Early airway infection, inflammation, and lung function in cystic fibrosis

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Hi,

the two most important statements from the article below are:

" No relation was identified between airway inflammation and lung function "

That matches our experience with Fiona so far. She has signs of continuous

airway inflammation (like thickening of the bronchial walls) but her lung

functions seems to be okay.

" Further studies are needed ... "

This is always my favorite ending :-(((

Peace

Torsten, dad of Fiona 5wcf

e-mail: torstenkrafft@...

Early airway infection, inflammation, and lung function in cystic fibrosis

G M Nixon1, D S Armstrong1, R Carzino1, J B Carlin2, A Olinsky1, C F

on1 and K Grimwood3

1 Department of Respiratory Medicine, Royal Children's Hospital, Melbourne,

Australia

2 Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research

Institute, Melbourne, Australia

3 Wellington School of Medicine and Health Sciences, University of Otago,

Wellington, New Zealand Correspondence to:

Dr G Nixon, Division of Respiratory Medicine, Montreal Children's Hospital,

2300 Tupper St, Montreal H3H 1P3, Canada; gillian.nixon@...

Aims: To determine the relation between lower

airway infection and inflammation, respiratory symptoms, and lung function

in infants and young children with cystic fibrosis (CF).

Methods: A prospective study of children with CF aged younger than 3 years,

diagnosed by a newborn screening programme. All were clinically stable and

had testing as outpatients. Subjects underwent bronchial lavage (BL) and

lung function testing by the raised volume rapid thoracoabdominal

compression technique under general anaesthesia. BL fluid was cultured and

analysed for neutrophil count, interleukin 8, and neutrophil elastase. Lung

function was assessed by forced expiratory volume in 0.5, 0.75, and 1

second.

Results: Thirty six children with CF were tested on 54 occasions. Lower

airway infection shown by BL was

associated with a 10% reduction in FEV0.5 compared with subjects without

infection. No relation was identified between airway inflammation and lung

function. Daily moist cough within the week before testing was reported on

20/54 occasions, but in only seven (35%) was infection detected. Independent

of either infection status or airway inflammation, those with daily cough

had lower lung function than those without respiratory symptoms at the time

of BL (mean adjusted FEV0.5 195 ml and

236 ml respectively).

Conclusions: In young children with CF, both respiratory symptoms and airway

infection have independent, additive

effects on lung function, unrelated to airway inflammation. Further studies

are needed to understand the mechanisms of airway obstruction in these young

patients.