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Erschienen in: Wiener klinische Wochenschrift 19-20/2020

30.04.2020 | original article

Influence of pancreatic status, CFTR mutations, Staphylococcus aureus and/or Pseudomonas aeruginosa infection/colonization on lung function in cystic fibrosis during a 2-year follow-up period

verfasst von: Maíra Andrade Pascoal, MSe, Fernando Augusto Lima Marson, PhD, Ilma Aparecida Paschoal, PhD, Carlos Emílio Levy, PhD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 19-20/2020

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Summary

Introduction

Cystic fibrosis (CF) presents with progressive and chronic deterioration of lung function due to inflammation and colonization/infection of the lungs. This study evaluated spirometry and colonization/infection with Staphylococcus aureus and/or Pseudomonas aeruginosa over a 24-month follow-up period.

Methods

A total of 52 CF patients were studied with spirometry: forced vital capacity (FVC), forced expiratory volume in one second of FVC (FEV1), FEV1/FVC and forced expiratory flow between 25% and 75% of FVC (FEF25–75%). Colonization/infection was evaluated as predominantly S. aureus, predominantly P. aeruginosa or concomitance of these microorganisms.

Results

In CF, there was a higher prevalence of p.Phe508del/p.Phe508del genotype (16/52; 30.8%) and female gender (33/52; 63.5%). Spirometry (% predicted) markers worsened for the following groups over the 24-month period: (i) male: FVC, FEV1, FEV1/FVC, FEF25–75%; (ii) female: FVC%, FEV1, (iii) predominantly S. aureus: FVC, FEV1, FEV1/FVC, FEF25–75%; (iv) predominantly P aeruginosa: FEV1/FVC; (v) concomitant S. aureus and P. aeruginosa: FVC, FEV1. Age correlated with reduction of FVC(Liter) (Rho = −0.50) and FEV1(Liter) (Rho = −0.46). Pancreatic insufficiency and severe cystic fibrosis transmembrane regultador (CFTR) mutations were associated with deteriorating lung function.

