Slide 1: Hypertonic saline, now a staple of cystic fibrosis therapy, was discovered incidentally by which athletes?

Slide 2: Surfers!

Slide 3: In the early 2000s, Peter Bye, a pulmonologist in Australia, noticed that his cystic fibrosis (CF) patients who surfed reported improved dyspnea. This led to the hypothesis that inhaled saltwater may counteract the disease process in CF, loosening up thick mucus by drawing water into the airways osmotically.

Slide 4: In 2006, two landmark trials were published in NEJM. In these trials, hypertonic saline improved mucus clearance, FEV1, FVC, and rates of pulmonary exacerbations in CF. Ever since, hypertonic saline has been a mainstay of CF therapy.


  • Surfers Inspire Cystic Fibrosis Therapy. The Sydney Morning Herald. Published November 29, 2005. Link.
  • Donaldson SH, Bennett WD, Zeman KL, Knowles MR, Tarran R, Boucher RC. Mucus clearance and lung function in cystic fibrosis with hypertonic saline. N Engl J Med. 2006;354(3):241-50. PMID 16421365 .
  • Elkins MR, Robinson M, Rose BR, et al. A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis. N Engl J Med. 2006;354(3):229-40. PMID 16421364.

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