Effect of Systemic Inflammation on Inspiratory and Limb Muscle Strength and Bulk in Cystic Fibrosis

Dufresne, Valérie; Knoop, Christiane; Muylem, Alain Van; Malfroot, Anne; Lamotte, Michel; Opdekamp, Christian; Deboeck, Gaël; Cassart, Marie; Stallenberg, Bernard; Casimir, Georges; Duchateau, Jean; Estenne, Marc

doi:10.1164/rccm.200802-232oc

Cited by 53 publications

(49 citation statements)

References 35 publications

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“…This finding complies with studies that demonstrated that in some situations the cytokines may get compartmentalized, for example, in the lungs, or because most of patients were clinically stable (CRP <0.5 mg), or by the inclusion of the study on those using ibuprofen and azithromycin [31,32].…”

Section: Discussionsupporting

confidence: 89%

Body Composition, Inflammation, Physical Exercises and Food Intake in Cystic Fibrosis: Cross-Sectional Study

Crmm¹,

Alp²,

Cvmng³

et al. 2016

Insights Chest Dis

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Section: Discussionsupporting

confidence: 89%

Body Composition, Inflammation, Physical Exercises and Food Intake in Cystic Fibrosis: Cross-Sectional Study

Crmm¹,

Alp²,

Cvmng³

et al. 2016

Insights Chest Dis

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“…In these patients inflammation was not identified as a predictor of respiratory muscle compromise, whereas fat-free mass and airway resistance were. 38 In our cohort of CF subjects with mild lung disease, diaphragm thickening might have not yet occurred, and the respiratory muscles might have been exposed to the deleterious effects of chronic infection and malnutrition in the absence of a counterbalancing diaphragm thickening mechanism.…”

Section: Discussionmentioning

confidence: 81%

“…15 It has been suggested that decreased muscular synthesis and impaired muscle regeneration occur in the presence of abundant pro-inflammatory cytokines in the chronically infected lung, which spill over and cause chronic systemic inflammation. 38 Recent work addressed sex differences in the course of P. aeruginosa infection in patients with CF, and highlighted that estrogen induces mucoid conversion of P. aeruginosa in women with CF and is associated with more frequent exacerbations. 6 On the other hand, male CF patients with impaired skeletal muscle strength have normal testosterone levels.…”

Section: Discussionmentioning

confidence: 99%

“…This was not deliberately done, although enrollment was limited to stable out-patients. Fur- 38 probably as a result of the training effect that the chronically increased respiratory load imposes on the respiratory muscles. In these patients inflammation was not identified as a predictor of respiratory muscle compromise, whereas fat-free mass and airway resistance were.…”

Section: Discussionmentioning

confidence: 99%

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ChronicPseudomonas aeruginosaInfection and Respiratory Muscle Impairment in Cystic Fibrosis