Conclusion

In CF, deterioration of lung function as evaluated by spirometry was continuous and varied according to sex, pancreatic insufficiency, and severe CFTR mutations. No differences were observed between groups in terms of predominant type of bacteria, but the reduction of spirometry parameters was significant in the predominantly S. aureus and concomitant infection groups.
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Literatur
1.
Zurück zum Zitat Knowles MR, Boucher RC. Mucus clearance as a primary innate defense mechanism for mammalian airways. J Clin Invest. 2002;109(5):571–7.CrossRef Knowles MR, Boucher RC. Mucus clearance as a primary innate defense mechanism for mammalian airways. J Clin Invest. 2002;109(5):571–7.CrossRef
2.
Zurück zum Zitat Wanner A, Salathé M, O’Riordan TG. Mucociliary clearance in the airways. Am J Respir Crit Care Med. 1996;154(6):1868–902.CrossRef Wanner A, Salathé M, O’Riordan TG. Mucociliary clearance in the airways. Am J Respir Crit Care Med. 1996;154(6):1868–902.CrossRef
3.
Zurück zum Zitat Baltimore RS, Christie CD, Smith GJ. Immunohistopathologic localization of Pseudomonas aeruginosa in lungs from patients with cystic fibrosis. Implications for the pathogenesis of progressive deterioration. Am Rev Respir Dis. 1989;140(6):1650–61.CrossRef Baltimore RS, Christie CD, Smith GJ. Immunohistopathologic localization of Pseudomonas aeruginosa in lungs from patients with cystic fibrosis. Implications for the pathogenesis of progressive deterioration. Am Rev Respir Dis. 1989;140(6):1650–61.CrossRef
4.
Zurück zum Zitat Worlitzsch D, Tarran R, Ulrich M, Schwab U, Cekici A, Meyer KC, et al. Effects of reduced mucus oxygen concentration in airway Pseudomonas aeruginosa of cystic fibrosis patients. J Clin Invest. 2002;209(3):317–25.CrossRef Worlitzsch D, Tarran R, Ulrich M, Schwab U, Cekici A, Meyer KC, et al. Effects of reduced mucus oxygen concentration in airway Pseudomonas aeruginosa of cystic fibrosis patients. J Clin Invest. 2002;209(3):317–25.CrossRef
5.
Zurück zum Zitat Boucher RC. Airway surface dehydration in cystic fibrosis: pathogenesis and therapy. Annu Rev Med. 2007;58:157–70.CrossRef Boucher RC. Airway surface dehydration in cystic fibrosis: pathogenesis and therapy. Annu Rev Med. 2007;58:157–70.CrossRef
6.
Zurück zum Zitat Huang YJ, LiPuma JJ. The microbiome in cystic fibrosis. Clin Chest Med. 2016;37(1):59–67.CrossRef Huang YJ, LiPuma JJ. The microbiome in cystic fibrosis. Clin Chest Med. 2016;37(1):59–67.CrossRef
8.
Zurück zum Zitat Dickson RP, Erb-Downward JR, Martinez FJ, Huffnagle GB. The microbiome and the respiratory tract. Annu Rev Physiol. 2016;78:481–504.CrossRef Dickson RP, Erb-Downward JR, Martinez FJ, Huffnagle GB. The microbiome and the respiratory tract. Annu Rev Physiol. 2016;78:481–504.CrossRef
9.
Zurück zum Zitat Erb-Downward JR, Thompson DL, Han MK, Freeman CM, McCloskey L, Schmidt LA, et al. Analysis of the lung microbiome in the “healthy” smoker and in COPD. PLoS One. 2011;6(2):e16384.CrossRef Erb-Downward JR, Thompson DL, Han MK, Freeman CM, McCloskey L, Schmidt LA, et al. Analysis of the lung microbiome in the “healthy” smoker and in COPD. PLoS One. 2011;6(2):e16384.CrossRef
10.
Zurück zum Zitat Morris A, Beck JM, Schloss PD, Campbell TB, Crothers K, Curtis JL, et al. Comparison of the respiratory microbiome in healthy non-smokers and smokers. Am J Respir Crit Care Med. 2013;187(10):1067–75.CrossRef Morris A, Beck JM, Schloss PD, Campbell TB, Crothers K, Curtis JL, et al. Comparison of the respiratory microbiome in healthy non-smokers and smokers. Am J Respir Crit Care Med. 2013;187(10):1067–75.CrossRef
11.
Zurück zum Zitat Farrell PM, White TB, Ren CL, Hempstead SE, Accurso F, Derichs N, et al. Diagnosis of cystic fibrosis: consensus guidelines from the cystic fibrosis foundation. J Pediatr. 2017;181:S4–S15.CrossRef Farrell PM, White TB, Ren CL, Hempstead SE, Accurso F, Derichs N, et al. Diagnosis of cystic fibrosis: consensus guidelines from the cystic fibrosis foundation. J Pediatr. 2017;181:S4–S15.CrossRef
12.
Zurück zum Zitat Marson FAL, Bertuzzo CS, Ribeiro MAGO, Ribeiro AF, Ribeiro JD. Screening for F508del as a first step in the molecular diagnosis of cystic fibrosis. J Bras Pneumol. 2013;39(3):306–16.CrossRef Marson FAL, Bertuzzo CS, Ribeiro MAGO, Ribeiro AF, Ribeiro JD. Screening for F508del as a first step in the molecular diagnosis of cystic fibrosis. J Bras Pneumol. 2013;39(3):306–16.CrossRef
13.
