Pereira Leticia Cristina Radin, Moreira Emilia Addison Machado, Bennemann Gabriela Datsch, Moreno Yara Maria Franco, Buss Ziliani da Silva, Barbosa Eliana, Ludwig-Neto Norberto, Wilhelm Filho Danilo, Fröde Tânia Silvia
Graduate Program in Nutrition, Federal University of Santa Catarina, Brazil.
Department of Nutrition and Graduate Program in Nutrition, Federal University of Santa Catarina, Brazil.
Life Sci. 2014 Jul 25;109(1):30-6. doi: 10.1016/j.lfs.2014.06.002. Epub 2014 Jun 12.
Recurrent infections and activation of the inflammatory response affect the prognosis of cystic fibrosis (CF). We investigated the relationship between inflammatory response, infection, and pulmonary function in CF.
A clinical-cross-sectional study was conducted with 86 subjects: control group (CG, n=31, the same age and sex of the CF group), and CF group (CFG, n=55, age: 1-16 years), further distributed into CFG negative or positive bacteriology (CFGB(-)/CFGB(+)), and CFG negative or positive Pseudomonas aeruginosa (CFGPa(-)/CFGPa(+)). Using the Wald test, multiple linear regression (95% confidence interval) was performed between CG and CFG, and between CG and each of the CF subgroups (CFGB(-)/CFGB(+) and CFGPa(-)/CFGPa(+)). The inflammatory markers evaluated were myeloperoxidase (MPO), adenosine deaminase (ADA) activities, interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), nitric oxide metabolites (NOx) levels, and total and differential leukocyte counts.
After adjusting for sex and age, CFG compared to CG revealed an increase of MPO, IL-1β (P<0.001 in all subgroups), and CRP: CFG (P=0.002), CFGB(-) (P=0.007), CFGB(+) (P=0.009), CFGPa(-) (P=0.004) and CFGPa(+) (P=0.020). NOx (P=0.001, P<0.001), leukocytes (P=0.002, P=0.001), and neutrophils (P=0.003, P<0.001) were increased in CFGB(+) and CFGPa(+), respectively. A negative correlation between FEV1 and leukocytes (P=0.008) and FEV1 and neutrophils (P=0.031) resulted in CFG.
The inflammatory response characterized by the increase of MPO, IL-1β, and CRP is determinant for CF. Also leukocytosis due to neutrophilia determines the pulmonary function deficiency in this disease.
反复感染和炎症反应激活会影响囊性纤维化（CF）的预后。我们研究了CF中炎症反应、感染与肺功能之间的关系。
对86名受试者进行了一项临床横断面研究：对照组（CG，n = 31，年龄和性别与CF组相同）和CF组（CFG，n = 55，年龄：1 - 16岁），进一步分为CFG细菌学阴性或阳性（CFGB(-)/CFGB(+)），以及CFG铜绿假单胞菌阴性或阳性（CFGPa(-)/CFGPa(+)）。使用Wald检验，在CG和CFG之间，以及CG与每个CF亚组（CFGB(-)/CFGB(+)和CFGPa(-)/CFGPa(+)）之间进行多元线性回归（95%置信区间）。评估的炎症标志物包括髓过氧化物酶（MPO）、腺苷脱氨酶（ADA）活性、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、一氧化氮代谢产物（NOx）水平以及白细胞总数和分类计数。
在调整性别和年龄后，与CG相比，CFG的MPO、IL-1β（所有亚组中P < 0.001）和CRP升高：CFG（P = 0.002）、CFGB(-)（P = 0.007）、CFGB(+)（P = 0.009）、CFGPa(-)（P = 0.004）和CFGPa(+)（P = 0.020）。CFGB(+)和CFGPa(+)中NOx（P = 0.001，P < 0.001）、白细胞（P = 0.002，P = 0.001）和中性粒细胞（P = 0.003，P < 0.001）分别升高。在CFG中，FEV1与白细胞（P = 0.008）和FEV1与中性粒细胞（P = 0.031）之间呈负相关。
以MPO、IL-1β和CRP升高为特征的炎症反应是CF的决定性因素。此外，中性粒细胞增多引起的白细胞增多决定了该疾病的肺功能缺陷。
