Inflammatory markers in cystic fibrosis patients with lung Pseudomonas aeruginosa infection.
Chronic endobronchial inflammation and bacterial infection are the main causes of morbidity and mortality in cystic fibrosis (CF), an autosomal recessive genetic disorder associated with improper function of chloride channels. Inflammation in CF lung is greatly amplified after Pseudomonas aeruginosa infection. In this study the relationship between P. aeruginosa status and inflammatory markers has been investigated. Seventeen CF children in acute lung exacerbation were examined. CF patients without P. aeruginosa infection were characterized by elevated activity of sputum elastase, reduced response of peripheral blood lymphocytes to PHA and significant resistance to the antiproliferative action of glucocorticoids. These parameters were normalized after antibiotic treatment. The patients with prolonged P. aeruginosa infection demonstrated extremely high levels of elastase activity and elevated amounts of sputum IL-8 and TNF-alpha. Although antibiotic treatment resulted in clinical improvement, it failed to suppress excessive immune response in the lung. The data indicate that CF patients with prolonged P. aeruginosa need the modified treatment, which should include immunomodulating drugs and protease inhibitors as well as antibacterial therapy.
Pukhalsky
A L
AL
Laboratory of Immunogenetics, Research Centre for Medical Genetics, Moscow, Russia.
Kapranov
N I
NI
Kalashnikova
E A
EA
Shmarina
G V
GV
Shabalova
L A
LA
Kokarovtseva
S N
SN
Pukhalskaya
D A
DA
Kashirskaja
N J
NJ
Simonova
O I
OI
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002478:Cells, Cultured; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications* / Q000503:physiopathology; D003907:Dexamethasone / Q000494:pharmacology; D006801:Humans; D007249:Inflammation; D016209:Interleukin-8 / Q000032:analysis; D019272:Leukocyte Elastase / Q000032:analysis; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology; D010835:Phytohemagglutinins; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D011550:Pseudomonas aeruginosa; D013183:Sputum / Q000737:chemistry; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014797:Vital Capacity
D000900:Anti-Bacterial Agents; D016209:Interleukin-8; D010835:Phytohemagglutinins; D014409:Tumor Necrosis Factor-alpha; D003907:Dexamethasone; D019272:Leukocyte Elastase