Indium-111 labelled granulocyte scanning to detect inflammation in the lungs of patients with chronic sputum expectoration.

Currie, D C; Peters, A. M.; Garbett, N D; George, Phillip; Strickland, Basil; Lavender, J. P.; Cole, P J

doi:10.1136/thx.45.7.541

Cited by 16 publications

(9 citation statements)

References 8 publications

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“…The group also measured neutrophil activity by PET and injected 18 FDG. Neutrophil emigration was evident in four of the five bronchiectatic patients they examined, a finding similar to other studies [35,36]. Despite the ongoing neutrophil migration into the lungs, minimal neutrophil metabolic activity was detected by 18 FDG-PET imaging in bronchiectatic patients.…”

Section: Discussionsupporting

confidence: 64%

Uptake of¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Labiris¹,

Nahmias²,

Freitag³

et al. 2003

Eur Respir J

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Positron emission tomography is a three-dimensional imaging technique that measures physiological effects, including metabolism. 18 Fluorodeoxyglucose has been extensively used as a tracer of cellular energy metabolism in the brain and in tumour detection. As neutrophils utilise glucose as an energy source during their respiratory burst, it was hypothesised that 18 fluorodeoxyglucose uptake, by these cells, could be interpreted as a measure of neutrophil activation in cystic fibrosis (CF).Ten adult CF patients were given a bolus intravenous injection of 18 fluorodeoxyglucose, followed by a 90-min dynamic mid-lung acquisition scan. Right-lung 18 fluorodeoxyglucose uptake was assessed using a Patlak plot and values were converted to glucose utilisation. Three clinically inactive pulmonary sarcoidosis patients served as controls.From the 10 CF patients with baseline sputum neutrophils of 14610 6 cells?mL -1 who were investigated, seven were found to have sputum at a normal or slightly depressed glucose utilisation rate (mean 1.33 mmol?g Positron emission tomography (PET) is a powerful, quantitative, nuclear medicine tomographic imaging technique. PET can be used to measure physiological effects such as blood flow, metabolism, ventilation, receptor occupancy, regional dose delivery and pharmacokinetics of radiolabelled drugs [1]. It combines principles of image reconstruction from projections with the use of specific biological molecules labelled with positron-emitting radioisotopes ( 11 C, 18 F, 15 O, 13 N) allowing regional measurements of dynamic processes to be taken. 18 FDG differs from glucose by the substitution of the hydroxyl group with a fluorine atom on the second carbon of the glucose. When injected intravenously, 18 FDG rapidly diffuses into the extracellular spaces throughout the body. It is transported into living cells by the same mechanism as glucose, via the D-glucose transporter and is phosphorylated by hexokinase to fluoro-deoxyglucose-6-phosphate. The deoxy substitution at the second carbon position prevents further metabolism and the product accumulates in the cell at a rate that reflects glucose metabolism. Increased glucose consumption is assumed to lead to an increased rate of tracer uptake. The rate of accumulation of 18 FDG in tissue after intravenous injection reflects the combined transport and hexokinase activity in the cells [9].18 FDG-PET studies of the lung are still relatively few compared with the number of oncological, neurological and cardiac studies.The inflammatory process, in particular neutrophils, has been implicated in the pathogenesis of a variety of lung diseases including cystic fibrosis (CF), bronchiectasis, and chronic bronchitis. Neutrophils contribute to pulmonary destruction by production and release of cytotoxic enzymes (e.g. elastase, myeloperoxidase) and toxic oxygen metabolites [10]. Markers of inflammation in blood, bronchoalveolar lavage (BAL), sputum and lung biopsy serve as indirect measurements of inflammation, making the detection of re...

