Inflammatory Responses, Spirometry, and Quality of Life in Subjects With Bronchiectasis Exacerbations.
BACKGROUND: Bronchiectasis exacerbations are critical events characterized by worsened symptoms and signs (ie, cough frequency, sputum volume, malaise). Objectives: Our goal was to examine variations in airway and systemic inflammation, spirometry, and quality of life during steady state, bronchiect...
| Published in: | Respiratory Care Vol. 60; no. 8; pp. 1180 - 1190 |
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| Main Authors: | , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Mary Ann Liebert, Inc.
Aug2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109826264&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109826264 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Aug2015 vid: 60 iid: 8 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 109826264 108735523 10.4187/respcare.04004 NLM26060319 109826264 ppf: 1180 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Inflammatory Responses, Spirometry, and Quality of Life in Subjects With Bronchiectasis Exacerbations. aug: au: Wei-jie Guan Yong-hua Gao Gang Xu Zhi-ya Lin Yan Tang Hui-min Li Zhi-min Lin Mei Jiang Jin-ping Zheng Rong-chang Chen Nan-shan Zhong affil: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China sug: subj: Bronchiectasis Physiopathology Disease Exacerbation Physiopathology Recovery Immunology Quality of Life Bacterial Infections Biological Markers Spirometry Human Sputum Analysis Blood Analysis Questionnaires Descriptive Statistics Adult Middle Age Forced Expiratory Volume Forced Expiratory Flow Rates Funding Source Female Male C-Reactive Protein Blood Data Analysis Software Chi Square Test T-Tests One-Way Analysis of Variance Kruskal-Wallis Test Antibiotics Therapeutic Use Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: BACKGROUND: Bronchiectasis exacerbations are critical events characterized by worsened symptoms and signs (ie, cough frequency, sputum volume, malaise). Objectives: Our goal was to examine variations in airway and systemic inflammation, spirometry, and quality of life during steady state, bronchiectasis exacerbations, and convalescence (1 week following a 2-week antibiotic treatment) to determine whether potentially pathogenic microorganisms, including Pseudomonas aeruginosa, were associated with poorer conditions during bronchiectasis exacerbations. METHODS: Peripheral blood and sputum were sampled to detect inflammatory mediators and bacterial densities. Spirometry and quality of life (St George Respiratory Questionnaire [SGRQ]) were assessed during the 3 stages. RESULTS: Forty-eight subjects with bronchiectasis (43.2 ± 14.2 y of age) were analyzed. No notable differences in species and density of potentially pathogenic microorganisms were found during bronchiectasis exacerbations. Except for CXCL8 and tumor necrosis factor alpha (TNF-a), serum inflammation was heightened during bronchiectasis exacerbations and recovered during convalescence. Even though sputum TNF-a was markedly higher during bronchiectasis exacerbations and remained heightened during convalescence, the variations in miscellaneous sputum markers were unremarkable. Bronchiectasis exacerbations were associated with notably higher SGRQ symptom and total scores, which recovered during convalescence. FVC, FEV!, and maximum mid-expiratory flow worsened during bronchiectasis exacerbations (median change from baseline of -2.2%, -0.8%, and -1.3%) and recovered during convalescence (median change from baseline of 0.6%, 0.7%, and -0.7%). Compared with no bacterial isolation, potentially pathogenic microorganism or P. aeruginosa isolation at baseline did not result in poorer clinical condition during bronchiectasis exacerbations. CONCLUSIONS: Bronchiectasis exacerbations are characterized by heightened inflammatory responses and poorer quality of life and spirometry, but not by increased bacterial density, which applies for subjects with and without potentially pathogenic microorganism isolation when clinically stable. (CIinicalTrials.gov registration NCT01761214.) pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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