High concentrations of pepsin in bronchoalveolar lavage fluid from children with cystic fibrosis are associated with high interleukin-8 concentrations.
Shields, M D
Dimitrov, B D
El Nazir, B
Taggart, C C
Greene, C M
McElvaney, N G
AffiliationRespiratory Research Division, Royal College of Surgeons in Ireland, Beaumont, Hospital, Dublin, Ireland. email@example.com
Bronchoalveolar Lavage Fluid/*chemistry
MetadataShow full item record
CitationThorax. 2011 Feb;66(2):140-3. Epub 2010 Dec 15.
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.
- Gastro-oesophageal reflux and aspiration of gastric contents in adult patients with cystic fibrosis.
- Authors: Blondeau K, Dupont LJ, Mertens V, Verleden G, Malfroot A, Vandenplas Y, Hauser B, Sifrim D
- Issue date: 2008 Aug
- Pepsin in bronchoalveolar lavage fluid: a specific and sensitive method of diagnosing gastro-oesophageal reflux-related pulmonary aspiration.
- Authors: Farrell S, McMaster C, Gibson D, Shields MD, McCallion WA
- Issue date: 2006 Feb
- Nasal wash as an alternative to bronchoalveolar lavage in detecting early pulmonary inflammation in children with cystic fibrosis.
- Authors: Pitrez PM, Brennan S, Turner S, Sly PD
- Issue date: 2005 Mar
- Interleukin-8 concentrations are elevated in bronchoalveolar lavage, sputum, and sera of children with cystic fibrosis.
- Authors: Dean TP, Dai Y, Shute JK, Church MK, Warner JO
- Issue date: 1993 Aug
- Stability of interleukin 8 and neutrophil elastase in bronchoalveolar lavage fluid following long-term storage.
- Authors: Berry LJ, Sheil B, Garratt L, Sly PD, AREST CF
- Issue date: 2010 Sep