Induced sputum inflammatory measures correlate with lung function in children with cystic fibrosis.

OBJECTIVE To validate a sputum induction technique in cystic fibrosis (CF), we examined the relation between airway inflammation and pulmonary function in children with CF by correlating inflammatory indexes in induced sputum with FEV(1). STUDY DESIGN We measured baseline spirometry and oxygen saturations and then performed sputum inductions with 3% hypertonic saline in 20 clinically stable children with CF (11 girls). We examined the relation of airway inflammation and lung function in the 19 individuals (95%) who expectorated an adequate sputum sample. Measures of airway inflammation in induced sputum included total cell counts, neutrophil (PMN) counts, interleukin-8 levels, and free neutrophil elastase activity. RESULTS There were significant inverse relations between FEV(1) and total cell counts and PMN counts (r = -0.57, P <.01 for both), interleukin-8 (r = -0.72, P =.002), and elastase (r = -0.75, P =.001). Airway infection, as assessed by bacterial density in induced sputum, did not correlate with lung function or indexes of inflammation. CONCLUSIONS We conclude that measures of inflammation in induced sputum correlate with FEV(1) in clinically stable children with CF with normal to mildly abnormal lung function and that they may be useful as surrogate outcome measures in clinical trials.

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