title: Using bacterial biomarkers to identify early indicators of cystic fibrosis pulmonary exacerbation onset.
abstract: Acute periods of pulmonary exacerbation are the single most important cause of morbidity in cystic fibrosis patients, and may be associated with a loss of lung function. Intervening prior to the onset of a substantially increased inflammatory response may limit the associated damage to the airways. While a number of biomarker assays based on inflammatory markers have been developed, providing useful and important measures of disease during these periods, such factors are typically only elevated once the process of exacerbation has been initiated. Identifying biomarkers that can predict the onset of pulmonary exacerbation at an early stage would provide an opportunity to intervene before the establishment of a substantial immune response, with major implications for the advancement of cystic fibrosis care. The precise triggers of pulmonary exacerbation remain to be determined; however, the majority of models relate to the activity of microbes present in the patient's lower airways of cystic fibrosis. Advances in diagnostic microbiology now allow for the examination of these complex systems at a level likely to identify factors on which biomarker assays can be based. In this article, we discuss key considerations in the design and testing of assays that could predict pulmonary exacerbations.
authors.affiliation: Molecular Microbiology Research Laboratory, Pharmaceutical Science Division, 150 Stamford Street, Franklin-Wilkins Building, King's College London, London, SE1 9NH, UK.
authors.forename: Geraint B
authors.initials: GB
authors.lastname: Rogers
authors.forename: Lucas R
authors.initials: LR
authors.lastname: Hoffman
authors.forename: Matt W
authors.initials: MW
authors.lastname: Johnson
authors.forename: Nicole
authors.initials: N
authors.lastname: Mayer-Hamblett
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schwarze
authors.forename: Mary P
authors.initials: MP
authors.lastname: Carroll
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Bruce
mesh_terms: D001419:Bacteria / Q000737:chemistry*; D001424:Bacterial Infections / Q000175:diagnosis / Q000503:physiopathology; D015415:Biomarkers; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000382:microbiology* / Q000503:physiopathology*; D006801:Humans; D012129:Respiratory Function Tests
chemical_list: D015415:Biomarkers