Zurück zum Zitat Bonadia LC, Marson FAL, Ribeiro JD, Paschoal IA, Pereira MC, Ribeiro AF, et al. CFTR genotype and clinical outcomes of adult patients carried as cystic fibrosis disease. Gene. 2014;540(2):183–90.CrossRef Bonadia LC, Marson FAL, Ribeiro JD, Paschoal IA, Pereira MC, Ribeiro AF, et al. CFTR genotype and clinical outcomes of adult patients carried as cystic fibrosis disease. Gene. 2014;540(2):183–90.CrossRef
14.
Zurück zum Zitat Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardization of spirometry. Eur Respir J. 2005;26(2):319–38.CrossRef Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardization of spirometry. Eur Respir J. 2005;26(2):319–38.CrossRef
15.
Zurück zum Zitat Pereira CA, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33(4):397–406.CrossRef Pereira CA, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33(4):397–406.CrossRef
16.
Zurück zum Zitat Lee TWR, Brownlee KG, Conway SP, Denton M, Littlewood JM. Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. J Cyst Fibros. 2003;2(1):29–34.CrossRef Lee TWR, Brownlee KG, Conway SP, Denton M, Littlewood JM. Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. J Cyst Fibros. 2003;2(1):29–34.CrossRef
17.
Zurück zum Zitat Harun SN, Wainwright C, Klein K, Hennig S. A systematic review of studies examining the rate of lung function decline in patients with cystic fibrosis. Paediatr Respir Rev. 2016;20:55–66.PubMed Harun SN, Wainwright C, Klein K, Hennig S. A systematic review of studies examining the rate of lung function decline in patients with cystic fibrosis. Paediatr Respir Rev. 2016;20:55–66.PubMed
18.
Zurück zum Zitat Sanders DB, Li Z, Laxova A, Rock MJ, Levy H, Collins J, et al. Risk factors for the progression of cystic fibrosis lung disease throughout childhood. Ann Am Thorac Soc. 2014;11(1):63–72.CrossRef Sanders DB, Li Z, Laxova A, Rock MJ, Levy H, Collins J, et al. Risk factors for the progression of cystic fibrosis lung disease throughout childhood. Ann Am Thorac Soc. 2014;11(1):63–72.CrossRef
19.
Zurück zum Zitat Cogen J, Emerson J, Sanders DB, Ren C, Schechter MS, Gibson RL, et al. Risk factors for lung function decline in a large cohort of young cystic fibrosis patients. Pediatr Pulmonol. 2015;50(8):763–70.CrossRef Cogen J, Emerson J, Sanders DB, Ren C, Schechter MS, Gibson RL, et al. Risk factors for lung function decline in a large cohort of young cystic fibrosis patients. Pediatr Pulmonol. 2015;50(8):763–70.CrossRef
20.
Zurück zum Zitat Dasenbrook EC, Merlo CA, Diener-West M, Lechtzin N, Boyle MP. Persistent methicillin-resistant Staphylococcus aureus and rate of FEV1 decline in cystic fibrosis. Am J Respir Crit Care Med. 2008;178(8):814–21.CrossRef Dasenbrook EC, Merlo CA, Diener-West M, Lechtzin N, Boyle MP. Persistent methicillin-resistant Staphylococcus aureus and rate of FEV1 decline in cystic fibrosis. Am J Respir Crit Care Med. 2008;178(8):814–21.CrossRef
21.
Zurück zum Zitat Szczesniak RD, McPhail GL, Duan LL, Macaluso M, Amin RS, Clancy JP. A semiparametric approach to estimate rapid lung function decline in cystic fibrosis. Ann Epidemiol. 2013;23(12):771–7.CrossRef Szczesniak RD, McPhail GL, Duan LL, Macaluso M, Amin RS, Clancy JP. A semiparametric approach to estimate rapid lung function decline in cystic fibrosis. Ann Epidemiol. 2013;23(12):771–7.CrossRef
22.
Zurück zum Zitat Kerem E, Corey M, Kerem BS, Rommens J, Markiewicz D, Levison H, et al. The relation between genotype and phenotype in cystic fibrosis—analysis of the most common mutation (delta F508). N Engl J Med. 1990;323(22):1517–22.CrossRef Kerem E, Corey M, Kerem BS, Rommens J, Markiewicz D, Levison H, et al. The relation between genotype and phenotype in cystic fibrosis—analysis of the most common mutation (delta F508). N Engl J Med. 1990;323(22):1517–22.CrossRef
23.
Zurück zum Zitat Gan KH, Veeze HJ, van den Ouweland AM, Halley DJ, Scheffer H, van der Hout A, et al. A cystic fibrosis mutation associated with mild lung disease. N Engl J Med. 1995;333(2):95–9.CrossRef Gan KH, Veeze HJ, van den Ouweland AM, Halley DJ, Scheffer H, van der Hout A, et al. A cystic fibrosis mutation associated with mild lung disease. N Engl J Med. 1995;333(2):95–9.CrossRef
24.
Zurück zum Zitat Corey M, Edwards L, Levison H, Knowles M. Longitudinal analysis of pulmonary function decline in patients with cystic fibrosis. J Pediatr. 1997;131(6):809–14.CrossRef Corey M, Edwards L, Levison H, Knowles M. Longitudinal analysis of pulmonary function decline in patients with cystic fibrosis. J Pediatr. 1997;131(6):809–14.CrossRef
