High concentrations of pepsin in bronchoalveolar lavage fluid from children with cystic fibrosis are associated with high interleukin-8 concentrations.

Hdl Handle:
http://hdl.handle.net/10147/207197
Title:
High concentrations of pepsin in bronchoalveolar lavage fluid from children with cystic fibrosis are associated with high interleukin-8 concentrations.
Authors:
McNally, P; Ervine, E; Shields, M D; Dimitrov, B D; El Nazir, B; Taggart, C C; Greene, C M; McElvaney, N G; Greally, P
Affiliation:
Respiratory Research Division, Royal College of Surgeons in Ireland, Beaumont, Hospital, Dublin, Ireland. paul.mcnally@olchc.ie
Citation:
Thorax. 2011 Feb;66(2):140-3. Epub 2010 Dec 15.
Journal:
Thorax
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207197
DOI:
10.1136/thx.2009.130914
PubMed ID:
21160087
Abstract:
BACKGROUND: Gastro-oesophageal reflux is common in children with cystic fibrosis (CF) and is thought to be associated with pulmonary aspiration of gastric contents. The measurement of pepsin in bronchoalveolar lavage (BAL) fluid has recently been suggested to be a reliable indicator of aspiration. The prevalence of pulmonary aspiration in a group of children with CF was assessed and its association with lung inflammation investigated. METHODS: This was a cross-sectional case-control study. BAL fluid was collected from individuals with CF (n=31) and healthy controls (n=7). Interleukin-8 (IL-8), pepsin, neutrophil numbers and neutrophil elastase activity levels were measured in all samples. Clinical, microbiological and lung function data were collected from medical notes. RESULTS: The pepsin concentration in BAL fluid was higher in the CF group than in controls (mean (SD) 24.4 (27.4) ng/ml vs 4.3 (4.0) ng/ml, p=0.03). Those with CF who had raised pepsin concentrations had higher levels of IL-8 in the BAL fluid than those with a concentration comparable to controls (3.7 (2.7) ng/ml vs 1.4 (0.9) ng/ml, p=0.004). Within the CF group there was a moderate positive correlation between pepsin concentration and IL-8 in BAL fluid (r=0.48, p=0.04). There was no association between BAL fluid pepsin concentrations and age, sex, body mass index z score, forced expiratory volume in 1 s or Pseudomonas aeruginosa colonisation status. CONCLUSIONS: Many children with CF have increased levels of pepsin in the BAL fluid compared with normal controls. Increased pepsin levels were associated with higher IL-8 concentrations in BAL fluid. These data suggest that aspiration of gastric contents occurs in a subset of patients with CF and is associated with more pronounced lung inflammation.
Language:
eng
MeSH:
Adolescent; Biological Markers/analysis; Bronchoalveolar Lavage Fluid/*chemistry; Case-Control Studies; Child; Child, Preschool; Cystic Fibrosis/complications/*metabolism; Female; Humans; Infant; Interleukin-8/*analysis; Male; Pepsin A/*analysis; Respiratory Aspiration/diagnosis/etiology
ISSN:
1468-3296 (Electronic); 0040-6376 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMcNally, Pen_GB
dc.contributor.authorErvine, Een_GB
dc.contributor.authorShields, M Den_GB
dc.contributor.authorDimitrov, B Den_GB
dc.contributor.authorEl Nazir, Ben_GB
dc.contributor.authorTaggart, C Cen_GB
dc.contributor.authorGreene, C Men_GB
dc.contributor.authorMcElvaney, N Gen_GB
dc.contributor.authorGreally, Pen_GB
dc.date.accessioned2012-02-01T10:01:42Z-
dc.date.available2012-02-01T10:01:42Z-
dc.date.issued2012-02-01T10:01:42Z-
dc.identifier.citationThorax. 2011 Feb;66(2):140-3. Epub 2010 Dec 15.en_GB
dc.identifier.issn1468-3296 (Electronic)en_GB
dc.identifier.issn0040-6376 (Linking)en_GB
dc.identifier.pmid21160087en_GB
dc.identifier.doi10.1136/thx.2009.130914en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207197-
dc.description.abstractBACKGROUND: Gastro-oesophageal reflux is common in children with cystic fibrosis (CF) and is thought to be associated with pulmonary aspiration of gastric contents. The measurement of pepsin in bronchoalveolar lavage (BAL) fluid has recently been suggested to be a reliable indicator of aspiration. The prevalence of pulmonary aspiration in a group of children with CF was assessed and its association with lung inflammation investigated. METHODS: This was a cross-sectional case-control study. BAL fluid was collected from individuals with CF (n=31) and healthy controls (n=7). Interleukin-8 (IL-8), pepsin, neutrophil numbers and neutrophil elastase activity levels were measured in all samples. Clinical, microbiological and lung function data were collected from medical notes. RESULTS: The pepsin concentration in BAL fluid was higher in the CF group than in controls (mean (SD) 24.4 (27.4) ng/ml vs 4.3 (4.0) ng/ml, p=0.03). Those with CF who had raised pepsin concentrations had higher levels of IL-8 in the BAL fluid than those with a concentration comparable to controls (3.7 (2.7) ng/ml vs 1.4 (0.9) ng/ml, p=0.004). Within the CF group there was a moderate positive correlation between pepsin concentration and IL-8 in BAL fluid (r=0.48, p=0.04). There was no association between BAL fluid pepsin concentrations and age, sex, body mass index z score, forced expiratory volume in 1 s or Pseudomonas aeruginosa colonisation status. CONCLUSIONS: Many children with CF have increased levels of pepsin in the BAL fluid compared with normal controls. Increased pepsin levels were associated with higher IL-8 concentrations in BAL fluid. These data suggest that aspiration of gastric contents occurs in a subset of patients with CF and is associated with more pronounced lung inflammation.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshBiological Markers/analysisen_GB
dc.subject.meshBronchoalveolar Lavage Fluid/*chemistryen_GB
dc.subject.meshCase-Control Studiesen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshCystic Fibrosis/complications/*metabolismen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInterleukin-8/*analysisen_GB
dc.subject.meshMaleen_GB
dc.subject.meshPepsin A/*analysisen_GB
dc.subject.meshRespiratory Aspiration/diagnosis/etiologyen_GB
dc.titleHigh concentrations of pepsin in bronchoalveolar lavage fluid from children with cystic fibrosis are associated with high interleukin-8 concentrations.en_GB
dc.contributor.departmentRespiratory Research Division, Royal College of Surgeons in Ireland, Beaumont, Hospital, Dublin, Ireland. paul.mcnally@olchc.ieen_GB
dc.identifier.journalThoraxen_GB
dc.description.provinceLeinster-

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