Document Detail


Infection, Inflammation and Lung Function Decline in Infants With Cystic Fibrosis.
MedLine Citation:
PMID:  21493738     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
RATIONALE: Better understanding of evolution of lung function in infants with cystic fibrosis (CF) and its association with pulmonary inflammation and infection is crucial in informing both early intervention studies aimed at limiting lung damage and the role of lung function as outcomes in such studies. OBJECTIVES: To describe longitudinal change in lung function in infants with CF and its association with pulmonary infection and inflammation. METHODS: Infants diagnosed following newborn screening or clinical presentation were recruited prospectively. Forced vital capacity (FVC), forced expiratory volume in 0.5 seconds (FEV0.5) and forced expiratory flows at 75% of exhaled vital capacity (FEF75) were measured using the raised-volume technique and z-scores calculated from published reference equations. Pulmonary infection and inflammation were measured in bronchoalveolar lavage within 48 hours of lung function testing. RESULTS: 37 infants had at least two successful repeat lung function measurements. Mean (SD) z-scores for FVC were -0.8 (1.0), -0.9 (1.1) and -1.7 (1.2) when measured at the first visit, one-year or two-year visits respectively. Mean (SD) z-scores for FEV0.5 were -1.4 (1.2), -2.4 (1.1) and -4.3 (1.6) respectively. In those infants in whom free neutrophil elastase was detected FVC z-scores were 0.81 lower (p=0.003), and FEV0.5 z-scores 0.96 lower (p=0.001) respectively. Significantly greater decline in FEV0.5 z-scores occurred in those infected with S. aureus (p=0.018) or P. aeruginosa (p=0.021). CONCLUSION: In infants with CF, pulmonary inflammation is associated with lower lung function while pulmonary infection is associated with a greater rate of decline in lung function. Strategies targeting pulmonary inflammation and infection are required to prevent early decline in lung function in infants with CF.
Authors:
Naveen Pillarisetti; Elizabeth Williamson; Barry Linnane; Billy Skoric; Colin F Robertson; Phil Robinson; John Massie; Graham L Hall; Peter Sly; Stephen Stick; Sarath Ranganathan;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  -     ISSN:  1535-4970     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia; Infection, Inflammation and Environment theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
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