatments. Herein we investigated dry powder inhaler (DPI) formulation of ciprofloxacin (CIP) nanoplex with mannitol/lactose as the excipient for NCFB therapy. The DPI of CIP nanoplex was evaluated against DPI of native CIP in terms of their (1) dissolution characteristics in artificial sputum medium, (2) ex vivo mucus permeability in sputum from NCFB and healthy individuals, (3) antibacterial efficacy in the presence of sputum against clinical Pseudomonas aeruginosa strains (planktonic and biofilm), and (4) cytotoxicity towards human lung epithelial cells...
August 25, 2018: International Journal of Pharmaceutics
Sandra D Anderson, Evangelia Daviskas, John D Brannan, Hak Kim Chan
The story of how we came to use inhaled mannitol to diagnose asthma and to treat cystic fibrosis began when we were looking for a surrogate for exercise as a stimulus to identify asthma. We had proposed that exercise-induced asthma was caused by an increase in osmolarity of the periciliary fluid. We found hypertonic saline to be a surrogate for exercise but an ultrasonic nebuliser was required. We produced a dry powder of sodium chloride but it proved unstable. We developed a spray dried preparation of mannitol and found that bronchial responsiveness to inhaling mannitol identified people with currently active asthma...
August 2018: Advanced Drug Delivery Reviews
Ajantha Nadesalingam, Jacky H K Chen, Armin Farahvash, Meraj A Khan
Tonicity of saline (NaCl) is important in regulating cellular functions and homeostasis. Hypertonic saline is administered to treat many inflammatory diseases, including cystic fibrosis. Excess neutrophil extracellular trap (NET) formation, or NETosis, is associated with many pathological conditions including chronic inflammation. Despite the known therapeutic benefits of hypertonic saline, its underlying mechanisms are not clearly understood. Therefore, we aimed to elucidate the effects of hypertonic saline in modulating NETosis...
2018: Frontiers in Immunology
Sarah J Nevitt, Judith Thornton, Clare S Murray, Tiffany Dwyer
BACKGROUND: Several agents are used to clear secretions from the airways of people with cystic fibrosis. Mannitol increases mucociliary clearance, but its exact mechanism of action is unknown. The dry powder formulation of mannitol may be more convenient and easier to use compared with established agents which require delivery via a nebuliser. Phase III trials of inhaled dry powder mannitol for the treatment of cystic fibrosis have been completed and it is now available in Australia and some countries in Europe...
February 9, 2018: Cochrane Database of Systematic Reviews
Barbara Porsio, Emanuela Fabiola Craparo, Nicolò Mauro, Gaetano Giammona, Gennara Cavallaro
Here, mucus-penetrating nanoparticles (NPs) for pulmonary administration of ivacaftor in patients with cystic fibrosis (CF) were produced with the dual aim of enhancing ivacaftor delivery to the airway epithelial cells, by rapid diffusion through the mucus barrier, and at the same time, promoting ivacaftor lung cellular uptake. Pegylated and Tat-decorated fluorescent nanoparticles (FNPs) were produced by nanoprecipitation, starting from two synthetic copolymers, and showed nanometric sizes (∼70 nm), a slightly negative ζ potential, and high cytocompatibility toward human bronchial epithelium cells...
January 10, 2018: ACS Applied Materials & Interfaces
Benjamin J Tarrant, Caitlin Le Maitre, Lorena Romero, Ranjana Steward, Brenda M Button, Bruce R Thompson, Anne E Holland
Inhaled mucoactive agents are used in respiratory disease to improve mucus properties and enhance secretion clearance. The effect of mannitol, recombinant human deoxyribonuclease/dornase alfa (rhDNase) and hypertonic saline (HS) or normal saline (NS) are not well described in chronic lung conditions other than cystic fibrosis (CF). The aim of this review was to determine the benefit and safety of inhaled mucoactive agents outside of CF. We searched Medline, Embase, CINAHL and CENTRAL for randomized controlled trials investigating the effects of mucoactive agents on lung function, adverse events (AEs), health-related quality of life (HRQOL), hospitalization, length of stay, exacerbations, sputum clearance and inflammation...
