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Wetenschappelijke studie Aerosal


VS Dr. Marco Salvadori

VS Dr. David Ruggeri


A decisive moment in the evolution of man was the passage from a state of hunter-gatherers to that of breeders-gatherers. About 10.000 years ago, man began having to preserve foodstuffs and, since then, salt became of vital importance: for thousands of years, it changed the history of human kind.

The famous salt roads, monopolized by the Roman Empire, were those the most ancient civilizations traveled for the supply of salt, which was then used for preserving meat and fish, for the production of cheese and sausages and for the processing of hides.

Salt was produced by the crystallization of marine water or by the extraction from rock salt deposits.

The salt roads allowed commercial exchange among the populations that brought weapons, wool and other products from the plains to the sea, receiving salt in exchange. The importance of this mineral often caused wars. The origin of salt-free bread, typical of some central Italian regions, such as Umbria, is to be found in the salt war between the Papal State and the citizens of Perugia who, in response to the increase in tax on salt, began to produce unsalted bread, with the aim of boycotting Rome.

The fact that salt was a precious good and also considered therapeutic is demonstrated by the name of the pay that Roman soldiers received on payday: 'salario’ (salary). Moreover, words of Latin origin related to health are salubritas (health care) and salus (health), whose root is sal (salt).

Salt was first used as a therapeutic practice during the Greek civilization. The school of Hippocrates used it together with vinegar and water as an emetic, an expectorant (through the inhalation of salted vaporized water) and for skin care practices.

The marine thermal cures of the Roman period are witnessed by the presence of curative centers along the Mediterranean coasts.

However, not before the first half of the 19th century did the first scientific observations on the effects of the salt take place. Felix Boczkowsky observed and reported that salt mine workers had a significantly reduced incidence of respiratory tract diseases. At the end of World War II, German doctor Hermann Spannagel hospitalized patients suffering from respiratory diseases in proper salt caves formed in a rock salt mine and observed the beneficial effects of their exposure to a saline environment.



The human medicine has long studied the effects of thermal waters. The most common are those containing sulfur and those containing sodium chloride, iodine and bromine. The latter have been claimed to have specific therapeutic properties by numerous scientific studies. The ACTA magazine, in vol. 7 of December 2013, reports an immunocompetent action in the respiratory tract, together with an increase of secretory IgA in the mucosal film, a eutrophic and decongestant action thanks to the effect of sodium chloride, which promotes the oozing from the gap to the mucosal surface with a reduction of the viscosity of the mucus secreted, while restoring the ciliary mucus clearance. The activity of the cilia would increase by 400 b.p.m. for effect of the electronegativity of the sodium chloride. An antiseptic and bacteriostatic action is also reported, thanks to the effect of iodine. Sodium chloride would instead promote osmotic lysis of microorganisms. Finally, a neurovegetative action has also been detected, which, thanks to iodine, promotes the modulation of the thyroid activity.

Numerous researches and studies on the effects of sodium chloride have demonstrated its therapeutic effects, in particular for the respiratory and dermatological diseases.

Studies carried out by Abdullaev et al (1993), Chervinskaya et al (1995), Chernenkov et al (1997) and Maev et al (1999) showed the beneficial effects of halotherapy on children suffering from asthma and on adults suffering from COPD (Chronic Obstructive Pulmonary Disease).

Hedman et al observed, after halotherapy, a significant reduction of the bronchial hyperactivity. However, no reduction of eosinophils and mast cells in the bronchoalveolar lavage.

Finally, human medicine has long demonstrated the therapeutic effects of halotherapy in atopic dermatitis.



The purpose of this study is to assess the effectiveness of aerosal® for the treatment of pathologies affecting sport horses’ respiratory tracts. The stress induced by agonistic activity and constant performance improvement, selection, increasingly specific and intense training, together with the particular physiology of the horse's cardio-respiratory system, have significantly increased the onset of inflammations in the respiratory tracts. Particular attention was paid to the inflammatory process that is most often the cause for poor performance. Together with the skeletal muscle pathologies, lower respiratory tract inflammation (IAD Inflammatory Airway Disease) is the main cause for performance loss. Hence, it represents a significant performance-related damage, which also affects the economy of the horse industry. The anti-inflammatory corticosteroid and antimicrobial therapies, included in the therapeutic protocols, improve the airways conditions. However, at the end of the therapeutic cycle, they need further maintenance therapies. Directly upon performance, the possibility to use therapies which cannot be detected as doping, could be a happy therapeutic and managerial solution.

In the study, attention was also paid to chronic obstructive pathologies, whose subjects would require consistent therapeutic treatments. The possibility to use halotherapy on these animals could reduce the need to administer corticosteroids, thus reducing the side effects and the rise of the inevitable long-term ones.



