Effects of Ionized Waterfall Aerosol on Pediatric Allergic Asthma

Abstract

Objective. Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effect was evaluated in a randomized controlled clinical trial as part of a summer asthma camp. Methods. Asthmatic allergic children (n = 54) spent 3 weeks in an alpine asthma camp; half of the group was exposed to water aerosol of an alpine waterfall for 1 hour per day, whereas the other half spent the same time at a “control site”. Immunological analysis, lung function testing, and fractional exhaled nitric oxide (FeNO) testing were performed during the stay, and sustaining effects were evaluated 2 months later. Symptom score testing was done over a period of 140 days. Results. The water aerosol group showed a significant improvement in all lung function parameters, whereas only the peak expiratory flow improved in the control group. All patients showed a significant improvement in symptom score and a significant decrease in FeNO after the camp. Only the water aerosol group exhibited a long-lasting effect on asthma symptoms, lung function, and inflammation in the follow-up examination. Induction of interleukin (IL)-10 and regulatory T (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group. Conclusions. Our findings confirm the induction of Treg cells and reduction in inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long-lasting beneficial effect on asthma symptoms, lung function, and airway inflammation.

Martin Gaisberger and Renata Šanović as well as Markus Ritter and Arnulf Hartl contributed equally to this work.

• allergic asthma
• FeNO
• high altitude
• ionized water aerosol
• lung inflammation
• Treg cells
• waterfall

Acknowledgements

We want to thank General Director Dr. Christian Heu, Grossglockner Hochalpenstrassen AG, Editor-in-Chief Hans Kutil, and Dr. Roland Drexler for their important input and discussion. We also want to thank Dr. Waltraud Eder, Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Austria, and Dr. Josef Riedler from the Kardinal Schwarzenberg Hospital, Schwarzach/St. Veit, Austria, for their valuable input and scientific discussion. This work was funded by the Oesterreichische Forschungsfoerderungsgesellschaft FFG, KNet Water Project 223.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes

Martin Gaisberger and Renata Šanović as well as Markus Ritter and Arnulf Hartl contributed equally to this work.