01224nas a2200157 4500000000100000008004100001653002400042653001200066100001600078700001100094245004800105300001100153490000600164050000600170520089000176 2007 d10aPeer Reviewed Paper10aChecked1 aElkins Mark1 aBye P.00aOther mucoactive agents for cystic fibrosis a30-39.0 v8 aN3 a

This review examines specific mucoactive agents from three classes: expectorants, which add water to the airway; ion-transport modifiers, which promote ion and water transport across the epithelium of the airway; and mucokinetics, which improve cough-mediated clearance by increasing airflow or reducing sputum adhesivity. The agents are isotonic and hypertonic saline, mannitol, denufosol and b-agonists. Our understanding of these agents has recently improved through pre-clinical research, clinical trials and, in particular, extensive research into the nature of the liquid lining the surface of the airway, both in health and in cystic fibrosis (CF). For each agent, recent research is reviewed, highlighting the evidence for possible mechanisms of action and for clinical efficacy in CF, as well as the implications for the optimal clinical application of the agent.