Non-invasive assessment of upper and lower airway infection and inflammation in CF patients

Fischer, Nele; Hentschel, Julia; Markert, Udo R.; Keller, Peter M.; Pletz, Mathias W.; Mainz, Jochen G.

doi:10.1002/ppul.22982

Cited by 31 publications

(43 citation statements)

References 43 publications

(86 reference statements)

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“…Comparative studies of cultures isolated from both the upper and lower airways of patients with CF have shown genotypic and phenotypic similarity between P. aeruginosa grown from sinus, sputum or endotracheal cultures, particularly in terms of bacterial type, strain and antibiotic resistance patterns in patients >8 years of age . In agreement with the descending infection hypothesis, the use of nasal lavage as a potential diagnostic tool to monitor the airways in patients with CF has been suggested by several studies …”

Section: Resultsmentioning

confidence: 66%

Clinical implications ofPseudomonas aeruginosalocation in the lungs of patients with cystic fibrosis

Moore

Mastoridis

2017

J Clin Pharm Ther

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SummaryWhat is known and objective: Pseudomonas aeruginosa is the leading cause of lung infection in patients with cystic fibrosis (CF) and is associated with significant morbidity and mortality. Antibiotics are regarded as the foundational pharmacological treatment for the suppressive management of chronic P. aeruginosa infections and to eradicate the first infection by P. aeruginosa. Inhalation remains a preferred route for drug administration, providing direct access to the site of infection while minimizing systemic side effects. Effective suppressive management of P. aeruginosa infections, however, requires an understanding of the location of the bacteria in the lungs and consideration of the factors that could limit access of the inhaled antibiotic to the infected area. This review provides a systematic assessment of the scientific literature to gain insight into the location of P. aeruginosa in the lungs of patients with CF and its clinical implications. The characteristics of antibiotic inhalation systems are also discussed in this context. Methods:We reviewed evidence-based literature from both human and animal studies in which P. aeruginosa lung location was reported. Relevant publications were identified through a screening strategy and summarized by reported P. aeruginosa location.Results and discussion: Most areas of the conductive and respiratory zones of the lungs are susceptible to P. aeruginosa colonization. Deposition of an inhaled antibiotic is dependent on the device and formulation characteristics, as well as the ability of the patient to generate sufficient inhaled volume. As patients with CF often experience a decline in lung function, the challenge is to ensure that the inhaled antibiotic can be delivered throughout the bronchial tree.

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Section: Resultsmentioning

confidence: 66%

Clinical implications ofPseudomonas aeruginosalocation in the lungs of patients with cystic fibrosis

Moore

Mastoridis

2017

J Clin Pharm Ther

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“…For this study, the following were the bacterial species we considered clinically “relevant”: P. aeruginosa , Staphylococcus aureus , Achromobacter xylosoxidans , Burkholderia cepacia complex , E. coli , Enterococcus , Streptococcus pneumoniae , Haemophilus influenzae , Proteus mirabilis , Serratia marcescens . Normal flora was defined based on published evidence available, including Neisseria spp., Corynebacterium spp., alpha‐hemolytic streptococci, Rothia spp., coagulase‐negative staphylococci, and non‐hemolytic streptococci, which are commonly considered part of the human nasopharyngeal microbiome …”

Section: Methodsmentioning

confidence: 99%

The burden of sinus disease in cystic fibrosis lung transplant recipients

Morlacchi

Greer

Tudorache

et al. 2018

Transplant Infectious Dis

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“…This part was carried out by following a previously described protocol 10 . Total cell counts, including percentages of polymorphonuclear (PMN) neutrophils, were measured by fluorescence flow cytometry (Sysmex XE‐5000; Sysmex Deutschland GmbH, Norderstedt, Germany).…”

Section: Methodsmentioning

confidence: 99%

Antibody response against Pseudomonas aeruginosa and its relationship with immune mediators in the upper and lower airways of cystic fibrosis patients

Mauch

Hentschel

Aanæs

et al. 2020

Pediatric Pulmonology

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Background The upper airways (UAW) are a niche and a reservoir of Pseudomonas aeruginosa strains that cause chronic infection of the lower airways (LAW) in cystic fibrosis (CF). Here, we assessed the role of anti‐P. aeruginosa immunoglobulin A (IgA) and IgG antibodies in upper and lower airway infections in cystic fibrosis patients. Methods Nasal lavage fluid and induced sputum samples of 40 CF patients were microbiologically cultured. We searched for correlations between anti‐P. aeruginosa IgA and IgG levels, measured by enzyme‐linked immunosorbent assay (optical density), and unspecific immune mediators in both specimens. Results Anti‐P. aeruginosa IgA (median optical density: 0.953 vs 0.298) and IgG (0.120 vs 0.059) were significantly higher in nasal lavage than in sputum, but not significantly different between patients with and without chronic P. aeruginosa infection in UAW. Matrix metallopeptidase‐9 (MMP‐9) in nasal lavage and neutrophil elastase (NE) in sputum were predictors of IgA in nasal lavage and IgA in sputum, respectively. IgA was a predictor of myeloperoxidase (MPO) in nasal lavage. Tissue inhibitor of metalloproteinases‐1 (TIMP‐1) was a predictor of IgG in sputum. IgG, TIMP‐1, and NE in sputum were predictors of IgG in nasal lavage. Conclusion The anti‐P. aeruginosa IgA response was more prominent in CF patients' UAW, indicating a lower degree of inflammatory responses. Proteases may play a role in the anti‐P. aeruginosa humoral response in the upper and LAW, and anti‐P. aeruginosa IgG may be involved in the crosstalk between upper and lower airways in cystic fibrosis patients.

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Non-invasive assessment of upper and lower airway infection and inflammation in CF patients

Cited by 31 publications

References 43 publications

Clinical implications ofPseudomonas aeruginosalocation in the lungs of patients with cystic fibrosis

Clinical implications ofPseudomonas aeruginosalocation in the lungs of patients with cystic fibrosis

The burden of sinus disease in cystic fibrosis lung transplant recipients

Antibody response against Pseudomonas aeruginosa and its relationship with immune mediators in the upper and lower airways of cystic fibrosis patients

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