EFFECTS OF GUAIFENESIN ON NASAL MUCOCILIARY CLEARANCE AND CILIARY BEAT FREQUENCY IN HEALTHY-VOLUNTEERS

Study objective: Mucociliary clearance is an important host defense function of the upper respiratory tract that requires the coordinated beating of cilia and results in the transport of mucus to the oropharynx. Guaifenesin is a commonly prescribed drug that is reported to improve the clearance of respiratory secretions. We hypothesized that guaifenesin increases nasal mucociliary clearance related to increases in ciliary beat frequency (CBF) and that a direct relationship exists between nasal CBF and nasal mucociliary clearance. Design: Double-blind placebo-controlled crossover study. Participants: Ten healthy volunteers with a previous history of sinus disease. Interventions: Subjects received guaifenesin or placebo on days 1 to 7 or days 14 to 21. Measurements and Results: In vivo saccharine transit time (STT) was measured by noting the time in minutes required for the subject to taste a saccharin particle placed on the inferior turbinate of the naris. The CBF was determined by video microscopy on ten separate groups of beating ciliated nasal mucosal cells obtained by brushing immediately after each STT determination. We found that there was no significant change between the guaifenesin- or placebo-treated groups from baseline values of STT (p=0.94) or CBF (p=0.46). Regression analysis demonstrated no relationship between STT and CBF for repeated measures within subjects (mean r(2)=0.18; mean p=0.66) and between STT and CBF when all paired measurements were combined across subjects (r(2)=0.47; p=0.46). Conclusion: We conclude that guaifenesin exerts no measurable effect on in vivo nasal mucociliary clearance or ex vivo nasal ciliary motility in healthy volunteers with previous sinus disease. In addition, there appears to be no relationship between nasal STT measured in vivo and CBF measured ex vivo. The lack of correlation is most likely due to variations in CBF related to sampling artifacts introduced by the nasal brushing process.