Aerosolized Recombinant Human Deoxyribonuclease I in the Treatment of Cystic Fibrosis

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Abstract
The preliminary report by Hubbard et al. (March 19 issue)1 on the use of aerosolized recombinant human deoxyribonuclease I (rhDNase) in the treatment of cystic fibrosis is intriguing, but the authors appear to have concluded that rhDNase reduced sputum viscoelasticity in vivo without support from the data. It has been demonstrated that sputum from patients with cystic fibrosis is equally or less viscoelastic than sputum from patients with chronic bronchitis or dogs that have undergone tracheostomy.2 3 4 5 A reference cited by the authors to support the contention that sputum in cystic fibrosis is hyperviscous because of its DNA content6 actually states, "Although purified DNA solutions are known to have high levels of viscosity and elasticity the DNA present in sputum seems to have little effect on either viscosity or elasticity." Although purulent sputum from patients with cystic fibrosis had a high DNA content, it was less viscous than mucoid secretions from patients with the disease that had lower DNA content.6