Cystic Fibrosis Clinical Trial
Official title:
Nasal Potential Difference Measurement in Infants
Nasal Potential Difference measurements (NPD) have been performed in Israel since 1996. NPD
measurements are used to assess the voltage across nasal epithelium, which correlates with
the transport of sodium and chloride across cell membranes. NPD was first demonstrated to be
abnormal in Cystic Fibrosis (CF) in 1981 and the technique has since been used to increase
our understanding of this condition. It is now established as an important diagnostic tool
and more recently has been used to assess the effectiveness of new treatments such as gene
and alternative therapy (Knowles 1995; Wilschanski 2003).
The nasal cavity is accessible which makes it a good site to examine the ion transport
characteristics of airway epithelia. Less than a centimetre into the nose the squamous
("skin type") epithelium becomes ciliated pseudocolumnar epithelium, characteristic of the
proximal airways.
The change in NPD with the perfusion of different solutions is demonstrated. By employing
NPD protocols with perfusion of different solutions and drugs, different aspects of the
nasal ion transport characteristics can be examined. In CF, this ion transport profile is
abnormal and the NPD measurement has a number of features that differentiate CF from non-CF.
This methodology is well established for measurements in subjects over 6 years of age.
Measurements on smaller children and infants have been very difficult to perform. We propose
a new method using smaller, single lumen catheters with much lower perfusion rates (0.2
ml/min compared to up to 5 ml/min with the adult method) .Perfusion measurements will be
possible in newly born infants. Obviously this opens up the potential for using NPD as a
diagnostic test in babies. This is important as the diagnosis of CF is often difficult to
make or refute in babies because of the problems in collecting enough sweat. This may be the
ideal diagnostic test for CF in the neonatal nursery in infants with meconium plug syndrome.
n/a
Observational Model: Case-Only, Time Perspective: Prospective
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