- Email: [email protected]
204 – Reactance measurements as an assessment of alveolar-capillar barrier of respiratory tract in patients with cystic fibrosis
POSTER PRESENTATIONS
S305
RESULTS
RESULTS
A significant negative correlation was found between scannography scores, trans-cutaneous O2 saturation (r = 0.44, p = 0.002) and the PaO2 (r = 0.40, p = 0.029). The best prediction for PaO2 was obtained with the score of mosaı¨c pattern during inspiration (r = 0.51, p = 0.004). As expected, a negative correlation was confirmed between parameters of pulmonary function testing (FEV 1, r = 0.63, p < 0.0001; DME 25/75, r = 0.71, p < 0.0001; VR/CPT, r = 0.57, p = 0.03) and scannography scores. There was no significant correlation between gas exchange parameters and scores that not include mosaic pattern.
Median age at first P. aeruginosa isolation was 14 months (age range 5 m to 13 y). Six patients received only step 1, three received step 2 and four received step 3 treatment. P. aeruginosa cultures post treatment were negative in all patients but one, for a period between 1 and 18 months (median of 3.5 m).
CONCLUSION Our modified scannography score is a predictive indicator of hypoxemia in CF patients. The proper role of HRCTscan compared with pulmonary function testing remains to be determined however, especially regarding frequency of follow-up studies. DOI: 10.1016/j.prrv.2006.04.087 E7/279 – Initial colonization with Pseudomonas aeruginosa in cystic fibrosis: Preliminary results of an eradication protocol F.V. Adde, J.B. Souza, P. Catherino, L.V.F. Silva and J.C. Rodrigues Instituto da Crianc¸a, Hospital das Clinicas, Sa˜o Paulo, Brazil Antipseudomonal therapy at the time of early Pseudomonas aeruginosa infection has been used in cystic fibrosis (CF) patients in order to try to eradicate this pathogen but the optimal drug regimen is not established
CONCLUSIONS The first P. aeruginosa isolation occured mostly in very young patients. Half of the patients needed more than one treatment and this led to a P. aeruginosa free-period in 12/13 patients, although the follow up in many of these patients is still too short. The early age of P.aeruginosa acquisition among our patients is a concern and long term follow up will be crucial in order to evaluate if this eradication protocol will be effective in postponing chronic P. aeruginosa infection. DOI: 10.1016/j.prrv.2006.04.088 E8/204 – Reactance measurements as an assessment of alveolar-capillar barrier of respiratory tract in patients with cystic fibrosis A. Minarowska1, M. Kaczmarski1, L. Minarowski2 and M. Mrugacz3 1 Medical University of Bialystok 3rd Department of Children’s Diseases, Bialystok, Poland; 2Public Clinical Hospital of Medical University of Bialystok, Bialystok, Poland; 3 Medical University of Bialystok Department of Children’s Ophtalmology, Bialystok, Poland Cystic fibrosis (CF) is the most common, genetic disease in Caucasians. Along with the progress of the lung disease and chronic infection of aggressive pathogens, there is continuous deterioration of alveolar gas exchange.
OBJECTIVES Evaluate the rate of eradication of initial P. aeruginosa isolation in CF patients that received systemic and inhaled antibiotics following a standard protocol.
MATERIAL AND METHODS Between Feb/04 and Dec/05 thirteen patients, 7M/6F, were evaluated in their first P. aeruginosa isolation. The eradication protocol consisted of: step 1 (1st isolation) = 3 weeks of ciprofloxacin or intravenous antibiotics + inhaled gentamicin or colistin for 3 to 6 weeks; step 2 (2nd isolation) = 3 weeks of ciprofloxacin or intravenous antibiotics + inhaled gentamicin or colistin for 12 weeks; step 3 (3rd isolation) = 6 weeks of ciprofloxacin + 6 months of inhaled gentamicin or colistin. Oropharyngeal swabs or sputum cultures were performed approximately every 2 months.
AIM OF THE STUDY The aim of this study was to assess the alveolar-capillary barrier in patients with CF using reactance measurement from impulsive oscillometry in comparison to single breath diffusion.
MATERIAL AND METHODS The study was performed in two groups: control group – 43 healthy subjects (14F, 18M) aged 6–23 yrs and studied group – 18 patients with diagnosed CF (7F, 11M) aged 8-27yrs.In both groups measurements of resistance (R at 5, 10, 20, 35 Hz) and reactance (X at 5, 10, 20 Hz) were performed. Measurements of TLCOSB, KCO and alveolar volume were performed to assess the alveolar-capillary barrier. Obtained results were compared to controls. In statistical analysis confidence interval of 95% was accepted.
