Document Detail

Bile acids in sputum and increased airway inflammation in patients with cystic fibrosis.
MedLine Citation:
PMID:  22135379     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Up to 80% of patients with cystic fibrosis (CF) may have increased gastroesophageal reflux and aspiration of duodenogastric contents into the lungs. We aimed to assess aspiration in patients with CF by measuring duodenogastric components in induced sputum and to investigate whether the presence of bile acids (BAs) in sputum was correlated with disease severity and markers of inflammation.
METHODS: In 41 patients with CF, 15 healthy volunteers, 29 patients with asthma, and 28 patients with chronic cough, sputum was obtained after inhalation of hypertonic saline. Sputum supernatant was tested for BA and neutrophil elastase. Spirometry and BMI were assessed on the day of sputum collection.
RESULTS: Two of 15 healthy patients (13%), eight of 29 patients (28%) with asthma, four of 28 patients (14%) with chronic cough, and 23 of 41 patients (56%) with CF had BA in sputum. BA concentrations were similar in patients who are positive for BA with genotype F508del homozygote, F508del heterozygote, and other CF mutations and were not related with BMI and age. Patients with CF with BA in sputum had a higher concentration of neutrophil elastase compared with patients without BA in sputum (31.25 [20.33-54.78] μg/mL vs 14.45 [7.11-27.88] μg/mL, P < .05). There was a significant correlation between BA concentrations and dynamic lung volumes (FEV(1) % predicted [r = -0.53, P < .01], FVC% [r = -0.59, P < .01]) as well as with number of days of antibiotic IV treatment (r = 0.58, P < .01).
CONCLUSIONS: BAs are present in the sputum of more than one-half of patients with CF, suggesting aspiration of duodenogastric contents. Aspiration of BA was associated with increased airway inflammation. In patients with BA aspiration, the levels of BA were clearly associated with the degree of lung function impairment as well as the need for IV antibiotic treatment.
Ans Pauwels; Ann Decraene; Kathleen Blondeau; Veerle Mertens; Ricard Farre; Marijke Proesmans; Pascal Van Bleyenbergh; Daniel Sifrim; Lieven J Dupont
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-12-01
Journal Detail:
Title:  Chest     Volume:  141     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-06     Completed Date:  2012-09-20     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1568-74     Citation Subset:  AIM; IM    
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MeSH Terms
Asthma / metabolism
Bile Acids and Salts / analysis*
Biological Markers / analysis
Case-Control Studies
Cell Count
Cough / metabolism
Cross-Sectional Studies
Cystic Fibrosis / complications,  metabolism*,  physiopathology
Gastroesophageal Reflux
Middle Aged
Respiratory Aspiration / etiology
Respiratory Function Tests
Risk Factors
Sputum / chemistry*,  cytology
Statistics, Nonparametric
Grant Support
G0802313//Medical Research Council
Reg. No./Substance:
0/Bile Acids and Salts; 0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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