Document Detail

Host inflammatory responses to first isolation of Pseudomonas aeruginosa from sputum in cystic fibrosis.
MedLine Citation:
PMID:  8327287     Owner:  NLM     Status:  MEDLINE    
Pseudomonas aeruginosa infection of the respiratory tract in patients with cystic fibrosis is a major determinant of morbidity and mortality. However, it has been postulated that the earliest phase of colonization is not associated with injury. To test this hypothesis we determined the association of the first recorded isolation of P. aeruginosa from the sputum on circulating markers of the inflammatory response in 6 patients with cystic fibrosis. At this time circulating C-reactive protein was increased in all 6 and neutrophil elastase alpha 1-antitrypsin complex (elastase-complex) was increased in 5 patients compared with healthy controls. This inflammatory response was associated with a reduction in the FEV1 and FVC of all patients [FEV1, 1.42 +/- 0.87 L (mean +/- SD) at first isolation vs. 2.08 +/- 0.74 L before isolation; P < 0.05; FVC, 1.94 +/- 0.93 L vs. 2.87 +/- 1.01 L, P < 0.05]. At a median interval of 10 months, 5 patients had raised titres of positive IgG antibody to P. aeruginosa, indicating significant exposure to this organism. At this time, lung function had returned to preinfection levels, whilst 3 patients showed continuing features of an inflammatory response, and the group mean value for elastase-complex was raised. Our findings demonstrate that at the time of first isolation of P. aeruginosa from the sputum of patients with cystic fibrosis, there is a concomitant systemic host response and an acute deterioration of pulmonary function.
J S Elborn; S M Cordon; D J Shale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  15     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-08-12     Completed Date:  1993-08-12     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  287-91     Citation Subset:  IM    
University of Wales College of Medicine, Section of Respiratory Medicine, Llandough Hospital, Penarth, South Glamorgan, UK.
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MeSH Terms
Antibodies, Bacterial / analysis
C-Reactive Protein / analysis
Cystic Fibrosis / complications,  immunology,  microbiology*,  physiopathology
Immunoglobulin G / analysis
Inflammation / diagnosis
Leukocyte Elastase*
Pancreatic Elastase / analysis
Prospective Studies
Pseudomonas Infections / complications,  diagnosis*,  microbiology
Pseudomonas aeruginosa / immunology,  isolation & purification*
Respiratory Mechanics
Respiratory Tract Infections / complications,  diagnosis*,  microbiology
Sputum / microbiology*
alpha 1-Antitrypsin / analysis
Reg. No./Substance:
0/Antibodies, Bacterial; 0/Immunoglobulin G; 0/alpha 1-Antitrypsin; 0/alpha 1-antitrypsin-leukocyte elastase complex; 9007-41-4/C-Reactive Protein; EC Elastase; EC Elastase

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