Safety evaluation of sinus surfactant solution on respiratory cilia function

Background: A common complaint of chronic rhinosinusitis (CRS) is thickened inspissated nasal secretions and concomitant postnasal drip. Recently, the use of diluted, baby shampoo demonstrated modest improvement in these complaints. Removal of hair-specific ingredients, such as thickeners and fragrances, and addition of a humectant and optimization of mucoactive ingredients generated a topical surfactant solution designed for sinonasal use. This study evaluates the safety of this solution on respiratory cilia function. Methods: Murine nasal explants as well as murine nasal air-liquid interface cultures were tested. Using high-speed video microscopy, baseline ciliary beat frequency (CBF) was established, followed by addition of the surfactant solution. CBF was recorded every 30 seconds for 15 minutes. Results: Sinonasal surfactant solution diluted in bicarbonate buffered saline resulted in a transient increase of CBF in murine explants and mature epithelial cultures with no evidence of toxicity on respiratory cilia over the 15 minutes. Conclusion: Respiratory mucosal explants and air-liquid interface cultures demonstrate robust ciliary beating and represent 2 model systems for screening topical agents for ciliotoxicity. In both systems, application of a novel sinonasal surfactant solution diluted in bicarbonate buffered saline was not ciliotoxic to respiratory epithelium over a 15-minute period.