title: Inflammatory and immunological biomarkers are not related to survival in adults with Cystic Fibrosis.
abstract: BACKGROUND
  Chronic Pseudomonas aeruginosa pulmonary infection is associated with a decline in lung function and reduced survival in people with Cystic Fibrosis (CF). Damaging inflammatory and immunological mediators released in the lungs can be used as markers of chronic infection, inflammation and lung tissue damage.
  
  
  METHODS
  Clinical samples were collected from CF patients and healthy controls. Serum IgG and IgA anti-Pseudomonas antibodies, sputum IL-8 and TNFα, plasma IL-6 and urine TNFr1 were measured by ELISA. Sputum neutrophil elastase (NE), cathepsin S and cathepsin B were measured by spectrophotometric and fluorogenic assays. The relationship between IgG and IgA, inflammatory mediators and long-term survival was determined.
  
  
  RESULTS
  IgG and IL-6 positively correlated with mortality. However, multivariate analysis demonstrated that after adjusting for FEV(1), IgG was not independently related to mortality. A relationship was observed between IgG and IL-6, TNFα, TNFr1 and between IgA and IL8, cathepsin S and cathepsin B.
  
  
  CONCLUSIONS
  These data indicate that biomarkers of inflammation are not independent predictors of survival in people with CF.
authors.affiliation: School of Pharmacy, Queen's University Belfast, United Kingdom.
authors.forename: K L
authors.initials: KL
authors.lastname: Moffitt
authors.affiliation: School of Pharmacy, Queen's University Belfast, United Kingdom.
authors.forename: S L
authors.initials: SL
authors.lastname: Martin
authors.affiliation: Manchester Adult CF Centre, South Manchester University Hospitals NHS Trust, Manchester, United Kingdom.
authors.forename: A M
authors.initials: AM
authors.lastname: Jones
authors.affiliation: Manchester Adult CF Centre, South Manchester University Hospitals NHS Trust, Manchester, United Kingdom.
authors.forename: A K
authors.initials: AK
authors.lastname: Webb
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Cardwell
authors.affiliation: School of Pharmacy, Queen's University Belfast, United Kingdom.
authors.forename: M M
authors.initials: MM
authors.lastname: Tunney
authors.affiliation: Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom. Electronic address: s.elborn@qub.ac.uk.
authors.forename: J S
authors.initials: JS
authors.lastname: Elborn
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D015415:Biomarkers / Q000378:metabolism; D002401:Cathepsin B / Q000378:metabolism; D002403:Cathepsins / Q000378:metabolism; D003550:Cystic Fibrosis / Q000276:immunology* / Q000382:microbiology / Q000401:mortality*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000378:metabolism; D053208:Kaplan-Meier Estimate; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D015999:Multivariate Analysis; D011552:Pseudomonas Infections / Q000276:immunology* / Q000401:mortality*; D011550:Pseudomonas aeruginosa / Q000276:immunology*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000652:urine; D013183:Sputum / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D015850:Interleukin-6; D016209:Interleukin-8; D047888:Receptors, Tumor Necrosis Factor, Type I; D014409:Tumor Necrosis Factor-alpha; D002403:Cathepsins; D019272:Leukocyte Elastase; C533912:CTSB protein, human; D002401:Cathepsin B; C028217:cathepsin S
keywords: Antibody titre; Cystic Fibrosis; Inflammation; Mortality; Proteases; Pseudomonas aeruginosa