Department of Child and Adolescent Health, Paediatrics III, Cystic Fibrosis Centre Innsbruck, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Praxis Dr. Zlamy, Kirchstrasse 10, 6091 Götzens, Austria.
Int J Mol Sci. 2024 Oct 15;25(20):11081. doi: 10.3390/ijms252011081.
The measurement of cytokines in induced sputum and nasal lavage (NL) samples has been performed for years in people with cystic fibrosis (CF). The aim of this study was to directly compare sputum and NL samples and interpret results based on disease severity in patients who were categorized as having mild or severe lung disease. The categorization was based primarily on structural abnormalities detected on lung computed tomography and secondarily on lung function. The serum inflammatory markers neutrophil elastase (NE), IL-1β, 2, 6, 8, 10 and 17a were measured in each sputum and NL sample. Thirty-two sample pairs from 29 patients were included in this study (13 mild, 19 severe). In the patients classified as severe, many systemic inflammatory markers as well as sputum cytokines were significantly higher compared to those in the mild patients. However, all the markers measured in the NL were higher in the mild patients ( =< 0.05 for NE, IL-6 and IL-8). In addition, many cytokines in the NL correlated negatively with those in the sputum samples. Major differences in the cytokine levels were shown although the samples were obtained at the same time in the same patient. Advanced structural lung disease was closely related to systemic and lower airway inflammation, whereas preserved lung function was associated with higher levels in the NL. We hypothesize that the main part of the immune response takes place in the nasal mucosa in patients with minor pulmonary changes. Our results suggest that inflammation must be interpreted individually depending on the compartment in which it is measured. Further research is needed to accurately understand inflammatory markers measured in NL.
多年来，人们一直在囊性纤维化 (CF) 患者中进行诱导痰和鼻洗液 (NL) 样本中的细胞因子测量。本研究的目的是直接比较痰和 NL 样本，并根据疾病严重程度对分类为轻度或重度肺病的患者的结果进行解释。分类主要基于肺部计算机断层扫描检测到的结构异常，其次是肺功能。在每个痰和 NL 样本中测量了血清炎症标志物中性粒细胞弹性蛋白酶 (NE)、IL-1β、2、6、8、10 和 17a。本研究纳入了 29 名患者的 32 对样本（轻度 13 对，重度 19 对）。在被归类为严重的患者中，与轻度患者相比，许多系统性炎症标志物以及痰细胞因子明显更高。然而，在轻度患者中，所有在 NL 中测量的标志物都更高（NE、IL-6 和 IL-8 的 =< 0.05）。此外，NL 中的许多细胞因子与痰样本呈负相关。尽管在同一患者的同一时间获得了样本，但显示出了明显的细胞因子水平差异。严重的结构性肺病与系统性和下气道炎症密切相关，而保留的肺功能与 NL 中的更高水平相关。我们假设，在肺部变化较小的患者中，免疫反应的主要部分发生在鼻黏膜中。我们的研究结果表明，炎症必须根据测量的部位进行单独解释。需要进一步的研究来准确理解 NL 中测量的炎症标志物。