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Section: Discussionsupporting

confidence: 64%

Uptake of¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Labiris¹,

Nahmias²,

Freitag³

et al. 2003

Eur Respir J

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“…Future studies should investigate whether markers of inflammation in the lung correlate more closely with measures of disease severity and health-related quality of life. These studies could use either lung secretions [4,5,19] or an imaging technique [22]. In addition, a high-resolution computed tomographic scoring system that incorporated bronchial wall thickness may correlate more closely with the level of inflammation than the simple extent of bronchiectasis.…”

Section: Discussionmentioning

confidence: 99%

Systemic markers of inflammation in stable bronchiectasis

Wilson¹,

Jones²,

O’Leary³

et al. 1998

Eur Respir J

100

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Patients with bronchiectasis have an active local and systemic inflammatory response during infective exacerbations. Systemic markers of inflammation were investigated during a stable phase of their illness, because continued inflammation could affect their general health and be involved in disease progression. The relationship between levels of various systemic markers of inflammation and extent of disease on computed tomographic scan, lung function, sputum bacteriology and health related quality of life (HRQoL) was investigated in 87 noncystic fibrosis bronchiectasis patients. Several markers were elevated and correlated with the extent of disease and poor lung function. The total white cell count, neutrophil count and erythrocyte sedimentation rate correlated with both disease measures. Sputum bacteriology did not correlate with inflammation markers and patients with positive and negative cultures were similar. C-reactive protein and total white cell count correlated with some components of a disease-specific HRQoL questionnaire. In conclusion, patients with bronchiectasis in a stable phase have raised systemic markers of inflammation. Some markers, particularly the neutrophil count, correlate with disease severity. This result is in keeping with the hypothesis that the level of inflammation determines disease progression and health status.

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“…In cystic fibrosis, infection can occur at an early age, before severe bronchiectasis has developed, and various explanations have been put forward for this unique host-bacterial interaction [20][21][22]. There is an exuberant inflammatory response to the chronic bacterial infection [23] and a large number of exotoxins are produced by P. aeruginosa [24]. There is a strong antibody response to P. aeruginosa in pulmonary secretions, saliva and serum, and [25].…”

Section: Baseline Pulmonary Function Testsmentioning

confidence: 99%

The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis

Davies

Au²,

Doffman³

et al. 2006

European Respiratory Journal

169

102

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Bronchiectasis patients are susceptible to infection with Pseudomonas aeruginosa. Isolation is associated with increased severity of disease, greater airflow obstruction and poorer quality of life. It is not known whether infection by P. aeruginosa is a marker of disease severity or contributes to disease progression.Consecutive non-cystic fibrosis adult bronchiectasis outpatients (n5163) with multiple sputum cultures and follow-up pulmonary function tests were designated, according to isolation of P. aeruginosa, as ''never infected'' (group 1; n567), ''intermittently isolated'' (group 2; n582) and ''chronically infected'' (group 3; n514). Based upon change in forced expiratory volume in one second (FEV1) % predicted levels at o2 yrs after presentation, longitudinal behaviour was characterised as ''improvement'' (o10% rise), ''decline'' (o10% fall) or ''stability''. Baseline pulmonary-function tests and longitudinal behaviour were examined in relation to pseudomonas status.There was no difference between the groups in age, sex, smoking habit or length of follow-up. Baseline FEV1 levels were highest in group 1 (mean¡SD: 77.4¡24.3) and higher in group 2 (67.3¡25.7) than in group 3 (55.2¡18.5). The same significant trends were seen for baseline FEV1/forced vital capacity ratios and diffusing capacity of the lung for carbon monoxide levels. Subsequent longitudinal behaviour was linked to baseline FEV1 levels, which were lowest in patients with improvement and lower in association with decline than with stability. However, longitudinal behaviour did not differ between groups 1, 2 and 3, either before or after adjustment for baseline FEV1 levels.Infection by Pseudomonas aeruginosa occurs in bronchiectasis patients with more severe impairment of pulmonary function but does not influence rate of decline in pulmonary function either before or after adjustment for baseline disease severity. Thus, Pseudomonas aeruginosa is a marker of bronchiectasis severity but is not linked to an accelerated decline in pulmonary function.

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Indium-111 labelled granulocyte scanning to detect inflammation in the lungs of patients with chronic sputum expectoration.

Cited by 16 publications

References 8 publications

Uptake of¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Uptake of¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Systemic markers of inflammation in stable bronchiectasis

The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis

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Indium-111 labelled granulocyte scanning to detect inflammation in the lungs of patients with chronic sputum expectoration.

Cited by 16 publications

References 8 publications

Uptake of18fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Uptake of18fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Systemic markers of inflammation in stable bronchiectasis

The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis

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Product

Resources

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Uptake of¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Uptake of¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?