S306
POSTER PRESENTATIONS
RESULTS
METHODS
In studied group mean values of resistance (kPa/l/s) were: R5 0.675 0.36 and R10 0.59 0.23 in females, R5 0.42 0.22 and R10 0.35 0.2 in males; reactance (kPa/ l/s): X5 0.33 0.22 and X10 0.15 0.19 in females, X5 0.14 0.08 and X10 0.026 0.05 in males. Obtained mean values of TLCOSB were: 3.69 2.5 L in females (control group: 6.8 1.2 L, p < 0.05) and 7.11 1.8 L (control group: 8.17 2.6 L, p = 0.25). Strong correlation of reactance (X) and diffusion factor for carbon monoxide (TLCOSB) was revealed in all groups, with highest values in studied female group (r = 0.93, p < 0.05).
Young CF children (<5 years) underwent BAL when clinically stable. Pooled BAL specimens from RUL, RML and lingula were sent for quantitative bacterial cultures, viral immunofluorescence, cell count and differential and S100 proteins. Paired serum/BAL samples were assayed for S100 proteins using the Phical Test ELIZA and a polyclonal antibody ELIZA.
CONCLUSIONS Impulse oscillometry can be an alternative method of alveolar-capillary barrier assessment in patients with cystic fibrosis or in cases when classis single breath diffusion is technically impossible to perform or patient’s compliance is poor. In studied group greater impaired gas exchange was revealed in female group. DOI: 10.1016/j.prrv.2006.04.089 E9/324 – Serum S-100 proteins (A12 and calprotectin) are associated with bronchoalveolar lavage evidence of airway infection and inflammation in young children with cystic fibrosis and are potential simple non-invasive markers of early lung disease Yvonne Belessis1, Steven Leach2, Glenn Hawkins3, Andrew Numa1, John Morton1, Kei Lui4 and Andrew Day1 1 Sydney Children’s Hospital Respiratory Medicine, Sydney, Australia; 2Strasser Research Laboratory, Randwick, Australia; 3 Seals, Randwick, Australia; 4Royal Hospital for Women Airway Inflammation Laboratory, Sydney, Australia
BACKGROUND Airway infection and neutrophilic inflammation occur early in CF and often go unrecognised, potentially leading to significant and irreversible lung disease. Bronchoalveolar lavage (BAL) identifies infection and inflammation in young children unable to expectorate but is invasive and resource intensive. Serum calprotectin (S-100A8/S-100A9), a cytosolic protein released during neutrophilic activation, has been used as a simple, non-invasive marker of inflammation and disease activity in several conditions including adult cystic fibrosis. We evaluated the role of serum S-100A12 and calprotectin in determining airway infection and inflammation in young CF children without clinically apparent disease.
AIMS To determine whether serum S100 proteins (A12, calprotectin) are elevated in the presence of airway infection and inflammation in young children with CF.
RESULTS 24 children (13 boys, aged 0.36–2.64 y, 50% homozygous DF508) were studied. 16 children (67%) had evidence of infection (>101 cfu/ml) of which 13 (54%) had significant infection (>105 cfu/ml) and 5 (21%) isolated Pseudomonas. Serum A12 and calprotectin were elevated in the presence of airway infection, see table. BAL neutrophils were significantly correlated with BAL calprotectin (r = 0.80, p = 000) and serum calprotectin, (r = 0.45, p = 0.029).
CONCLUSION Serum A12 and calprotectin are elevated in the presence of airway infection and inflammation and may be useful noninvasive markers of early lung disease in young CF children with minimal clinical signs. DOI: 10.1016/j.prrv.2006.04.090
Respiratory Manifestations of Extra-Pulmonary Diseases (Including AIDS) G1/260 – Correlation between switched memory B cells and development of bronchietasis in patients with Common variable immunodeficiency Asghhar Aghamohammadi1, Mostafa Moin1, Mohammad Vodjgani2, Morteza Samadi2, Abdolfattah Sarraf Nejad2, Jamshid Hajati2, Mahro Mirahmadian2, Nima Parvaneh1, Ali Salavati1 and Sina Abdollahzade1 1 Tehran University Medical Sciences Department of Pediatrics, Tehran, Iran; 2Tehran University of Medical Sciences Department of Immunology, Tehran, Iran Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency disorders characterized by hypogammaglobulinemia resulting to recurrent infections. Some groups of patients with CVID are particularly prone to earlier onset of respiratory disease and bronchiectasis. Based on switched memory B cells, CVID patients are divided into two groups: Group I (switched memory B cells less than 0.4% of PBLs) and Group II (switched memory B cells greater than 0.4% of PBLs). CVID patients in Group I are more susceptible to recurrent respiratory infection compared with Group II. To determine the correlation between switched memory B cells and development of bronchietasis in patients
S305
RESULTS
RESULTS
A significant negative correlation was found between scannography scores, trans-cutaneous O2 saturation (r = 0.44, p = 0.002) and the PaO2 (r = 0.40, p = 0.029). The best prediction for PaO2 was obtained with the score of mosaı¨c pattern during inspiration (r = 0.51, p = 0.004). As expected, a negative correlation was confirmed between parameters of pulmonary function testing (FEV 1, r = 0.63, p < 0.0001; DME 25/75, r = 0.71, p < 0.0001; VR/CPT, r = 0.57, p = 0.03) and scannography scores. There was no significant correlation between gas exchange parameters and scores that not include mosaic pattern.
