PubMed1980
Antihistaminic drugs may interfere with ion and water transport across bronchial epithelium, decreasing the water content of the bronchial mucus and thus adversely affecting mucociliary clearance. A double-blind trial was therefore undertaken to study the short-term effects of ketotifen, a new antiasthmatic drug with antianaphylactic and antihistaminic properties, on the physicochemical properties of sputum in 16 patients with clinically stable chronic reversible airway diseases. The study lasted 5 weeks, during which the patients received 2 mg ketotifen daily for two or three weeks and placebo for the remaining weeks; thus, all patients received both the active drug and a placebo. The patients were evaluated weekly and different measurements, including graded clinical observations, ventilatory tests and blood studies were carried out. Objective sputum measurements included 24-hour volume, dry weight, "apparent" viscosity (at a shear rate of 900 s-1), content of fucose, neuraminic acid, immunoglobulin A and acid mucus glycoprotein fibers. Of the sputum characteristics the daily volume decreased slightly after ketotifen. In contrast, sputum dry weight appeared to increase. The "apparent" viscosity showed a tendency to decrease. Fucose, neuraminic acid and immunoglobulin A content varied slightly, as did the percentage of acid mucus glycoprotein fibers. Since none of the sputum characteristics changed significantly during short-term therapy with ketotifen, this drug probably does not alter either the water content or the mucus biopolymers--both of which are responsible for the flow properties of bronchial mucus--thus presumably leaving mucociliary transport unchanged in patients with chronic reversible airway diseases.