Ordoñez Claudia L, Henig Noreen R, Mayer-Hamblett Nicole, Accurso Frank J, Burns Jane L, Chmiel James F, Daines Cori L, Gibson Ronald L, McNamara Sharon, Retsch-Bogart George Z, Zeitlin Pamela L, Aitken Moira L
Department of Pediatrics, Harvard Medical School, Boston, MA 02215, USA.
Am J Respir Crit Care Med. 2003 Dec 15;168(12):1471-5. doi: 10.1164/rccm.200306-731OC. Epub 2003 Sep 11.
Induced sputum has been used to study airway inflammation. We sought to determine whether markers of infection and inflammation in induced sputum were a useful and safe outcome measure in cystic fibrosis. We hypothesized that bacterial density and inflammatory content of induced sputum would decrease after antibiotic therapy. Induced sputum was assayed for bacterial density, cell count, and differential and inflammatory markers before and after treatment with intravenous antibiotics. Fifty-five of the 72 subjects enrolled (mean age +/- SD 18.2 +/- 7.9 years) completed the study. FEV1 increased by an average 0.3 +/- 0.3 L (10.4 +/- 8.7% predicted FEV1), p<0.0001; density of Pseudomonas aeruginosa and Staphylococcus aureus decreased by 2.4 +/- 3.1 log10 cfu/g (p<0.0005) and 4.0 +/- 2.3 log10 cfu/ml (p<0.0001), respectively; neutrophil count decreased by 0.4 +/- 0.6 log10 cells/ml (p<0.0001), interleukin-8 concentration by 0.5 +/- 1.3 log10 pg/ml (p<0.05), and neutrophil elastase by 0.4 +/- 0.7 log10 microg/ml (p<0.005). Seven of 127 (6%) sputum induction procedures showed a decrease in FEV1 of 20% or more. We conclude that markers in induced sputum may be useful, noninvasive outcome measures to assess response to therapies in cystic fibrosis studies.
诱导痰已被用于研究气道炎症。我们试图确定诱导痰中的感染和炎症标志物是否是囊性纤维化中一种有用且安全的结果测量指标。我们假设抗生素治疗后诱导痰中的细菌密度和炎症成分会降低。在用静脉抗生素治疗前后，对诱导痰进行细菌密度、细胞计数、分类及炎症标志物检测。纳入研究的72名受试者中有55名（平均年龄±标准差18.2±7.9岁）完成了研究。第一秒用力呼气容积（FEV1）平均增加0.3±0.3升（预计FEV1的10.4±8.7%），p<0.0001；铜绿假单胞菌和金黄色葡萄球菌密度分别降低2.4±3.1 log10 cfu/g（p<0.0005）和4.0±2.3 log10 cfu/ml（p<0.0001）；中性粒细胞计数降低0.4±0.6 log10细胞/ml（p<0.0001），白细胞介素-8浓度降低0.5±1.3 log10 pg/ml（p<0.05），中性粒细胞弹性蛋白酶降低0.4±0.7 log10 μg/ml（p<0.005）。127次痰诱导操作中有7次（6%）显示FEV1下降20%或更多。我们得出结论，诱导痰中的标志物可能是评估囊性纤维化研究中治疗反应的有用的非侵入性结果测量指标。
