Journal Article

Dynamics of soluble and cellular inflammatory markers in nasal lavage obtained from Cystic Fibrosis patients during intravenous antibiotic treatment

Böer, Klas, Pletz, Mathias W, Hentschel, Julia, Beiersdorf, Natalie, Mainz, Jochen G, Markert, Udo R, Jäger, Manuela, Doht, Franziska, Keller, Peter M, Michl, Ruth K, Lehmann, Thomas, Fischer, Nele

2014

Overview

Background In cystic fibrosis (CF) patients, the upper airways display the same ion channel defect as evident in the lungs, resulting in chronic inflammation and infection. Recognition of the sinonasal area as a site of first and persistent infection with pathogens, such as Pseudomonas aeruginosa , reinforces the “one-airway” hypothesis. Therefore, we assessed the effect of systemic antibiotics against pulmonary pathogens on sinonasal inflammation. Methods Nasal lavage fluid (NLF) from 17 CF patients was longitudinally collected prior to and during elective intravenous (i.v.) antibiotic treatment to reduce pathogen burden and resulting inflammation (median treatment time at time of analysis: 6 days). Samples were assessed microbiologically and cytologically. Cytokine and chemokine expression was measured by Cytometric Bead Array and ELISA (interleukin (IL)-1β, IL-6, IL-8, MPO, MMP9, RANTES and NE). Findings were compared with inflammatory markers from NLF obtained from 52 healthy controls. Results Initially, the total cell count of the NLF was significantly higher in CF patients than in controls. However after i.v. antibiotic treatment it decreased to a normal level. Compared with controls, detection frequencies and absolute concentrations of MPO, IL-8, IL-6 and IL-1β were also significantly higher in CF patients. The detection frequency of TNF was also higher. Furthermore, during i.v. therapy sinonasal concentrations of IL-6 decreased significantly ( P  = 0.0059), while RANTES and MMP9 levels decreased 10-fold and two-fold, respectively. PMN-Elastase, assessed for the first time in NFL, did not change during therapy. Conclusions Analysis of NLF inflammatory markers revealed considerable differences between controls and CF patients, with significant changes during systemic i.v. AB treatment within just 6 days. Thus, our data support further investigation into the collection of samples from the epithelial surface of the upper airways by nasal lavage as a potential diagnostic and research tool.

• Publisher: BioMed Central,BioMed Central Ltd
• Subject: Administration, Intravenous / Adolescent / Adult / Analysis / Anti-Bacterial Agents - therapeutic use / Case-Control Studies / Child / Critical Care Medicine / Cystic Fibrosis - diagnosis / Cystic Fibrosis - drug therapy / Cytokines - analysis / Female / Health aspects / Humans / Infectious / Inflammation Mediators - analysis / Intensive / Interleukin-6 - analysis / Interleukin-8 - analysis / Interleukins / Internal Medicine / Leukocyte Elastase - analysis / Longitudinal Studies / Male / Medicine / Medicine & Public Health / Monitoring, Physiologic - methods / Nasal Lavage Fluid - chemistry / Nasal Lavage Fluid - cytology / Pneumology/Respiratory System / Pseudomonas aeruginosa / Rare and Idiopathic Pulmonary Diseases / Reference Values / Research Article / Risk Assessment / Severity of Illness Index / Statistics, Nonparametric / Treatment Outcome / Young Adult