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Updated: Jul 10, 2025
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Nasal airway inflammatory responses and pathogen detection in infants with cystic fibrosis
Benjamin T Kopp1, Sydney E Ross2, Dinesh Bojja1
1Division of Pulmonology, Asthma, Cystic Fibrosis, and Sleep, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
Insights
Nasal fluid analysis can detect airway inflammation in infants with cystic fibrosis (CF). Inflammatory markers like IL-6 and neutrophil elastase (NE) increase during viral infections and pulmonary exacerbations (PEx).
Area of Science:
- Pediatric Pulmonology
- Inflammatory Biomarkers
- Cystic Fibrosis Research
Background:
- Non-invasive detection of airway inflammation in infants with cystic fibrosis (CF) is challenging.
- Inflammatory markers in nasal fluid were hypothesized to indicate inflammation during viral infections or pulmonary exacerbations (PEx).
Purpose of the Study:
- To measure inflammatory markers (IL-1β, IL-6, IL-8, IL-10, IL-17A, neutrophil elastase (NE), TNF-α) in nasal fluid of infants with CF.
- To assess if these markers correlate with viral infections, PEx, or environmental exposures like smoke.
Main Methods:
- Collected nasal fluid, swabs, and hair from 34 infants with CF.
- Analyzed nasal fluid for cytokines and nasal swabs for respiratory viruses.
- Measured nicotine in hair samples and compared cytokine levels based on viral status, PEx, and smoke exposure.
Main Results:
- Increased concentrations of IL-6, IL-8, TNF-α, and NE were observed in infants with respiratory viruses.
- IL-17A decreased in infants with viral infections and PEx.
- Elevated IL-6, IL-10, and NE levels were found in infants with detectable nicotine levels.
Conclusions:
- Noninvasive nasal fluid collection is a viable method for identifying airway inflammation in infants with CF.
- This approach can help monitor inflammation related to clinical changes and environmental exposures.
Background:
Detecting airway inflammation non-invasively in infants with cystic fibrosis (CF) is difficult. We hypothesized that markers of inflammation in CF [IL-1β, IL-6, IL-8, IL-10, IL-17A, neutrophil elastase (NE) and tumor necrosis factor (TNF-α)] could be measured in infants with CF from nasal fluid and would be elevated during viral infections or clinician-defined pulmonary exacerbations (PEx).
Methods:
We collected nasal fluid, nasal swabs, and hair samples from 34 infants with CF during monthly clinic visits, sick visits, and hospitalizations. Nasal fluid was isolated and analyzed for cytokines. Respiratory viral detection on nasal swabs was performed using the Luminex NxTAG® Respiratory Pathogen Panel. Hair samples were analyzed for nicotine concentration by reverse-phase high-performance liquid chromatography. We compared nasal cytokine concentrations between the presence and absence of detected respiratory viruses, PEx, and smoke exposure.
Results:
A total of 246 samples were analyzed. Compared to measurements in the absence of respiratory viruses, mean concentrations of IL-6, IL-8, TNF-α, and NE were significantly increased while IL-17A was significantly decreased in infants positive for respiratory viruses. IL-17A was significantly decreased and NE increased in those with a PEx. IL-8 and NE were significantly increased in infants with enteric pathogen positivity on airway cultures, but not P. aeruginosa or S. aureus. Compared to those with no smoke exposure, there were significantly higher levels of IL-6, IL-10, and NE in infants with detectable levels of nicotine.
Conclusions:
Noninvasive collection of nasal fluid may identify inflammation in infants with CF during changing clinical or environmental exposures.
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