Median age at first P. aeruginosa isolation was 14 months (age range 5 m to 13 y). Six patients received only step 1, three received step 2 and four received step 3 treatment. P. aeruginosa cultures post treatment were negative in all patients but one, for a period between 1 and 18 months (median of 3.5 m).
CONCLUSION Our modified scannography score is a predictive indicator of hypoxemia in CF patients. The proper role of HRCTscan compared with pulmonary function testing remains to be determined however, especially regarding frequency of follow-up studies. DOI: 10.1016/j.prrv.2006.04.087 E7/279 – Initial colonization with Pseudomonas aeruginosa in cystic fibrosis: Preliminary results of an eradication protocol F.V. Adde, J.B. Souza, P. Catherino, L.V.F. Silva and J.C. Rodrigues Instituto da Crianc¸a, Hospital das Clinicas, Sa˜o Paulo, Brazil Antipseudomonal therapy at the time of early Pseudomonas aeruginosa infection has been used in cystic fibrosis (CF) patients in order to try to eradicate this pathogen but the optimal drug regimen is not established
CONCLUSIONS The first P. aeruginosa isolation occured mostly in very young patients. Half of the patients needed more than one treatment and this led to a P. aeruginosa free-period in 12/13 patients, although the follow up in many of these patients is still too short. The early age of P.aeruginosa acquisition among our patients is a concern and long term follow up will be crucial in order to evaluate if this eradication protocol will be effective in postponing chronic P. aeruginosa infection. DOI: 10.1016/j.prrv.2006.04.088 E8/204 – Reactance measurements as an assessment of alveolar-capillar barrier of respiratory tract in patients with cystic fibrosis A. Minarowska1, M. Kaczmarski1, L. Minarowski2 and M. Mrugacz3 1 Medical University of Bialystok 3rd Department of Children’s Diseases, Bialystok, Poland; 2Public Clinical Hospital of Medical University of Bialystok, Bialystok, Poland; 3 Medical University of Bialystok Department of Children’s Ophtalmology, Bialystok, Poland Cystic fibrosis (CF) is the most common, genetic disease in Caucasians. Along with the progress of the lung disease and chronic infection of aggressive pathogens, there is continuous deterioration of alveolar gas exchange.
OBJECTIVES Evaluate the rate of eradication of initial P. aeruginosa isolation in CF patients that received systemic and inhaled antibiotics following a standard protocol.
MATERIAL AND METHODS Between Feb/04 and Dec/05 thirteen patients, 7M/6F, were evaluated in their first P. aeruginosa isolation. The eradication protocol consisted of: step 1 (1st isolation) = 3 weeks of ciprofloxacin or intravenous antibiotics + inhaled gentamicin or colistin for 3 to 6 weeks; step 2 (2nd isolation) = 3 weeks of ciprofloxacin or intravenous antibiotics + inhaled gentamicin or colistin for 12 weeks; step 3 (3rd isolation) = 6 weeks of ciprofloxacin + 6 months of inhaled gentamicin or colistin. Oropharyngeal swabs or sputum cultures were performed approximately every 2 months.
AIM OF THE STUDY The aim of this study was to assess the alveolar-capillary barrier in patients with CF using reactance measurement from impulsive oscillometry in comparison to single breath diffusion.
MATERIAL AND METHODS The study was performed in two groups: control group – 43 healthy subjects (14F, 18M) aged 6–23 yrs and studied group – 18 patients with diagnosed CF (7F, 11M) aged 8-27yrs.In both groups measurements of resistance (R at 5, 10, 20, 35 Hz) and reactance (X at 5, 10, 20 Hz) were performed. Measurements of TLCOSB, KCO and alveolar volume were performed to assess the alveolar-capillary barrier. Obtained results were compared to controls. In statistical analysis confidence interval of 95% was accepted.
