OPP5 EFFICACY OF NEBULISED HYPERTONIC SALINE IN CHILDREN WITH NON-CYSTIC FIBROSIS BRONCHIECTASIS

Quraisiah Adam1, Cindy Shuan Ju Teh1, Jessie Anne de Bruyne2, Kah Peng Eg1, Chun Wie Chong3, Rafdzah Ahmad Zaki1, Siti Hajar Tubirin2, Anis Najwa Muhamad1, Yee Qing Lee1, Anna Marie Nathan1
1University of Malaya, Kuala Lumpur, Malaysia
2University of Malaya Medical Centre, Kuala Lumpur, Malaysia
3Monash University, Kuala Lumpur, Malaysia

INTRODUCTION:

Non-Cystic Fibrosis Bronchiectasis (NCFBE) in children has limited treatment options. Inhaled hypertonic saline (HS) may reduce mucus viscosity, increase mucus transportability, and potentially reduce bacterial carriage, leading to improved health.

OBJECTIVE:

To assess the efficacy of nebulized 5% hypertonic saline (HS) on the quality of life, respiratory health, and lung microbiome, in children with NCFBE

METHODS:

In this double-blind, randomized, placebo-controlled study, symptomatic children with NCFBE were assigned to either inhaled 5% HS or 0.9% isotonic saline (IS) twice daily for 12 weeks. Assessments pre- and post-treatments were evaluated: Parent-proxy Cough Quality of Life (PCQoL) questionnaire, spirometry, respiratory exacerbations, cough severity. DNA from nasopharyngeal (NP) swabs, pre- and post-treatment were analyzed using 16S rRNA gene sequencing. The difference in the bacterial communities from NP samples were assessed using alpha and beta diversity

Forty-six children participated, with 22 in the HS group and 24 in the IS group. Cough quality (p=0.026) and PCQoL scores (p=0.002) significantly improved only in the HS group. No improvement in spirometry or exacerbation rates were observed. The HS group showed significant changes in microbial composition, with increased evenness (P=0.044) but no change in alpha diversity. Beta diversity showed significant differences in microbial community composition within the HS group only: Bray-Curtis dissimilarity (R²=0.054, P=0.02) and Centered Log-Ratio (CLR) transformations (R²=0.020, P=0.001). As for bacterial communities, Firmicutes and Proteobacteria were the predominant phyla post-treatment in both groups. Streptococcus and Staphylococcus abundance were reduced significantly in both post-treatment groups. Dolosigranulum, Corynebacterium, and Moraxella abundance increased significantly (post-treatment) only in the IS group. There were no significant changes in Hemophilus and Neisseria in both groups post-treatment.

CONCLUSION:

This study showed that HS improved respiratory health and QoL and balanced the microbial community in patients with NCFBE.