This concentrated saltwater solution improves airway clearance for patients with cystic fibrosis (CF), according to research reported in the Jan. 19 issue of the New England Journal of Medicine.

The idea for the study, supported by the Cystic Fibrosis Foundation, began when the Australian surfers with CF told their doctors that their airways felt clearer after exposure to the salt spray. The medical team was aware of some evidence that in CF, salt is depleted from the liquid that lines the airways. The team thus hypothesized that sterile saltwater may be a useful therapy. They were right. Now CF patients worldwide may benefit from this “low tech” treatment.

CF is one of the most common fatal genetic diseases and causes a thick mucus to clog the lungs which leads to chronic infections and damage. Australian researchers at Royal Prince Alfred Hospital received funding from the Cystic Fibrosis Foundation to conduct the hypertonic saline trial. It was the largest CF clinical trial ever conducted in Australia.

“Our team was delighted with the outcome using this inexpensive therapy,” said Peter Bye,  M.D., head of Cystic Fibrosis Service, Royal Prince Alfred Hospital, Sydney, Australia, and the project's principal investigator. He also noted, “The hypertonic saline therapy should be administered after a bronchodilator-a drug to open the airways. CF patients should consult with their doctors before using the saline solution. Patients should also continue all their current medications.”

Some 164 patients from 16 adult or pediatric hospitals in Australia participated in the double-blind, parallel-group trial. The hypertonic saline study was conducted between September 2000 and November 2003.

For the experimental treatments, patients were first given a bronchodilator. Then the volunteers were assigned randomly to inhale through a nebulizer either 4 ml of 7 percent hypertonic saline (experimental) or 0.9 percent saline (control), twice daily for 48 weeks. A nebulizer is a medical device that delivers liquid medication in the form of a mist to the airways.

Researchers found that study participants who were given hypertonic saline had fewer pulmonary “flare-ups” than volunteers who were not given the solution. When pulmonary flare-ups did occur, those volunteers who were taking hypertonic saline tended to recover more swiftly than the other volunteers.

“This innovative new therapy is just one of the many novel CF treatments we have in our drug discovery and development pipeline,” said Robert J. Beall, Ph.D., president and CEO of the Cystic Fibrosis Foundation. He added, “When researchers proposed this study to us, we were eager to provide support to evaluate the treatment as safe and effective, then get it quickly to CF patients.”

In addition to the U.S. Cystic Fibrosis Foundation, this study was supported by the National Health and Medical Research Council of Australia and the Australian Cystic Fibrosis Research Trust.

The Cystic Fibrosis Foundation, headquartered in Bethesda, Md., is a donor-supported, nonprofit organization committed to finding therapies and ultimately a cure for CF, and to improving the lives of those with the disease. CF is a life-threatening, genetic disease that can lead to fatal lung infections and digestive problems.