Intestinal inflammation in cystic fibrosis.
BACKGROUND
There is controversy about whether the inflammatory response observed in the cystic fibrosis (CF) lung occurs secondary to bacterial infection or is caused by a dysregulation of the inflammatory response associated with the basic cellular defect of CF.


OBJECTIVE
To study the inflammatory response in the gastrointestinal tract of children with CF; and to investigate whether there is increased inflammation in the gastrointestinal tract of CF children with fibrosing colonopathy.


METHODS
Whole gut lavage was performed on 21 pancreatic insufficient children with CF, who were clinically well, five children with CF and fibrosing colonopathy, and 12 controls. Intestinal outputs of plasma derived proteins (albumin, alpha(1) antitrypsin, IgG), secretory immunoglobulins (IgA and IgM), cellular constituents (eosinophil cationic protein and neutrophil elastase), and cytokines (interleukin 8 and interleukin 1beta) were measured.


RESULTS
Compared to controls, the 21 CF patients, with no intestinal complications, had increased intestinal outputs of albumin, IgG, IgM, eosinophil cationic protein, neutrophil elastase, interleukin 1beta, and interleukin 8. Similar values were obtained for the CF patients with fibrosing colonopathy.


CONCLUSIONS
These data suggest that there is immune activation in the gastrointestinal mucosa of children with cystic fibrosis, which may result from the basic cellular defect. Fibrosing colonopathy does not appear to be associated with increased inflammation.
Smyth
R L
RL
University Institute of Child Health, Royal Liverpool Children's Hospital, Liverpool L12 2AP, UK. r.l.smyth@liv.ac.uk
Croft
N M
NM
O'Hea
U
U
Marshall
T G
TG
Ferguson
A
A
D000293:Adolescent; D000418:Albumins / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000276:immunology*; D004760:Enterocolitis / Q000276:immunology*; D004804:Eosinophils / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007223:Infant; D007375:Interleukin-1 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007413:Intestinal Mucosa / Q000276:immunology* / Q000378:metabolism; D019272:Leukocyte Elastase / Q000032:analysis; D014361:Trypsin Inhibitors / Q000032:analysis
D000418:Albumins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007375:Interleukin-1; D016209:Interleukin-8; D014361:Trypsin Inhibitors; D019272:Leukocyte Elastase