Sagel Scott D, Sontag Marci K, Wagener Jeffrey S, Kapsner Robert K, Osberg Iris, Accurso Frank J
Department of Pediatrics, University of Colorado Health Sciences Center, Denver, USA.
J Pediatr. 2002 Dec;141(6):811-7. doi: 10.1067/mpd.2002.129847.
To validate a sputum induction technique in cystic fibrosis (CF), we examined the relation between airway inflammation and pulmonary function in children with CF by correlating inflammatory indexes in induced sputum with FEV(1).
We measured baseline spirometry and oxygen saturations and then performed sputum inductions with 3% hypertonic saline in 20 clinically stable children with CF (11 girls). We examined the relation of airway inflammation and lung function in the 19 individuals (95%) who expectorated an adequate sputum sample. Measures of airway inflammation in induced sputum included total cell counts, neutrophil (PMN) counts, interleukin-8 levels, and free neutrophil elastase activity.
There were significant inverse relations between FEV(1) and total cell counts and PMN counts (r = -0.57, P <.01 for both), interleukin-8 (r = -0.72, P =.002), and elastase (r = -0.75, P =.001). Airway infection, as assessed by bacterial density in induced sputum, did not correlate with lung function or indexes of inflammation.
We conclude that measures of inflammation in induced sputum correlate with FEV(1) in clinically stable children with CF with normal to mildly abnormal lung function and that they may be useful as surrogate outcome measures in clinical trials.
为验证囊性纤维化(CF)患者的痰液诱导技术,我们通过将诱导痰中的炎症指标与第一秒用力呼气容积(FEV₁)相关联,研究了CF患儿气道炎症与肺功能之间的关系。
我们测量了20名临床稳定的CF患儿(11名女孩)的基线肺量计参数和血氧饱和度,然后用3%高渗盐水进行痰液诱导。我们研究了19名(95%)咳出足够痰液样本的个体的气道炎症与肺功能之间的关系。诱导痰中的气道炎症指标包括细胞总数、中性粒细胞(PMN)计数、白细胞介素-8水平和游离中性粒细胞弹性蛋白酶活性。
FEV₁与细胞总数、PMN计数(两者r = -0.57,P <.01)、白细胞介素-8(r = -0.72,P =.002)和弹性蛋白酶(r = -0.75,P =.001)之间存在显著的负相关。通过诱导痰中的细菌密度评估的气道感染与肺功能或炎症指标无关。
我们得出结论,在肺功能正常至轻度异常的临床稳定CF患儿中,诱导痰中的炎症指标与FEV₁相关,并且它们可能在临床试验中用作替代结局指标。