Cytokines and inflammatory mediators do not indicate acute infection in cystic fibrosis

Clin Diagn Lab Immunol. 1999 Mar;6(2):260-5.

Abstract

Various treatment regimens and difficulties with research design are encountered with cystic fibrosis (CF) because no standard diagnostic criteria exist for defining acute respiratory exacerbations. This study evaluated the role of serial monitoring of concentrations of selected cytokines and inflammatory mediators in serum and sputum as predictors of respiratory exacerbation, as useful outcome measures for CF, and to guide therapy. Interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-alpha), neutrophil elastase-alpha-1-protease inhibitor complex (NE complex), protein, and alpha-1-protease inhibitor (alpha-1-PI) were measured in serum and sputum collected from CF patients during respiratory exacerbations and periods of well-being. Levels of NE complex, protein, and alpha-1-PI in sputum rose during respiratory exacerbations and fell after institution of antibiotic therapy (P = 0.078, 0.001, and 0.002, respectively). Mean (+/- standard error of the mean) levels of IL-8 and TNF-alpha were extremely high in sputum (13,780 +/- 916 and 249.4 +/- 23.5 ng/liter, respectively) but did not change significantly with clinical deterioration of the patient (P > 0.23). IL-8 and TNF-alpha were generally undetectable in serum, and therefore these measures were unhelpful. Drop in forced expiratory volume in 1 s was the only clinical or laboratory parameter that was close to being a determinant of respiratory exacerbation (P = 0.055). This study provides evidence of intense immunological activity occurring continually within the lungs of adult CF patients. Measurement of cytokines and inflammatory mediators in CF sputum is not helpful for identifying acute respiratory exacerbations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Cystic Fibrosis / immunology*
  • Cystic Fibrosis / microbiology
  • Disease Progression
  • Female
  • Humans
  • Inflammation Mediators / analysis
  • Inflammation Mediators / blood*
  • Inflammation Mediators / immunology
  • Interleukin-8 / analysis
  • Interleukin-8 / blood
  • Interleukin-8 / immunology
  • Leukocyte Elastase / analysis
  • Leukocyte Elastase / immunology
  • Leukocyte Elastase / metabolism
  • Male
  • Pneumonia, Bacterial / immunology*
  • Predictive Value of Tests
  • Pseudomonas Infections / immunology*
  • Reproducibility of Results
  • Respiratory Function Tests
  • Sputum / chemistry
  • Sputum / microbiology
  • Tumor Necrosis Factor-alpha / analysis
  • Tumor Necrosis Factor-alpha / immunology
  • Tumor Necrosis Factor-alpha / metabolism*
  • alpha 1-Antitrypsin / analysis
  • alpha 1-Antitrypsin / immunology
  • alpha 1-Antitrypsin / metabolism

Substances

  • Inflammation Mediators
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • alpha 1-Antitrypsin
  • alpha 1-antitrypsin-leukocyte elastase complex
  • Leukocyte Elastase