25.
Zurück zum Zitat Schibler A, Bolt I, Gallati S, Schoni MH, Kraemer R. High morbidity and mortality in cystic fibrosis patients compound heterozygous for 3905insT and deltaF508. Eur Respir J. 2001;17(6):1181–6.CrossRef Schibler A, Bolt I, Gallati S, Schoni MH, Kraemer R. High morbidity and mortality in cystic fibrosis patients compound heterozygous for 3905insT and deltaF508. Eur Respir J. 2001;17(6):1181–6.CrossRef
26.
Zurück zum Zitat Schaedel C, de Monestrol I, Hjelte L, Johannesson M, Kornfält R, Lindblad A, et al. Predictors of deterioration of lung function in cystic fibrosis. Pediatr Pulmonol. 2002;33(6):483–91.CrossRef Schaedel C, de Monestrol I, Hjelte L, Johannesson M, Kornfält R, Lindblad A, et al. Predictors of deterioration of lung function in cystic fibrosis. Pediatr Pulmonol. 2002;33(6):483–91.CrossRef
27.
Zurück zum Zitat Taylor-Robinson D, Whitehead M, Diderichsen F, Olesen HV, Pressler T, Smyth RL, et al. Understanding the natural progression in %FEV1 decline in patients with cystic fibrosis: a longitudinal study. Thorax. 2012;67(10):860–6.CrossRef Taylor-Robinson D, Whitehead M, Diderichsen F, Olesen HV, Pressler T, Smyth RL, et al. Understanding the natural progression in %FEV1 decline in patients with cystic fibrosis: a longitudinal study. Thorax. 2012;67(10):860–6.CrossRef
28.
Zurück zum Zitat Peters BM, Jabra-Rizk MA, O’May GA, Costerton JW, Shirtliff ME. Polymicrobial interactions: impact on pathogenesis and human disease. Clin Microbiol Rev. 2012;25:193–213.CrossRef Peters BM, Jabra-Rizk MA, O’May GA, Costerton JW, Shirtliff ME. Polymicrobial interactions: impact on pathogenesis and human disease. Clin Microbiol Rev. 2012;25:193–213.CrossRef
29.
Zurück zum Zitat Harrison F. Microbial ecology of the cystic fibrosis lung. Microbiology. 2007;153:917–23.CrossRef Harrison F. Microbial ecology of the cystic fibrosis lung. Microbiology. 2007;153:917–23.CrossRef
30.
Zurück zum Zitat Schuster M, Sexton DJ, Diggle SP, Greenberg EP. Acyl-homoserine lactone quorum sensing: from evolution to application. Annu Rev Microbiol. 2013;67:43–63.CrossRef Schuster M, Sexton DJ, Diggle SP, Greenberg EP. Acyl-homoserine lactone quorum sensing: from evolution to application. Annu Rev Microbiol. 2013;67:43–63.CrossRef
31.
Zurück zum Zitat Limoli DH, Whitfield GB, Kitao T, Ivey ML, Davis MR Jr, Grahl N, et al. Pseudomonas aeruginosa alginate overproduction promotes coexistence with Staphylococcus aureus in a model of cystic fibrosis respiratory infection. mBio. 2017;8:e00186–17.CrossRef Limoli DH, Whitfield GB, Kitao T, Ivey ML, Davis MR Jr, Grahl N, et al. Pseudomonas aeruginosa alginate overproduction promotes coexistence with Staphylococcus aureus in a model of cystic fibrosis respiratory infection. mBio. 2017;8:e00186–17.CrossRef
32.
Zurück zum Zitat Bjarnsholt T, Alhede M, Alhede M, Eickhardt-Sørensen SR, Moser C, Kühl M, et al. The in vivo biofilm. Trends Microbiol. 2013;21:466–74.CrossRef Bjarnsholt T, Alhede M, Alhede M, Eickhardt-Sørensen SR, Moser C, Kühl M, et al. The in vivo biofilm. Trends Microbiol. 2013;21:466–74.CrossRef
33.
Zurück zum Zitat Kragh KN, Hutchison JB, Melaugh G, Rodesney C, Roberts AEL, Irie Y, et al. Role of multicellular aggregates in biofilm formation. mBio. 2016;7:e00237–16.CrossRef Kragh KN, Hutchison JB, Melaugh G, Rodesney C, Roberts AEL, Irie Y, et al. Role of multicellular aggregates in biofilm formation. mBio. 2016;7:e00237–16.CrossRef
34.
Zurück zum Zitat Connell JL, Kim J, Shear JB, Bard AJ, Whiteley M. Real-time monitoring of quorum sensing in 3D-printed bacterial aggregates using scanning electrochemical microscopy. Proc Natl Acad Sci USA. 2014;111:18255–60.CrossRef Connell JL, Kim J, Shear JB, Bard AJ, Whiteley M. Real-time monitoring of quorum sensing in 3D-printed bacterial aggregates using scanning electrochemical microscopy. Proc Natl Acad Sci USA. 2014;111:18255–60.CrossRef
Metadaten
Titel
Influence of pancreatic status, CFTR mutations, Staphylococcus aureus and/or Pseudomonas aeruginosa infection/colonization on lung function in cystic fibrosis during a 2-year follow-up period
verfasst von
Maíra Andrade Pascoal, MSe
Fernando Augusto Lima Marson, PhD
Ilma Aparecida Paschoal, PhD
Carlos Emílio Levy, PhD
Publikationsdatum
30.04.2020
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 19-20/2020
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-020-01660-7

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