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Published ahead of print on September 11, 2003, doi:10.1164/rccm.200306-731OC
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American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 1471-1475, (2003)
© 2003 American Thoracic Society

Inflammatory and Microbiologic Markers in Induced Sputum after Intravenous Antibiotics in Cystic Fibrosis

Claudia L. Ordoñez, Noreen R. Henig, Nicole Mayer-Hamblett, Frank J. Accurso, Jane L. Burns, James F. Chmiel, Cori L. Daines, Ronald L. Gibson, Sharon McNamara, George Z. Retsch-Bogart, Pamela L. Zeitlin and Moira L. Aitken

Departments of Pediatrics, Harvard Medical School, Boston, Massachusetts; University of Colorado School of Medicine, Denver, Colorado; Case Western Reserve University School of Medicine, Cleveland; University of Cincinnati College of Medicine, Cincinnati, Ohio; University of North Carolina, Chapel Hill, North Carolina; The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Stanford University School of Medicine, Stanford, California; and Departments of Pediatrics and Medicine, University of Washington, Seattle, Washington

Correspondence and requests for reprints should be addressed to Claudia L. Ordoñez, M.D., Children's Hospital, Division of Respiratory Diseases, 300 Longwood Avenue, Boston, MA 02215. E-mail: claudia.ordonez{at}tch.harvard.edu

Induced sputum has been used to study airway inflammation. We sought to determine whether markers of infection and inflammation in induced sputum were a useful and safe outcome measure in cystic fibrosis. We hypothesized that bacterial density and inflammatory content of induced sputum would decrease after antibiotic therapy. Induced sputum was assayed for bacterial density, cell count, and differential and inflammatory markers before and after treatment with intravenous antibiotics. Fifty-five of the 72 subjects enrolled (mean age ± SD 18.2 ± 7.9 years) completed the study. FEV1 increased by an average 0.3 ± 0.3 L (10.4 ± 8.7% predicted FEV1), p < 0.0001; density of Pseudomonas aeruginosa and Staphylococcus aureus decreased by 2.4 ± 3.1 log10 cfu/g (p < 0.0005) and 4.0 ± 2.3 log10 cfu/ml (p < 0.0001), respectively; neutrophil count decreased by 0.4 ± 0.6 log10 cells/ml (p < 0.0001), interleukin-8 concentration by 0.5 ± 1.3 log10 pg/ml (p < 0.05), and neutrophil elastase by 0.4 ± 0.7 log10 µg/ml (p < 0.005). Seven of 127 (6%) sputum induction procedures showed a decrease in FEV1 of 20% or more. We conclude that markers in induced sputum may be useful, noninvasive outcome measures to assess response to therapies in cystic fibrosis studies.

Key Words: cystic fibrosis • induced sputum • inflammatory markers • bacterial density




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