Molecular Microbiology Research Laboratory, Pharmaceutical Science Division, 150 Stamford Street, Franklin-Wilkins Building, King's College London, London, SE1 9NH, UK.
Expert Rev Mol Diagn. 2011 Mar;11(2):197-206. doi: 10.1586/erm.10.117.
Acute periods of pulmonary exacerbation are the single most important cause of morbidity in cystic fibrosis patients, and may be associated with a loss of lung function. Intervening prior to the onset of a substantially increased inflammatory response may limit the associated damage to the airways. While a number of biomarker assays based on inflammatory markers have been developed, providing useful and important measures of disease during these periods, such factors are typically only elevated once the process of exacerbation has been initiated. Identifying biomarkers that can predict the onset of pulmonary exacerbation at an early stage would provide an opportunity to intervene before the establishment of a substantial immune response, with major implications for the advancement of cystic fibrosis care. The precise triggers of pulmonary exacerbation remain to be determined; however, the majority of models relate to the activity of microbes present in the patient's lower airways of cystic fibrosis. Advances in diagnostic microbiology now allow for the examination of these complex systems at a level likely to identify factors on which biomarker assays can be based. In this article, we discuss key considerations in the design and testing of assays that could predict pulmonary exacerbations.
急性肺部恶化期是囊性纤维化患者发病的最主要原因，可能导致肺功能丧失。在炎症反应显著增加之前进行干预，可能有助于限制气道的相关损伤。虽然已经开发出许多基于炎症标志物的生物标志物检测方法，为这些时期的疾病提供了有用和重要的衡量指标，但这些因素通常仅在恶化过程开始后才会升高。确定能够在早期预测肺部恶化发作的生物标志物，将为在建立实质性免疫反应之前进行干预提供机会，这对囊性纤维化护理的发展具有重大意义。肺部恶化的确切触发因素仍有待确定；然而，大多数模型都与囊性纤维化患者下呼吸道中存在的微生物的活性有关。诊断微生物学的进步现在可以在可能确定生物标志物检测方法可以依据的因素的水平上检查这些复杂的系统。在本文中，我们讨论了设计和测试能够预测肺部恶化的检测方法的关键考虑因素。