S306
POSTER PRESENTATIONS
RESULTS
METHODS
In studied group mean values of resistance (kPa/l/s) were: R5 0.675 0.36 and R10 0.59 0.23 in females, R5 0.42 0.22 and R10 0.35 0.2 in males; reactance (kPa/ l/s): X5 0.33 0.22 and X10 0.15 0.19 in females, X5 0.14 0.08 and X10 0.026 0.05 in males. Obtained mean values of TLCOSB were: 3.69 2.5 L in females (control group: 6.8 1.2 L, p < 0.05) and 7.11 1.8 L (control group: 8.17 2.6 L, p = 0.25). Strong correlation of reactance (X) and diffusion factor for carbon monoxide (TLCOSB) was revealed in all groups, with highest values in studied female group (r = 0.93, p < 0.05).
Young CF children (<5 years) underwent BAL when clinically stable. Pooled BAL specimens from RUL, RML and lingula were sent for quantitative bacterial cultures, viral immunofluorescence, cell count and differential and S100 proteins. Paired serum/BAL samples were assayed for S100 proteins using the Phical Test ELIZA and a polyclonal antibody ELIZA.
CONCLUSIONS Impulse oscillometry can be an alternative method of alveolar-capillary barrier assessment in patients with cystic fibrosis or in cases when classis single breath diffusion is technically impossible to perform or patient’s compliance is poor. In studied group greater impaired gas exchange was revealed in female group. DOI: 10.1016/j.prrv.2006.04.089 E9/324 – Serum S-100 proteins (A12 and calprotectin) are associated with bronchoalveolar lavage evidence of airway infection and inflammation in young children with cystic fibrosis and are potential simple non-invasive markers of early lung disease Yvonne Belessis1, Steven Leach2, Glenn Hawkins3, Andrew Numa1, John Morton1, Kei Lui4 and Andrew Day1 1 Sydney Children’s Hospital Respiratory Medicine, Sydney, Australia; 2Strasser Research Laboratory, Randwick, Australia; 3 Seals, Randwick, Australia; 4Royal Hospital for Women Airway Inflammation Laboratory, Sydney, Australia
BACKGROUND Airway infection and neutrophilic inflammation occur early in CF and often go unrecognised, potentially leading to significant and irreversible lung disease. Bronchoalveolar lavage (BAL) identifies infection and inflammation in young children unable to expectorate but is invasive and resource intensive. Serum calprotectin (S-100A8/S-100A9), a cytosolic protein released during neutrophilic activation, has been used as a simple, non-invasive marker of inflammation and disease activity in several conditions including adult cystic fibrosis. We evaluated the role of serum S-100A12 and calprotectin in determining airway infection and inflammation in young CF children without clinically apparent disease.
AIMS To determine whether serum S100 proteins (A12, calprotectin) are elevated in the presence of airway infection and inflammation in young children with CF.
RESULTS 24 children (13 boys, aged 0.36–2.64 y, 50% homozygous DF508) were studied. 16 children (67%) had evidence of infection (>101 cfu/ml) of which 13 (54%) had significant infection (>105 cfu/ml) and 5 (21%) isolated Pseudomonas. Serum A12 and calprotectin were elevated in the presence of airway infection, see table. BAL neutrophils were significantly correlated with BAL calprotectin (r = 0.80, p = 000) and serum calprotectin, (r = 0.45, p = 0.029).
CONCLUSION Serum A12 and calprotectin are elevated in the presence of airway infection and inflammation and may be useful noninvasive markers of early lung disease in young CF children with minimal clinical signs. DOI: 10.1016/j.prrv.2006.04.090
Respiratory Manifestations of Extra-Pulmonary Diseases (Including AIDS) G1/260 – Correlation between switched memory B cells and development of bronchietasis in patients with Common variable immunodeficiency Asghhar Aghamohammadi1, Mostafa Moin1, Mohammad Vodjgani2, Morteza Samadi2, Abdolfattah Sarraf Nejad2, Jamshid Hajati2, Mahro Mirahmadian2, Nima Parvaneh1, Ali Salavati1 and Sina Abdollahzade1 1 Tehran University Medical Sciences Department of Pediatrics, Tehran, Iran; 2Tehran University of Medical Sciences Department of Immunology, Tehran, Iran Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency disorders characterized by hypogammaglobulinemia resulting to recurrent infections. Some groups of patients with CVID are particularly prone to earlier onset of respiratory disease and bronchiectasis. Based on switched memory B cells, CVID patients are divided into two groups: Group I (switched memory B cells less than 0.4% of PBLs) and Group II (switched memory B cells greater than 0.4% of PBLs). CVID patients in Group I are more susceptible to recurrent respiratory infection compared with Group II. To determine the correlation between switched memory B cells and development of bronchietasis in patients