et al. 2013

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BACKGROUND: Chronic infection with Pseudomonas aeruginosa in patients with cystic fibrosis (CF) is associated with increased morbidity. Chronic infection can cause limb and respiratory muscle compromise. Respiratory muscle function can be assessed via maximal inspiratory pressure (P Imax ), maximal expiratory pressure (P Emax ), and the pressure-time index of the respiratory muscles (PTI mus ). We studied the effect of chronic P. aeruginosa infection on respiratory muscle function in patients with CF. METHODS: This cross-sectional study assessed P Imax , P Emax , PTI mus , FEV 1 , FVC, maximum expiratory flow during the middle half of the FVC maneuver, body mass index, and upper arm muscle area in 122 subjects with CF, in 4 subgroups matched for age and sex at different stages of P. aeruginosa infection, according to the Leeds criteria. We compared respiratory muscle function in the subgroups according to P. aeruginosa infection state. RESULTS: Median P Imax was significantly lower in CF subjects with chronic P. aeruginosa infection (P Imax ‫؍‬ 62 cm H 2 O), compared to subjects who were never infected (P Imax ‫؍‬ 86 cm H 2 O, P ‫؍‬ .02), free of infection (P Imax ‫؍‬ 74 cm H 2 O, P ‫؍‬ .01), or intermittently infected (P Imax ‫؍‬ 72 cm H 2 O, P ‫؍‬ .02). Median PTI mus was significantly increased in CF subjects with chronic P. aeruginosa infection (PTI mus ‫؍‬ .142), compared to subjects who were free of infection (PTI mus ‫؍‬ .102, P ‫؍‬ .006). Median upper-arm muscle area was significantly lower in CF subjects with chronic P. aeruginosa infection (upper-arm muscle area ‫؍‬ 2,219 mm 2 ), compared to subjects who were never infected (2,754 mm 2 , P ‫؍‬ .03), free of infection (2,678 mm 2 , P ‫؍‬ .01), or intermittently infected (2,603 mm 2 , P ‫؍‬ .04). Multivariate logistic regression revealed P. aeruginosa state of infection as a significant determinant of PTI mus (P ‫؍‬ .03) independently of sex, upper-arm muscle area, and FEV 1 . CON-CLUSIONS: CF subjects with chronic P. aeruginosa infection exhibited impaired respiratory muscle function and decreased inspiratory muscle strength, and chronic P. aeruginosa infection independently impacts respiratory muscle function in subjects with CF.

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“…Published human studies of IL-17 in CF are rare but some support the importance of this axis. Increased levels of IL-17 have been found in bronchoalveolar lavage (BAL) of children and adults during infective exacerbations and in the serum of clinically stable adults [16][17][18][19]. In addition, people with CF who exhibit robust T-cell responses to Pseudomonas aeruginosa manifest more severe lung disease [20].…”

mentioning

confidence: 99%

Raised interleukin-17 is immunolocalised to neutrophils in cystic fibrosis lung disease

Brodlie¹,

McKean²,

Johnson³

et al. 2010

Eur Respir J

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Interleukin (IL)-17 is pivotal in orchestrating the activity of neutrophils. Neutrophilic inflammation is the dominant pathology in cystic fibrosis (CF) lung disease. We investigated IL-17 protein expression in the lower airway in CF, its cellular immunolocalisation and the effects of IL-17 on CF primary bronchial epithelial cells.Immunohistochemistry was performed on explanted CF lungs and compared with the nonsuppurative condition pulmonary hypertension (PH). Airway lavages and epithelial cultures were generated from explanted CF lungs.Immunoreactivity for IL-17 was significantly increased in the lower airway epithelium in CF (median 14.1%) compared with PH (2.95%, p50.0001). The number of cells staining positive for IL-17 in the lower airway mucosa was also increased (64 cells?mm -1 compared with 9 cells?mm -1 basement membrane, p50.0005) and included both neutrophils in addition to mononuclear cells. IL-17 was detectable in airway lavages from explanted CF lungs. Treatment of epithelial cultures with IL-17 increased production of IL-8, IL-6 and granulocyte macrophage colony-stimulating factor.In conclusion, immunoreactive IL-17 is raised in the lower airway of people with CF and localises to both neutrophils and mononuclear cells. IL-17 increases production of pro-neutrophilic mediators by CF epithelial cells, suggesting potential for a positive feedback element in airway inflammation.

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Effect of Systemic Inflammation on Inspiratory and Limb Muscle Strength and Bulk in Cystic Fibrosis

Abstract: In patients with CF, the intensity of systemic inflammation does not account significantly for the variance of FFM and diaphragm or limb muscle strength and bulk. Training of the diaphragm in CF occurs despite the presence of systemic inflammation.

Cited by 53 publications

References 35 publications

Body Composition, Inflammation, Physical Exercises and Food Intake in Cystic Fibrosis: Cross-Sectional Study

Body Composition, Inflammation, Physical Exercises and Food Intake in Cystic Fibrosis: Cross-Sectional Study

ChronicPseudomonas aeruginosaInfection and Respiratory Muscle Impairment in Cystic Fibrosis

Raised interleukin-17 is immunolocalised to neutrophils in cystic fibrosis lung disease

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