Article Text

This article has a correction. Please see:

Download PDFPDF

Early airway infection, inflammation, and lung function in cystic fibrosis
  1. G M Nixon1,
  2. D S Armstrong1,
  3. R Carzino1,
  4. J B Carlin2,
  5. A Olinsky1,
  6. C F Robertson1,
  7. K Grimwood3
  1. 1Department of Respiratory Medicine, Royal Children’s Hospital, Melbourne, Australia
  2. 2Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, Australia
  3. 3Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
  1. Correspondence to:
    Dr G Nixon, Division of Respiratory Medicine, Montreal Children’s Hospital, 2300 Tupper St, Montreal H3H 1P3, Canada;
    gillian.nixon{at}muhc.mcgill.ca

Abstract

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.

  • respiratory function test
  • cystic fibrosis
  • infection
  • inflammation
  • BL, bronchial lavage
  • CBA, chocolate bacitracin agar
  • CF, cystic fibrosis
  • CFU, colony forming unit
  • FEV, forced expiratory volume
  • GEE, generalised estimating equation
  • IL, interleukin
View Full Text

Statistics from Altmetric.com

Footnotes

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Linked Articles

    • CORRECTION
      BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health