Key inflammatory markers in bronchoalveolar lavage predict bronchiectasis progression in young children with CF

作者：Hamed Horati, Camilla Margaroli, Joshua D. Chandler, Matthew B. Kilgore, B. Manaï, Eleni‐Rosalina Andrinopoulou, Limin Peng, Lokesh Guglani, Harm Tiddens, Daan Caudri, Bob J. Scholte, Rabindra Tirouvanziam, Hettie M. Janssens · 发表于：Journal of Cystic Fibrosis · 年份：2024 · DOI：10.1016/j.jcf.2024.01.002 · 被引用次数：11 · 研究领域：Cystic Fibrosis Research Advances、Neonatal Respiratory Health Research、Respiratory Support and Mechanisms

INTRODUCTION: Inflammation appears early in cystic fibrosis (CF) pathogenesis, with specific elevated inflammatory markers in bronchoalveolar lavage fluid (BALF) correlating with structural lung disease. Our aim was to identify markers of airway inflammation able to predict bronchiectasis progression over two years with high sensitivity and specificity. METHODS: Children with CF with two chest computed tomography (CT) scans and bronchoscopies at a two-year interval were included (n= 10 at 1 and 3 years and n= 27 at 3 and 5 years). Chest CTs were scored for increase in bronchiectasis (Δ%Bx), using the PRAGMA-CF score. BALF collected with the first CT scan were analyzed for neutrophil% (n= 36), myeloperoxidase (MPO) (n= 25), neutrophil elastase (NE) (n= 26), and with a protein array for inflammatory and fibrotic markers (n= 26). RESULTS: MPO, neutrophil%, and inducible T-cell costimulator ligand (ICOSLG), but not clinical characteristics, correlated significantly with Δ%Bx. Evaluation of neutrophil%, NE, MPO, interleukin-8 (IL-8), ICOSLG, and hepatocyte growth factor (HGF), for predicting an increase of > 0.5% of Δ%Bx in two years, showed that IL-8 had the best sensitivity (82%) and specificity (73%). Neutrophil%, ICOSLG and HGF had sensitivities of 85, 82, and 82% and specificities of 59, 67 and 60%, respectively. The odds ratio for risk of >0.5% Δ%Bx was higher for IL-8 (12.4) than for neutrophil%, ICOSLG, and HGF (5.9, 5.3, and 6.7, respectively). Sensitivity and specificity...