Enzymatic Dissolution of Pulmonary Secretions

Abstract

Viscid tracheobronchial secretions are the main cause of morbidity in cystic fibrosis of the pancreas.¹Proteolytic enzyme therapy has been employed only sporadically for thinning these secretions,^2-5but some clinicians have not been impressed by its effectiveness.^4,5It is conceivable that the increased levels of circulating trypsin inhibitor found in these children^6,7may affect the use of these enzymes and perhaps result in an inadequate therapeutic trial. More recently, deoxyribonuclease (DNase) has been found to have beneficial effects upon the secretions both in vitro⁸and clinically.⁵It would appear that studies of the enzymatic dissolution of the respiratory secretions in cystic fibrosis would be of interest, not only from a clinical point of view, but as an aid in understanding the factors responsible for the high viscosity of the mucous secretions. During my initial studies with pulmonary secretions obtained from children with cystic fibrosis