Osmolytes and ion transport modulators: new strategies for airway surface rehydration

Curr Opin Pharmacol. 2010 Jun;10(3):294-9. doi: 10.1016/j.coph.2010.04.003. Epub 2010 May 1.


Mucociliary clearance (MCC) in CF lung disease is limited by airway dehydration, leading to persistent bacterial infection and inflammation in the airways. Agents designed to rehydrate the airway mucosa lead to improved MCC. Hyperosmolar agents, such as hypertonic saline and mannitol, create a luminal osmotic gradient, drawing water into the dehydrated ASL. Ion transport modulators function to activate alternative chloride channels and/or to block sodium hyperabsorption that occurs through a dysregulated ENaC channel. Combinations of these therapies may result in a synergistic improvement in airway hydration, and thus, restore MCC. Active ongoing phase II and III trials of new pharmacotherapeutics are covered in this review.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / physiopathology
  • Diuretics, Osmotic / pharmacology
  • Diuretics, Osmotic / therapeutic use
  • Drug Synergism
  • Humans
  • Ion Transport / drug effects
  • Mannitol / pharmacology
  • Mannitol / therapeutic use
  • Mucociliary Clearance / drug effects*
  • Respiratory Mucosa / drug effects*
  • Saline Solution, Hypertonic / pharmacology
  • Saline Solution, Hypertonic / therapeutic use


  • Diuretics, Osmotic
  • Saline Solution, Hypertonic
  • Mannitol