Jensen P Ø, Moser C, Kharazmi A, Presler T, Koch C, Høiby N
Department of Clinical Microbiology, University of Copenhagen, Denmark.
J Cyst Fibros. 2006 Aug;5(3):145-51. doi: 10.1016/j.jcf.2005.12.004. Epub 2006 Feb 28.
Chronic Pseudomonas aeruginosa lung infection is the major reason for premature death in patients with cystic fibrosis (CF). Infected patients experience a progressive deterioration of the lung tissue caused by a persistent accumulation of PMNs. We investigated if the pulmonary accumulation of PMNs is reflected as a migration of PMNs through the blood in chronically infected CF patients.
Blood and sputum samples from 37 stable, chronically (CF+P) and 6 non-infected (CF-P) CF patients without exacerbations were compared using FACS, leukocyte counting, and ELISA. Within the CF+P patients, the blood parameters were compared to the lung function (FEV1 and FVC) and to the sputum. Similar measurements were performed on 15 chronically infected CF patients before and after elective antibiotic treatment.
In the CF+P patients the concentration of G-CSF in the sera and PMNs in the blood was increased and correlated to poor lung function. However, only the concentration of G-CSF in the sera was correlated to the concentration of TNF-alpha in the sputum. After the antibiotic treatment, the lung function was improved and the concentration of PMNs in the blood and G-CSF in the sera was reduced.
G-CSF in the sera may contribute to the pulmonary inflammation in CF patients with chronic P. aeruginosa lung infection by regulating the number of PMNs available for migration and may be considered as an indicator of clinical status.
慢性铜绿假单胞菌肺部感染是囊性纤维化(CF)患者过早死亡的主要原因。受感染患者会因中性粒细胞持续积聚而出现肺组织渐进性恶化。我们研究了在慢性感染的CF患者中,中性粒细胞在肺部的积聚是否表现为中性粒细胞通过血液的迁移。
使用流式细胞术、白细胞计数和酶联免疫吸附测定法,对37例病情稳定、慢性感染(CF+P)且无病情加重的CF患者以及6例未感染(CF-P)的CF患者的血液和痰液样本进行比较。在CF+P患者中,将血液参数与肺功能(第一秒用力呼气容积和用力肺活量)以及痰液进行比较。对15例慢性感染的CF患者在择期抗生素治疗前后进行了类似测量。
在CF+P患者中,血清中粒细胞集落刺激因子(G-CSF)的浓度和血液中中性粒细胞的浓度升高,且与肺功能差相关。然而,只有血清中G-CSF的浓度与痰液中肿瘤坏死因子-α(TNF-α)的浓度相关。抗生素治疗后,肺功能得到改善,血液中中性粒细胞的浓度和血清中G-CSF的浓度降低。
血清中的G-CSF可能通过调节可用于迁移的中性粒细胞数量,导致慢性铜绿假单胞菌肺部感染的CF患者发生肺部炎症,可被视为临床状态的一个指标。