Early pulmonary infection, inflammation, and clinical outcomes in infants with cystic fibrosis
Early pulmonary infection, inflammation, and clinical outcomes in infants with cystic fibrosis
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DOI：
10.1002/ppul.1144
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发表时间：
2001-11-01
影响因子：
3.1
通讯作者：
Ramsey, BW
中科院分区：
文献类型：
--
作者：
Rosenfeld, M;Gibson, RL;Ramsey, BW
彻底了解囊性纤维化(CF)肺部疾病的早期自然病史对于在最年轻的患者中开发有效的干预措施至关重要。我们通过每年一次的支气管肺泡灌洗(BAL)进行促炎和抗炎细胞因子的培养和测量，每半年一次的婴儿肺功能测试和季度临床评估，评估了40名婴儿在两年时间里肺部感染、炎症和临床病程的演变。无论病原体是否恢复，婴儿有中性粒细胞下呼吸道炎症和升高的IL-8浓度。无论分离的细菌是铜绿假单胞菌还是其他病原体，BAL液中的白细胞总数、中性粒细胞密度和IL-8浓度均随CIF病原体浓度的增加而增加。慢性阻塞性肺病患者和非慢性阻塞性肺病患者的IL-10浓度相似。婴儿通常有不理想的生长(低体重和身高百分位数)和阻塞性肺疾病(呼气流量减少和空气滞留)。在>；10(5)cfu/m L时，分离出CFs病原体的受试者空气滞留情况最差，Brasfield胸片评分最低。我们的研究结果为未来对慢性肺病早期干预的研究提供了基础，包括抗菌和抗炎治疗。(C)2001年Wiley-Liss，Inc.
A thorough understanding of the early natural history of cystic fibrosis (CF) lung disease is critical for the development of effective interventions in the youngest patients. We assessed the evolution of pulmonary infection, inflammation, and clinical course among 40 infants over a 2-year period through annual bronchoalveolar lavage (BAL) for culture and measurements of pro- and anti-inflammatory cytokines, semiannual infant pulmonary function testing, and quarterly clinical evaluations.Both the prevalence of CIF pathogens and their density in BAL fluid increased with age. Infants had neutrophilic lower airway inflammation and elevated IL-8 concentrations independent of whether CF pathogens were recovered. Total leukocyte and neutrophil densities and IL-8 concentrations increased with density of CIF pathogens in BAL fluid, whether the isolated organism was P. aeruginosa or another pathogen. IL-10 concentrations were similar in CF subjects and non-CF historical controls. Infants generally had suboptimal growth (low weight and height percentiles) and obstructive lung disease (decreased expiratory flows and air trapping). Subjects from whom CF pathogens were isolated at > 10(5) cfu/mL had the worst air trapping and lowest Brasfield chest X-ray scores. Our findings provide a foundation for future studies of early intervention in CF lung disease, including antimicrobial and anti-inflammatory therapy. (C) 2001 Wiley-Liss, Inc.