Inflammatory markers in cystic fibrosis

Area of Science:

• Biochemistry
• Immunology
• Pulmonology

Background:

• Cystic fibrosis (CF) is characterized by chronic pulmonary inflammation.
• Pseudomonas aeruginosa infection is common in CF patients and exacerbates inflammation.
• Biomarkers of inflammation require evaluation for monitoring CF patients.

Purpose of the Study:

• To assess plasma concentrations of neutrophil elastase-alpha 1 antiproteinase complex, lactoferrin, and C-reactive protein (CRP) in CF patients.
• To investigate the relationship between these inflammatory markers and clinical status, infection, and lung function.
• To evaluate the impact of antibiotic treatments on inflammatory markers in CF.

Main Methods:

• Longitudinal study over 15 months in 26 CF patients (21 with chronic P. aeruginosa infection).
• Measurement of plasma neutrophil elastase-alpha 1 antiproteinase complex, lactoferrin, and CRP.
• Review of antibiotic treatment courses (intravenous and oral ciprofloxacin) and clinical data.

Main Results:

• Elevated median concentrations of neutrophil products and CRP in stable CF patients compared to healthy controls.
• Further CRP increase during symptomatic exacerbations.
• Both IV antibiotics and oral ciprofloxacin improved clinical scores and lung function.
• IV antibiotics reduced neutrophil products and CRP; oral ciprofloxacin reduced neutrophil elastase-alpha 1 antiproteinase complex only.
• Higher inflammatory marker levels during exacerbations with fever and leukocytosis.
• Negative correlation between lung function and CRP/lactoferrin; positive correlation among inflammatory markers.

Conclusions:

• Neutrophil granule products and CRP reflect the pulmonary inflammatory state in cystic fibrosis.
• These markers may be valuable for monitoring treatment efficacy and disease activity in CF.
• Antibiotic choice influences the reduction of specific inflammatory markers.