Submucosal gland secretions in airways from cystic fibrosis patients have normal [Na+] and pH but elevated viscosity

S Jayaraman, NS Joo, B Reitz… - Proceedings of the …, 2001 - National Acad Sciences
S Jayaraman, NS Joo, B Reitz, JJ Wine, AS Verkman
Proceedings of the National Academy of Sciences, 2001National Acad Sciences
Fluid and macromolecule secretion by submucosal glands in mammalian airways is
believed to be important in normal airway physiology and in the pathophysiology of cystic
fibrosis (CF). An in situ fluorescence method was applied to measure the ionic composition
and viscosity of freshly secreted fluid from airway glands. Fragments of human large airways
obtained at the time of lung transplantation were mounted in a humidified perfusion chamber
and the mucosal surface was covered by a thin layer of oil. Individual droplets of secreted …
Fluid and macromolecule secretion by submucosal glands in mammalian airways is believed to be important in normal airway physiology and in the pathophysiology of cystic fibrosis (CF). An in situ fluorescence method was applied to measure the ionic composition and viscosity of freshly secreted fluid from airway glands. Fragments of human large airways obtained at the time of lung transplantation were mounted in a humidified perfusion chamber and the mucosal surface was covered by a thin layer of oil. Individual droplets of secreted fluid were microinjected with fluorescent indicators for measurement of [Na+], [Cl], and pH by ratio imaging fluorescence microscopy and viscosity by fluorescence recovery after photobleaching. After carbachol stimulation, 0.1–0.5 μl of fluid accumulated in spherical droplets at gland orifices in ≈3–5 min. In gland fluid from normal human airways, [Na+] was 94 ± 8 mM, [Cl] was 92 ± 12 mM, and pH was 6.97 ± 0.06 (SE, n = 7 humans, more than five glands studied per sample). Apparent fluid viscosity was 2.7 ± 0.3-fold greater than that of saline. Neither [Na+] nor pH differed in gland fluid from CF airways, but viscosity was significantly elevated by ≈2-fold compared to normal airways. These results represent the first direct measurements of ionic composition and viscosity in uncontaminated human gland secretions and indicate similar [Na+], [Cl], and pH to that in the airway surface liquid. The elevated gland fluid viscosity in CF may be an important factor promoting bacterial colonization and airway disease.
National Acad Sciences