Sulphurous thermal water inhalation impacts respiratory metabolic parameters in heavy smokers

Cecilia Carubbi, Elena Masselli, Elisa Calabrò, Elisa Bonati, Carlotta Galeone, Roberta Andreoli, Matteo Goldoni, Massimo Corradi, Nicola Sverzellati, Giulia Pozzi, Antonio Banchini, Ugo Pastorino, Marco Vitale

Research output: Contribution to journalArticlepeer-review


Sulphurous thermal water inhalations have been traditionally used in the treatment of airway diseases. In vivo and in vitro studies reported that they ameliorate mucus rheology, mucociliary clearance and reduce inflammation. Cigarette smoking induces an inflammatory damage, with consequent remodeling of respiratory airways, which in turn affect pulmonary functions. Despite the anti-inflammatory effects of H2S are clinically documented in several airway inflammatory diseases, data on the effects of sulphurous thermal water treatment on pulmonary function and biomarkers of airways inflammation in smokers are still scant. Therefore, we investigated whether a conventional cycle of sulphurous thermal water inhalation produced changes in markers of respiratory inflammation and function. A cohort of 504 heavy current and former smokers underwent 10-day cycles of sulphurous thermal water inhalation. Pulmonary function and metabolic analyses on exhaled breath condensate were then performed at day 0 and after the 10-day treatment. Spirometric data did not change after spa therapy, while exhaled breath condensate analysis revealed that a single 10-day cycle of sulphurous water inhalation was sufficient to induce a statistically significant increase of citrulline levels along with a decrease in ornithine levels, thus shifting arginine metabolism towards a reduced nitric oxide production, i.e. an anti-inflammatory profile. Overall, sulphurous thermal water inhalation impacts on arginine catatabolic intermediates of airways cells, shifting their metabolic balance towards a reduction of the inflammatory activity, with potential benefits for smokers.

Original languageEnglish
Pages (from-to)1209-1216
Number of pages8
JournalInternational Journal of Biometeorology
Issue number9
Publication statusPublished - Sep 15 2019


  • Exhaled breath condensate
  • Hydrogen sulphide
  • Nitric oxide
  • Pulmonary function
  • Smoking habit
  • Thermal water therapy

ASJC Scopus subject areas

  • Ecology
  • Atmospheric Science
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'Sulphurous thermal water inhalation impacts respiratory metabolic parameters in heavy smokers'. Together they form a unique fingerprint.

Cite this