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Mannitol is a naturally occurring sugar alcohol which is a stable compound with few side-effects and is commonly used as a pharmaceutical excipient and food additive.
Aridol/Osmohale (mannitol dry powder for inhalation) is prepared by spray drying mannitol to produce fine particles of respirable size which are then encapsulated and delivered via a dry powder inhaler.
Following inhalation of Aridol/Osmohale, mannitol is deposited on the airway surface which causes an increase in osmolarity of the airway surface liquid. Water then moves out of the epithelial cells in an attempt to restore balance, causing the epithelial cells to shrink. As the cells attempt to regain their volume, intracellular calcium rises, which is thought to trigger the release of inflammatory mediators such as histamines, prostaglandins and leukotrienes. In sensitive individuals the release of these mediators causes the bronchial smooth muscle to contract and the airways to narrow. This is measured by a fall in FEV1 (Forced Expiratory Volume in one second).
Aridol/Osmohale is an indirect osmotic bronchial challenge test which can be used to identify bronchial hyperresponsiveness, a clinical feature of some respiratory conditions such as asthma.