BALF Nitrite as an Indicator of Inflammation in Children with Cystic Fibrosis

Abstract

Background: A unique substance reflecting the degree of inflammation localized to the lower respiratory tract in patients with cystic fibrosis (CF) has been the concern of several investigators and nitric oxide has gained interest for this purpose in the last decades. Objectives: The aim of this study was to evaluate the cytokine and nitrite levels by showing the relationship between them in serum and bronchoalveolar lavage fluid (BALF) of patients with CF and patients in which flexible fiberoptic bronchoscopy (FFB) was applied because of indications other than infection. Methods: 20 children with CF with mean age 8.2 years and 10 children as control group with mean age 4.2 years were included in the study. Cultures for aerobes, anaerobes, fungi and mycobacteria, cell differentials, cytokine and nitrite measurements were made from BALF specimens. White blood cell (WBC) count, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (QCRP), cytokine and nitrite levels were measured from serum samples. Results: BALF neutrophil, TNF-α, IL-8 and nitrite levels were significantly higher in patients with CF than control patients. There was no correlation between serum and BALF cytokine and nitrite levels. However, there was a significantly positive correlation between BALF IL-8 and nitrite levels in patients with CF (r = 0.5) and also in control patients (r = 0.6). Conclusions: The results suggest that BALF nitrite levels reflect the degree of inflammation localized to lower respiratory tract and may be a useful indicator of airway inflammation for patients with CF.

Prevention of primary graft dysfunction in lung transplantation by N-acetylcysteine after prolonged cold ischemia

“…In another study, significant positive correlation was reported between BAL IL-8 and nitrite levels. 32 These results also confirm our findings supporting the idea of a low inflammatory situation caused by NAC treatment.…”

Impact of Topical Cooling Solution and Prediction of Pulmonary Graft Viability From Non–heart-beating Donors

“…24 The measurement of nitrite in breath condensates and BAL has been reported to objectively assess airway inflammation in asthmatic children and in cystic fibrosis and lung transplant recipients. [25][26][27][28] There was a significant positive correlation found between BAL IL-8 and nitrite levels. 27 These results also support our findings.…”

“…[25][26][27][28] There was a significant positive correlation found between BAL IL-8 and nitrite levels. 27 These results also support our findings. BAL nitrite concentration after 3 hours of warm ischemia was significantly higher in saline compared with Perfadex.…”

Bronchoscopy in Bronchiectasis and Cystic Fibrosis

“…Bronchoscopy has been used for studying inflammatory markers such as Interleukin -8 and nitrite in the lower airway of patients with Cystic Fibrosis (Noah, T.L. 2003, Cetin, I. 2004, Davis, S.D.…”

“…There were no significant differences in the secondary outcomes such as FEV1, weight or BMI amongst the two groups. BAL fluid in cystic fibrosis patients has also been used to quantify and assess BAL fluid nitrite levels as this may reflect adequate the degree of inflammation in the respiratory tract and could potentially be a useful indicator of airway inflammation for patients with CF (Cetin, I 2004). …”