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Inflammation, infection, and pulmonary function in infants and young children with cystic fibrosis

Carolyn J Dakin1, Andrew H Numa, He Wang

  • 1Department of Respiratory Medicine and Intensive Care Unit, Sydney Children's Hospital, Sydney, New South Wales, Australia. CarolynD@adhb.govt.nz

American Journal of Respiratory and Critical Care Medicine
|April 6, 2002
PubMed

Insights

Lower airway infections in cystic fibrosis (CF) infants and children are linked to inflammation and impaired lung function. Early detection of pathogens in bronchoalveolar lavage (BAL) is crucial for managing CF progression.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Cystic Fibrosis Research

Background:

  • Lower airway infections are a significant concern in pediatric cystic fibrosis (CF).
  • Assessing the impact of these infections on clinical parameters and lung function in young CF patients is essential for early intervention.

Purpose of the Study:

  • To investigate the effects of lower airway infection on clinical status, pulmonary function, and inflammation in clinically stable infants and young children with CF.
  • To identify risk factors associated with lower airway pathogens in this population.

Main Methods:

  • Prospective cohort study of 22 CF patients under 4 years old.
  • Utilized elective anesthesia and intubation for passive respiratory mechanics, lung volumes (nitrogen washout), and bronchoalveolar lavage (BAL).
  • BAL analysis included cytology, interleukin-8 (IL-8) levels, and quantitative microbiology.

Main Results:

  • Lower respiratory pathogens were detected in 14 out of 22 subjects.
  • Higher pathogen levels in BAL correlated significantly with increased neutrophils (78% variability) and IL-8 levels (34% variability).
  • Pathogen load was associated with reduced respiratory system compliance and altered lung volumes (functional residual capacity/total lung capacity ratio).

Conclusions:

  • The presence of pathogens in the lower airways of young CF patients is associated with increased inflammation.
  • Lower airway infections correlate with impaired pulmonary function, including reduced respiratory system compliance and air trapping.
  • Prior respiratory admissions, asthma history, and chronic symptoms like wheezing increase the risk of lower airway pathogens in CF.

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