August 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
K De Boeck, E Haarman, J Hull, L C Lands, A Moeller, A Munck, J Riethmüller, H Tiddens, S Volpi, J Leadbetter, B Charlton, A Malfroot
INTRODUCTION: Inhaled mannitol has beneficial effects on lung function, mucociliary clearance, quality of life and sputum properties. This trial examined the efficacy of inhaled mannitol in children with cystic fibrosis (CF). METHODS: The efficacy of inhaled mannitol in children with CF aged 6-17years was assessed in a phase 2, randomised, placebo-controlled crossover study. Subjects were randomly assigned to mannitol 400mg every 12h or matching placebo for 8weeks, followed by an 8week washout and an 8week period with the alternate treatment...
May 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Emanuela F Craparo, Barbara Porsio, Domenico Schillaci, Maria G Cusimano, Dario Spigolon, Gaetano Giammona, Gennara Cavallaro
AIM: Efficacy of antibiotics in cystic fibrosis (CF) is compromised by the poor penetration through mucus barrier. This work proposes a new 'nano-into-micro' approach, used to obtain a combinatorial effect: achieve a sustained delivery of tobramycin and overcome mucus barrier. METHODS: Mannitol microparticles (MPs) were loaded with a tobramycin polymeric nanocomplex and characterized in presence of CF artificial mucus. RESULTS & DISCUSSION: MPs are able to alter the rheological properties of CF artificial mucus, enhancing drug penetration into it and allowing a prolonged drug release...
January 2017: Nanomedicine
Clizia Cazzarolli, Chiara Tartali, Ugo Pradal
No abstract text is available yet for this article.
April 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
G Costabile, I d'Angelo, R d'Emmanuele di Villa Bianca, E Mitidieri, B Pompili, P Del Porto, L Leoni, P Visca, A Miro, F Quaglia, F Imperi, R Sorrentino, F Ungaro
Flucytosine (5-fluorocytosine, 5-FC) is a fluorinated analogue of cytosine currently approved for the systemic treatment of fungal infections, which has recently demonstrated a very promising antivirulence activity against the bacterial pathogen Pseudomonas aeruginosa. In this work, we propose novel inhalable hyaluronic acid (HA)/mannitol composite dry powders for repositioning 5-FC in the local treatment of lung infections, including those affecting cystic fibrosis (CF) patients. Different dry powders were produced in one-step by spray-drying...
September 28, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Connie Yang, Mark Chilvers, Mark Montgomery, Sarah J Nolan
BACKGROUND: Dornase alfa is currently used as a mucolytic to treat pulmonary disease (the major cause of morbidity and mortality) in cystic fibrosis. It reduces mucus viscosity in the lungs, promoting improved clearance of secretions. This is an update of a previously published review. OBJECTIVES: To determine whether the use of dornase alfa in cystic fibrosis is associated with improved mortality and morbidity compared to placebo or other medications that improve airway clearance, and to identify any adverse events associated with its use...
April 4, 2016: Cochrane Database of Systematic Reviews
Sarah J Nolan, Judith Thornton, Clare S Murray, Tiffany Dwyer
No abstract text is available yet for this article.
March 2016: Paediatric Respiratory Reviews
Coralie Barrera, Bénédicte Richaud-Thiriez, Steffi Rocchi, Bénédicte Rognon, Sandrine Roussel, Frédéric Grenouillet, Audrey Laboissière, Jean-Charles Dalphin, Gabriel Reboux, Laurence Millon
Allergic bronchopulmonary aspergillosis (ABPA) is difficult to diagnose; diagnosis relies on clinical, radiological, pathological, and serological criteria. Our aim was to assess the performance of two new commercially available kits and a new in-house assay: an Aspergillus fumigatus enzyme-linked immunosorbent assay (ELISA) IgG kit (Bordier Affinity Products), an Aspergillus Western blotting IgG kit (LDBio Diagnostics), and a new in-house time-resolved fluorometric IgE assay (dissociation-enhanced lanthanide fluorescent immunoassay, or DELFIA) using recombinant proteins from an Aspergillus sp...
December 23, 2015: Clinical and Vaccine Immunology: CVI
(no author information available yet)
Mannitol improves mucus clearance in non-cystic fibrosis (CF) bronchiectasis and improves mucus clearance and pulmonary function test results in patients with CF. It is not clear to what extent inhaled mannitol has an impact on exacerbation rates and quality of life in patients with non-CF bronchiectasis.
September 2015: Breathe
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