Experimental protocol

The clinical study was performed on twenty-six subjects aged between 2 and 16. Eighteen trotters and eight competition horses were subjected to a general examination, an arterial blood gas test, a cardiovascular apparatus check-up, a clinical test of the respiratory tract, a cytological examination of the bronchial alveolar irrigation and a microbiological examination of the tracheal suction. After a month of treatment with aerosal®, the subjects were again subjected to all of the clinical investigations performed upon the preliminary test.

The general test examined the following: Body temperature, status of the examinable lymph nodes, heart rate, time of capillary refill, respiratory rate and information on the nutritional state.

The arterial blood gas test was carried out by taking arterial blood from the carotid artery with a 2.5 ml syringe heparinized beforehand. Immediately after the blood was taken, and after a body temperature correction, it was analyzed with Vetstat Ideex®. The useful data detected for the purpose of research are the partial pressure of carbon dioxide (paCO2), the pH and oxygen partial pressure (PaO2).

The clinical examination of the respiratory tract examined the following: the inhaling and exhaling amplitude (normal; reduced), the frequency (acts/min), the speed (normal; increased), the murmur (normal; inspiratory crackling; hypophonic; expiratory crackling), an endoscopic examination with an assessment of the nasopharynx, of the examinable mucous membranes, presence of exudate, the condition of the inter-bronchial septum and of the examinable bronchi.

After the endoscopic examination of the airways, a bronchial alveolar irrigation was performed with a MILA® sterile catheter, which was slid slowly into the ventral meatus of the nasal cavity until it was possible to observe the horse’s swallowing attempts upon arrival in the trachea and once the bronchial septum was surpassed the catheter was also pushed further until the diameter became equal to that of the penetrated bronco and subsequently, the cuff was insufflated with 5 ml of air.

Two hundred milliliters of a 0.9% sterile sodium chloride solution were instilled through the catheter and after 30” the aspiration of the bronchial alveolar irrigation began. The sample was preserved in EDTA (ethylenediaminetetraacetic acid) and then, within a few hours, processed by the cytologist.

Via a trans-endoscopy, a sample was taken from the third medium of the trachea with a sterile Olympus® catheter, for a microbiological analysis.

Between the entry examination and the check, all twenty-six horses were subjected to a treatment with aerosal® in a properly equipped stall, 30 minutes a day for 30 days.


The stall used is a normal stable stall with no litter, sealed in such a way as to allow the air to maintain the desired concentration of micronized salt on which exterior, on one of its walls, dry saline dispenser is applied. Inside of it is a standard quantity of NaCl, whose micronized salt is inhaled inside the stall through a PVC connector. The size of the micronized salt particles is comprised between 0.23 µm and 20 µm. Such data was detected with laser spectrometer for powders - model 1.109 with GRIMM® technology. The concentration of the particles (350-500 µg/mc) is maintained constant for the whole duration of the treatment through an electronic control system that alternates delivery and pause periods. The salt introduced in the dispenser is micronized vacuum, packed and sealed in special rooms to prevent bacterial contamination by Tecnosun® Italy. Each sachet is composed of 150g of NaCl, of which 75g of RG salt (reagent grade) in micronized form and 75g of ESCO iodized non-micronized salt, which stabilizes the salt inside the dose and integrates it with iodine in order to simulate the marine environment.



While waiting to publish statistical information at the meeting scheduled in March 2014, we observed very comforting results. From a clinical point of view, a significant improvement in the breathing characteristics and in the endoscopic reliefs was detected. The inspiratory crackling, detectable in many horses upon the entry check-up, was no longer audible in most of the horses, after the treatment. The concentration of exudate detected in the trachea upon the entry check-up was reduced in almost all of the subjects. In 25% of these it was no longer observable. In the race horses’ group, an improvement in performance was also observed. From an initial examination, the cytological examination of the bronchial alveolar irrigation after treatment showed a significant reduction of the inflammation cells in almost all of the subjects; this was much more evident in horses which usually jump obstacles, which in addition have shown a greater clinical response. Probably the smaller ''respiratory stress'' to which these subjects are subjected (lower intensity trainings) makes the therapeutic response more evident. Pending the statistical analysis of the data relating to the cytological evaluation of Bal, we can consider that the response to the treatment was overall positive. In addition to the clinical findings, we should also emphasize the satisfaction of the coaches and the riders of the examined horses for the clinical response, the practicality of execution and the absence of employment of staff to carry out the treatment.


DR MARCO Salvadori

Veterinary Surgeon MI 2656

18, via Belluno - 20132 MILANO

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