Antimicrobial peptides, disease severity and exacerbations in bronchiectasis
| Autor: | Martina Oriano, Ana Rodrigo-Troyano, Guillermo Suarez-Cuartin, Lidia Perea, Holly R. Keir, Oriol Sibila, Stefano Aliberti, Elisabet Cantó, Diane Cassidy, Francesco Blasi, Amelia Shoemark, James D. Chalmers, Silvia Vidal, A. T. H. Smith, Samantha Ong |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Exacerbation medicine.medical_treatment medicine.disease_cause Severity of Illness Index Cathelicidin Proinflammatory cytokine 03 medical and health sciences 0302 clinical medicine Cathelicidins medicine Humans Secretory Leukocyte Peptidase Inhibitor Prospective Studies Aged 030304 developmental biology 0303 health sciences Bronchiectasis biology Pseudomonas aeruginosa Lactoferrin business.industry Sputum medicine.disease Europe Phenotype 030228 respiratory system Immunology Disease Progression biology.protein Female Muramidase medicine.symptom business Biomarkers Antimicrobial Cationic Peptides SLPI |
| Zdroj: | THORAX r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 1468-3296 0040-6376 |
| DOI: | 10.1136/thoraxjnl-2018-212895 |
| Popis: | RationaleRecently a frequent exacerbator phenotype has been described in bronchiectasis, but the underlying biological mechanisms are unknown. Antimicrobial peptides (AMPs) are important in host defence against microbes but can be proinflammatory in chronic lung disease.ObjectivesTo determine pulmonary and systemic levels of AMP and their relationship with disease severity and future risk of exacerbations in bronchiectasis.MethodsA total of 135 adults with bronchiectasis were prospectively enrolled at three European centres. Levels of cathelicidin LL-37, lactoferrin, lysozyme and secretory leucocyte protease inhibitor (SLPI) in serum and sputum were determined at baseline by ELISA. Patients were followed up for 12 months. We examined the ability of sputum AMP to predict future exacerbation risk.Measurements and main resultsAMP levels were higher in sputum than in serum, suggesting local AMP release. Patients with more severe disease at baseline had dysregulation of airway AMP. Higher LL-37 and lower SLPI levels were associated with Bronchiectasis Severity Index, lower FEV1 (forced expiratory volume in 1 s) and Pseudomonas aeruginosa infection. Low SLPI levels were also associated with the exacerbation frequency at baseline. During follow-up, higher LL-37 and lower SLPI levels were associated with a shorter time to the next exacerbation, whereas LL-37 alone predicted exacerbation frequency over the next 12 months.ConclusionsPatients with bronchiectasis showed dysregulated sputum AMP levels, characterised by elevated LL-37 and reduced SLPI levels in the frequent exacerbator phenotype. Elevated LL-37 and reduced SLPI levels are associated with Pseudomonas aeruginosa infection and can predict future risk of exacerbations in bronchiectasis. |
| Databáze: | OpenAIRE |
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