Changing the airway pH: is it helping asthma control?

Abstract

Background Although airway hyperacidity may have a great effect in the pathogenesis of asthma, its evaluation may be difficult. This study was conducted at Mansoura University Hospitals aiming to evaluate the degree of asthma control by increasing pH in uncontrolled asthma cases by the use of inhaled NaHCO3 8.4% for 3 months. Patients and methods A total of 100 patients with asthma were included, and they were divided by simple randomization to 75 patients in study group and 25 controls. All participants were subjected to history taking, clinical examination, sputum cell count and pH assessment, PFT, high-resolution computed tomography, and sputum induction and NaHCO3 8.4% inhalation. Evaluation of asthma exacerbation 6 months before and after intervention was carried out. Results There was no significant difference between study and control groups regarding demographic data, all basic investigations, pulmonary function, or sputum total and differential cells. We found a significant increase of sputum pH after treatment in the study group. Furthermore, significant improvement of forced expiratory volume in 1 s, forced vital capacity, four parameters of control assessment, and exacerbation also was seen in the study group after treatment. There was a significant decrease of total cells and eosinophils in sputum in the study group. The linear regression model showed a significant negative correlation for all the studied factors except short-acting beta 2 (SABA) and day symptom improvement. Conclusion We conclude that the decrease of airway acidity by NaHCO3 8.4% leads to significant decrease in inflammatory cells and frequency of exacerbation and improves pulmonary function in poorly controlled bronchial asthma.

Keywords

• airway acidity
• inhalation nahco3
• ph change
• uncontrolled bronchial asthma