Early pulmonary inflammation in infants with cystic fibrosis.
Early pulmonary inflammation in infants with cystic fibrosis.
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囊性纤维化婴儿的早期肺部炎症。
DOI：
10.1164/ajrccm/151.4.1075
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Riches,DW
中科院分区：
文献类型：
--
作者：
Khan,TZ;Wagener,JS;Bost,T;Martinez,J;Accurso,FJ;Riches,DW
囊性纤维化（CF）中肺部疾病和早期呼吸道疾病的发病机制尚不清楚。通过全州新生儿筛查项目确定CF患儿，我们调查了这些患儿是否存在气道炎症，目的是进一步了解这种肺部疾病的早期事件。对16例CF患儿（平均年龄6个月）和11例疾病对照患儿（平均年龄12个月）的支气管肺泡灌洗液（BALF）进行了以下炎症参数检查：(1)中性粒细胞计数；(2)游离中性粒细胞弹性酶活性；(3)弹性酶/ α 1-抗蛋白酶抑制剂复合物；(4)白细胞介素-8 （IL-8）水平。我们还量化了IL-8 mRNA转录物在气道巨噬细胞中的自发表达水平。CF患儿BALF中气道炎症各指标均较对照组升高。此外，在支气管肺泡灌洗（BAL）时，对常见细菌性CF相关病原体以及常见呼吸道病毒和真菌进行阴性培养（n = 7）的CF婴儿中，中性粒细胞数量和IL-8水平均升高。这些发现表明，在4周大的CF婴儿中，气道炎症已经存在。此外，尽管许多不同类型的细胞（如上皮细胞）可能表达IL-8，但气道巨噬细胞似乎是这种趋化因子的来源，因此可能在早期中性粒细胞流入肺中发挥重要作用。
The mechanisms underlying the initiation of lung disease and early respiratory morbidity in cystic fibrosis (CF) are poorly understood. By identifying infants with CF through a statewide neonatal screening program, we investigated whether airway inflammation was present in these infants, with the goal of furthering our understanding of the early events in this lung disease. Bronchoalveolar lavage fluid (BALF) from 16 infants with CF (mean age, 6 mo) and 11 disease control infants (mean age, 12 mo) was examined for the following inflammatory parameters: (1) neutrophil count; (2) activity of free neutrophil elastase; (3) elastase/alpha 1-antiprotease inhibitor complexes; and (4) the level of interleukin-8 (IL-8). We also quantified the spontaneous level of expression of IL-8 mRNA transcripts by airway macrophages. Each index of airway inflammation was increased in the BALF of infants with CF as compared with control infants. In addition, both the number of neutrophils and IL-8 levels were increased in infants with CF who had negative cultures (n = 7) for common bacterial CF-related pathogens, as well as for common respiratory viruses and fungi at the time of bronchoalveolar lavage (BAL). These findings suggest that airway inflammation is already present in infants with CF who are as young as 4 wks. Furthermore, although many different cell types (e.g., epithelial cells) may express IL-8, airway macrophages appear to be a source of this chemokine, and may thus play a prominent role in early neutrophil influx into the lung.