Sputum Desmosine During Hospital Admission for Pulmonary Exacerbation in Cystic Fibrosis
Sputum Desmosine During Hospital Admission for Pulmonary Exacerbation in Cystic Fibrosis
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DOI：
10.1378/chest.09-0217
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发表时间：
2009-12-01
期刊：
影响因子：
9.6
通讯作者：
Accurso, Frank J.
中科院分区：
文献类型：
--
作者：
Laguna, Theresa A.;Wagner, Brandie D.;Accurso, Frank J.
背景：囊性纤维化（CF）肺病的特点是气道和实质的结构变化。不存在痰生物标志物来测量 CF 患者肺部恶化期间活性结构破坏的程度。锁链素（弹性蛋白的分解产物）的无创测量可能反映持续的肺损伤，并作为短期损伤的生物标志物。我们的目的是测量住院治疗肺部病情加重的 CF 患者痰液中的锁链素，并探讨锁链素水平与住院后其他临床改善标志物（包括肺功能和炎症、介质）之间的相关性。方法：在住院期间的多个时间点收集痰液和血液样本，并进行肺功能测量。我们使用重复测量模型，根据年龄和测量之间的时间进行调整，比较多个时间点的对数转换痰锁链素水平，并将这些水平与相关变量相关联。结果：通过放射免疫测定法测量了因 26 次肺部恶化住院的 19 名 CF 患者的 71 份痰液样本中的锁链素水平（结果范围，0 至 200 pmol/L，锁链素/mL）。住院第一周期间，痰锁链素水平显着下降 (p = 0.04)。锁链素水平与血浆 C 反应蛋白 (rho = 0.59；p = 0.03)、痰白细胞介素 8 (rho = 0.96；p < 0.01) 和痰中性粒细胞弹性蛋白酶 (rho = 0.78；p < 0.01) 呈正相关。 结论：痰锁链素是急性结构性肺损伤的一种新测量方法，可作为CF 肺部疾病恶化期间发生结构性肺损伤的标志。 （胸部 2009 年；136：1561-1568）
Background: Cystic fibrosis (CF) lung disease is characterized by structural changes in the airways and parenchyma. No sputum biomarker exists to measure the degree of active structural destruction during pulmonary exacerbation in patients with CF. The noninvasive measurement of desmosine, a breakdown product of elastin, may reflect ongoing lung injury and serve as a biomarker of short-term damage. Our objectives were to measure desmosine in the sputum of patients with CF hospitalized for treatment of a pulmonary exacerbation and to explore the correlation between desmosine levels and other markers of clinical improvement, including lung function and inflammatory, mediators, following hospitalization.Methods: Sputum and blood samples collected and lung function measurements were made at multiple time points during hospitalization. We used a repeated measures model, adjusted for age and time between measurements, to compare log-transformed sputum desmosine levels across multiple time points and to correlate those levels with related variables.Results: Desmosine levels were measured by radioimmunoassay in 71 expectorated sputum samples from 19 patients with CF hospitalized for 26 pulmonary exacerbations (range of results, 0 to 200 pmol/L, desmosine/mL). Sputum desmosine levels decreased significantly during the first week of hospitalization (p = 0.04). Desmosine levels were positively associated with plasma C-reactive protein (rho = 0.59; p = 0.03), sputum interleukin-8 (rho = 0.96; p < 0.01), and sputum neutrophil elastase (rho = 0.78; p < 0.01).Conclusions: Sputum desmosine, a novel measure of acute structural lung injury, may serve as a marker of structural lung damage occurring during exacerbations of lung disease in CF. (CHEST 2009; 136:1561-1568)