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Short-Term Variation of Lung Function and Airway Inflammation in Children and Adolescents with Bronchiolitis

Jonas Eckrich¹, Eva Herrmann², Sandra Voss³

¹Department of Paediatric Pulmonology, Allergy and Cystic Fibrosis, Children's Hospital, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. jonas.eckrich@kgu.de.

|June 22, 2016

Insights

Bronchiolitis obliterans (BO) patients exhibit low short-term variation in lung function and sputum neutrophilia. This stability is crucial for assessing individual treatment success and establishing future study endpoints in BO research.

Area of Science:

Pulmonology
Immunology
Medical Research

Background:

Bronchiolitis obliterans (BO) remains under-researched regarding lung function and inflammatory markers.
Short-term fluctuations in these parameters for BO patients have not been previously investigated.

Purpose of the Study:

To investigate short-term variations in lung function, sputum cellularity, and cytokine profiles in patients with Bronchiolitis obliterans (BO).
To compare these variations between two visits spaced four to six weeks apart.

Main Methods:

Twenty BO patients underwent lung function tests, reversibility testing, and induced sputum analysis.
Sputum cell composition and levels of IL-1ß, IL-6, and IL-8 were quantified.
Short-term variations were statistically analyzed and compared to healthy controls and previous patient data.

Main Results:

BO patients demonstrated minimal short-term variation in lung function (VCmax, FVC, FEV1, FEV1/VC, MEF25, RV/TLC) and inflammatory cell profiles.
Lung function was significantly impaired in BO patients compared to controls (lower FVC, FEV1, Tiffeneau index, MEF25; higher RV/TLC).
Sputum analysis revealed consistent neutrophilic inflammation, while cytokine levels (IL-1ß, IL-6, IL-8) showed high variability.

Conclusions:

The short-term variability of sputum neutrophilia and lung function is low in Bronchiolitis obliterans (BO) patients.
This finding is important for identifying effective treatments in individual patients.
The low variability can serve as a valuable endpoint for future clinical studies on BO.

Read full analysis

Abstract

Purpose:

Bronchiolitis obliterans (BO) is an inadequately researched disease in terms of lung function as well as inflammatory profile. The short-term variation of these parameters has not been investigated. Therefore, the objective of this study was the investigation of lung function, sputum cells and cytokine profiles in BO at two visits within of four to six weeks.

Methods:

Twenty patients with BO (median age = 14.6, range 8.3-24.3) performed lung function tests, airway reversibility testing and induction of sputum within four to six weeks. The cell composition in the sputum was analysed and cytokine levels of IL-1ß, IL-6 and IL-8 were determined by cytometric bead array analysis. The short-term variation was then statistically quantified and compared to that of twenty-two healthy controls. Furthermore, we compared data on short-term variation of lung function and airway inflammation with a previous investigation in these patients 10-15 months earlier.

Results:

Patients with BO showed minimal variation of lung function (VCmax, FVC, FEV1, FEV1/VC, MEF25 and RV/TLC) and the inflammatory cell profile. The lung function data were significantly lower for FVC, FEV1, the Tiffeneau index and MEF25 compared to the control group, whereas RV/TLC was significantly increased. Analysis of the BO sputum cells showed a consistent neutrophil inflammation. The levels of inflammatory cytokines IL-1ß, IL-6 and IL-8 had a great variability.

Conclusions:

The short-term variability of sputum neutrophilia and lung function is low in BO patients. This finding should be considered to identify successful treatment in the individual patient and could be used as endpoints for future BO-related studies.

Keywords:

Bronchial inflammation Bronchiolitis obliterans Cytometric bead array Induced sputum Lung function

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