Aerosol therapy is often the preferred route of administration for medications to treat airway disease (1). Cystic fibrosis (CF) has as its hallmarks, chronic airway infection, inflammation, and sputum retention. This is thought to be due to abnormal ion transport cause by defective the CF transmembrane conductance regulator (CFTR/ABCC7) and epithelial sodium channel that are responsible for chloride, bicarbonate, and sodium transport across the apical (air) side of the airway epithelium. This leads to isoosmolar volume loss of the periciliary fluid with poor secretion clearance and inability to effectively clear bacterial infection with chronic infection, biofilm formation, and hyper inflammation as a result (2).
Since first described in the 1940’s, many aerosol therapies have been tried for CF. Some, such as high humidity through mist tents, have been stunning failures due to therapeutic ineffectiveness coupled with an increased risk of bacterial colonization of the mist tent; other aerosol therapies have been dramatically successful and transformed the prognosis of CF lung disease. I review here, commonly used aerosol therapies for CF therapy, delivery systems that are used, the order of aerosol delivery and the future of aerosol therapy in CF.