The articles below would give credence to the use of iron
binding substances in the treatment of lung disease.

Inhaled Mannitol Improves Lung Function in Cystic Fibrosis Patients

NEW YORK (Reuters Health) Jul 22 - Treatment with inhaled mannitol
leads to significantly improved lung function in patients with cystic
fibrosis (CF), according to a report by Australian researchers in the
June issue of Chest.

Anna Jaques, of Pharmaxis Ltd. in Frenchs Forest, New South Wales and
colleagues write, "Inhaled mannitol is an osmotic agent that increases
the water content of the airway surface liquid, and improves the
clearance of mucus with the potential to improve lung function and
respiratory health."

The investigators analyzed the efficacy and safety of inhaled mannitol
therapy in 39 patients with mild-to-moderate CF lung disease who were
randomized to treatment with either mannitol (420 mg) or placebo twice
daily for 2 weeks. Patients crossed over to the reciprocal arm after a
2-week washout period.

According to the report, FEV1 increased from baseline by 7.0% with
mannitol vs. 0.3% with placebo (p < 0.01). The mean absolute
improvement in FEV1 was 121 mL with mannitol vs 2 mL with placebo.

Mannitol also produced a significant increase in the forced expiratory
flow in the middle half of the forced vital capacity test (FEF25-75,
15.5% versus 0.7% with placebo; p < 0.02). Patients in the mannitol
arm had a mean absolute increase in FEF25-75 of 150 mL/s, vs a mean
decrease of -10 mL/s in the placebo arm.

Study subjects were asked to complete the Cystic Fibrosis
Questionnaire-revised, a validated tool for assessing quality of life.
"Quality of life measures of the respiratory, health, vitality, and
physical domains... appeared to improve and were most marked in the
respiratory domain of those 14 years of age and older," the
investigators said. They speculate that the nonsignificant quality of
life improvements in the overall group may be due to the small study
population and the short duration of treatment."

No serious treatment-related adverse events were reported.

Chest 2008;133:1388-1396.
--------------------

"Mannitol significantly improved the health status "

Respirology. 2005 Jan;10(1):46-56. Related Articles, Links

Inhaled mannitol for the treatment of mucociliary dysfunction in
patients with bronchiectasis: Effect on lung function, health status
and sputum.

Daviskas E, Anderson SD, Gomes K, Briffa P, Cochrane B, Chan HK, Young
IH, Rubin BK.

Department of Respiratory Medicine, Royal Prince Alfred Hospital,
Sydney, Australia.

Inhaled mannitol for the treatment of mucociliary dysfunction in
patients with bronchiectasis: Effect on lung function, health status
and sputum
DAVISKAS E, ANDERSON SD, GOMES K, BRIFFA P, COCHRANE B, CHAN H-K,
YOUNG IH, RUBIN BK.
Respirology 2005; 10: 46-56
Objective:
Inhaled mannitol increases mucus clearance in patients with
bronchiectasis by an unclear mechanism. The effect of mannitol on lung
function, health status and sputum properties was investigated.
Methodology: Nine patients with bronchiectasis inhaled 400 mg of
mannitol once daily for 12 days. Health status was assessed using the
St George's Respiratory Questionnaire (SGRQ). Sputum was analysed for
viscosity, elasticity,
spinnability, surface tension, contact angle, solids, mucociliary
transportability (MCTR) on a frog palate, and cough transportability
(CTR) on a simulated cough machine. Results: Lung function was
unchanged with treatment (baseline FEV(1) 82.0 +/- 16.2%) apart from
an improvement in FEF from 85.4 +/- 13% (baseline) to 90.7 +/- 14.4%
(P < 0.05; 12th treatment; visit 7). The total SGRQ score (mean +/-
SD) of 49.3 +/- 13.8 at baseline, decreased by 12.4 +/- 10.2 (P <
0.01; visit 7) and 10.1 +/- 9.4 units (P < 0.02) 6-10 days after
treatment cessation. The baseline subscores for symptoms (72.9 +/-
11.8), activity (44.7 +/- 20.9) and impact (44.4 +/- 14.3) were
reduced by 0.8 +/- 9.1 (P > 0.7), 8.4 +/- 16.0 (P > 0.1) and 19.2 +/-
13.7 (P < 0.005) units, respectively (visit 7). Mannitol reduced the
baseline (mean +/- SE) surface tension from 94.5 +/- 1.4 to 84.7 +/-
2.1 mN/m (P < 0.0001), contact angle from 51.1 +/- 2.8 to 33.2 +/- 2.4
degrees (P < 0.0001), spinnability from 11.6 +/- 0.4 to 10.0 +/- 0.2
mm (P < 0.005), and solids from 5.7 +/- 0.4 to 4.3 +/- 0.7% (P <
0.02), acutely (visit 7). Viscosity, elasticity and MCTR did not
change significantly, while
CTR was increased from 25.8 +/- 1.0 to 34.1 +/- 2.7 mm (P < 0.003).
Conclusion:
Mannitol significantly improved the health status over 12
days and this improvement was maintained for 6-10 days after cessation
of treatment. In addition, mannitol reduced the tenacity, increased
the hydration of mucus acutely and improved cough clearability in
patients with bronchiectasis.

PMID: 15691238 [PubMed - in process]

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http://www.biochemj.org/bj/224/bj2240761.htm

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