title: The relationship of systemic inflammation to prior hospitalization in adult patients with cystic fibrosis.
abstract: BACKGROUND
  In cystic fibrosis (CF) patients, it has been suggested that systemic inflammation may be an important risk factor for poor health outcomes. The relationship of plasma inflammatory biomarkers to lung function and hospitalization history remains largely unexplored.
  
  
  METHODS
  This cross-sectional study included 58 consecutive, clinically stable adults from the CF Clinic at St. Paul's Hospital (Vancouver, Canada). Blood levels of interleukin (IL)-6, IL-1β, C-reactive protein (CRP), interleukin (IL)-6, IL-1β, granzyme B (GzmB), chemokine C-C motif ligand 18 (CCL18/PARC), surfactant protein D (SP-D), lipopolysaccharide (LPS)-binding protein, and soluble cluster of differentiation 14 (sCD14) were measured using enzyme-linked immunosorbent assays, and LPS levels were measured using a Limulus amebocyte lysate assay. Spirometry was also performed. Multivariable linear regression analysis was used to assess relationships of the blood biomarkers to lung function.
  
  
  RESULTS
  Lung function impairment was independently associated with elevated plasma levels of CRP (P < 0.01), IL-6 (P = 0.04), IL-1β (P < 0.01), and LBP (P < 0.01). Increasing age (P < 0.01), reduced body mass index (P = 0.02), prior hospitalizations (P = 0.03), and presence of Pseudomonas aeruginosa in sputum cultures (P < 0.01) were also associated with reduced lung function. Elevated concentrations of LPS in plasma were associated with a previous history of hospitalization (P < 0.05). There was a trend towards an increase in plasma IL-6 (P = 0.07) and IL-1β (P = 0.06) levels in patients who were previously hospitalized.
  
  
  CONCLUSIONS
  IL-6 and IL-1β are promising systemic biomarkers for lung function impairment and history of hospitalization in adult patients with CF.
authors.affiliation: UBC James Hogg Research Centre, Institute for Heart + Lung Health at St, Paul's Hospital and Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Ngan
authors.forename: Pearce G
authors.initials: PG
authors.lastname: Wilcox
authors.forename: May
authors.initials: M
authors.lastname: Aldaabil
authors.forename: Yuexin
authors.initials: Y
authors.lastname: Li
authors.forename: Jonathon A
authors.initials: JA
authors.lastname: Leipsic
authors.forename: Don D
authors.initials: DD
authors.lastname: Sin
authors.forename: S F Paul
authors.initials: SF
authors.lastname: Man
mesh_terms: D000209:Acute-Phase Proteins; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002352:Carrier Proteins / Q000097:blood; D019742:Chemokines, CC / Q000097:blood; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000097:blood*; D005260:Female; D053804:Granzymes / Q000097:blood; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000097:blood; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood; D012307:Risk Factors; D013147:Spirometry; D013183:Sputum / Q000382:microbiology; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002097:C-Reactive Protein; D002352:Carrier Proteins; D019742:Chemokines, CC; D053804:Granzymes; D053583:Interleukin-1beta; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D037663:Pulmonary Surfactant-Associated Protein D; D000099231:Lipopolysaccharide-Binding Protein; C111792:CCL18 protein, human