Inflammatory markers in cystic fibrosis patients with lung Pseudomonas aeruginosa infection

CHRONIC endobronchial inflammation and bacterial infection are the main cau ses of morbidity and mortality in cystic fibrosis (CF), an autosomal recess ive genetic disorder associated with improper function of chloride channels . Inflammation in CF lung is greatly amplified after Pseudomonas aeruginosa infection. In this study the relationship between P. aeruginosa status and inflammatory markers has been investigated. Seventeen CF children in acute lung exacerbation were examined. CF patients without P. aeruginosa infecti on mere characterized by elevated activity of sputum elastase, reduced resp onse of peripheral blood lymphocytes to PHA and sig significant resistance to the antiproliferative action of glucocorticoids. These parameters were n ormalized after antibiotic treatment. The patients with prolonged P. aerugi nosa infection demonstrated extremely high levels of elastase activity and elevated amounts of sputum IL-8 and TNF-alpha. Although antibiotic treatmen t resulted in clinical improvement, it failed to suppress excessive immune response in the lung. The data indicate that CF patients with prolonged P. aeruginosa need the modified treatment, which should include immunomodulati ng drugs and protease inhibitors as well as antibacterial therapy.