Abstract
BackgroundMarkers of lung inflammation measured directly in expectorated sputum have the potential of improving the timing of antibiotic treatment in cystic fibrosis (CF). L-Lactate might be a marker of inflammation, as it is produced from glucose by polymorphonuclear neutrophils (PMNs) in CF lungs. We aimed to investigate changes in and associations between PMNs, glucose and L-lactate in sputum during antibiotic treatment. In addition, the effect of hemoglobin A1c and plasma glucose on these biomarkers were investigated.MethodsWe sampled non-induced sputum at day 0, 7, 14 and 42 in 27 chronically infected CF patients electively treated with 14 days of intravenous antibiotic. To analyze sputum samples, we used flowcytometry to count PMNs and colorimetric assays to estimate lactate and glucose.ResultsNo changes in levels of PMNs, glucose and lactate were detected in sputum during the antibiotic treatment. Sputum PMNs were positively associated with both glucose (log coefficient = 0.20, p = 0.01) and L-lactate (log coefficient = 0.34, p<0.001). In multivariate analyses, hemoglobin A1c was negatively associated with sputum PMNs (log coefficient = -1.68, p<0.001) and plasma glucose was negatively associated with sputum glucose (log coefficient = -0.09, p = 0.02).ConclusionsIn CF sputum PMNs, glucose and lactate were unchanged during elective antibiotic treatment. However, sputum PMNs were associated with both sputum glucose and sputum lactate. Surprisingly, hyperglycemia seemed to be associated with less PMNs infiltration and less glucose in CF sputum.
Highlights
Frequent intravenous antibiotic treatments extend the life expectancy of patients with cystic fibrosis (CF) [1]
Hemoglobin A1c was negatively associated with sputum Polymorphonuclear neutrophils (PMNs) and plasma glucose was negatively associated with sputum glucose
In CF sputum PMNs, glucose and lactate were unchanged during elective antibiotic treatment
Summary
Frequent intravenous antibiotic treatments extend the life expectancy of patients with cystic fibrosis (CF) [1]. Measuring biomarkers directly in sputum might be a superior approach for assessing lung inflammation. Polymorphonuclear neutrophils (PMNs) are the predominant leukocytes in CF sputum during stable conditions [5, 6] and they become more abundant during pulmonary exacerbations [7, 8]. Markers of lung inflammation measured directly in expectorated sputum have the potential of improving the timing of antibiotic treatment in cystic fibrosis (CF). L-Lactate might be a marker of inflammation, as it is produced from glucose by polymorphonuclear neutrophils (PMNs) in CF lungs. We aimed to investigate changes in and associations between PMNs, glucose and L-lactate in sputum during antibiotic treatment. The effect of hemoglobin A1c and plasma glucose on these biomarkers were investigated
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