scholarly journals Changes of Proteases, Antiproteases, and Pathogens in Cystic Fibrosis Patients’ Upper and Lower Airways after IV-Antibiotic Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-16 ◽  
Author(s):  
Ulrike Müller ◽  
Julia Hentschel ◽  
Wibke K. Janhsen ◽  
Kerstin Hünniger ◽  
Uta-Christina Hipler ◽  
...  

Background. In cystic fibrosis (CF) the upper (UAW) and lower airways (LAW) are reservoirs for pathogens likePseudomonas aeruginosa. The consecutive hosts’ release of proteolytic enzymes contributes to inflammation and progressive pulmonary destruction. Objectives were to assess dynamics of protease : antiprotease ratios and pathogens in CF-UAW and LAW sampled by nasal lavage (NL) and sputum before and after intravenous- (IV-) antibiotic therapy.Methods. From 19 IV-antibiotic courses of 17 CF patients NL (10 mL/nostril) and sputum were collected before and after treatment. Microbiological colonization and concentrations of NE/SLPI/CTSS (ELISA) and MMP-9/TIMP-1 (multiplex bead array) were determined. Additionally, changes of sinonasal symptoms were assessed (SNOT-20).Results. IV-antibiotic treatment had more pronounced effects on inflammatory markers in LAW, whereas trends to decrease were also found in UAW. Ratios of MMP-9/TIMP-1 were higher in sputum, and ratios of NE/SLPI were higher in NL. Remarkably, NE/SLPI ratio was 10-fold higher in NL compared to healthy controls. SNOT-20 scores decreased significantly during therapy(P=0.001).Conclusion. For the first time, changes in microbiological patterns in UAW and LAW after IV-antibiotic treatments were assessed, together with changes of protease/antiprotease imbalances. Delayed responses of proteases and antiproteases to IV-antibiotic therapy were found in UAW compared to LAW.

2011 ◽  
Vol 58 (3) ◽  
Author(s):  
Aleksandra Lisowska ◽  
Andrzej Pogorzelski ◽  
Grzegorz Oracz ◽  
Wojciech Skorupa ◽  
Szczepan Cofta ◽  
...  

Antibiotic therapy in the cystic fibrosis (CF) mouse model has been shown to result in reduced bacterial load of the intestine and significant body mass gain. The effect was suggested to be linked to the improvement of intestinal digestion and absorption. Therefore, we aimed to assess the influence of routinely applied antibiotic therapy in CF patients on fat assimilation. Twenty-four CF patients aged 6 to 30 years entered the study. Inclusion criteria comprised confirmed exocrine pancreatic insufficiency and bronchopulmonary exacerbation demanding antibiotic therapy. Exclusion criteria comprised: antibiotic therapy six weeks prior to the test, liver cirrhosis, diabetes mellitus, oxygen dependency, the use of systemic corticosteroids. In all enrolled CF subjects, (13)C-labelled mixed triglyceride breath test ((13)C MTG-BT) was performed to assess lipid digestion and absorption, before and after antibiotic therapy. Sixteen subjects were treated intravenously with ceftazidime and amikacin, eight patients orally with ciprofloxacin. Cumulative percentage dose recovery (CPDR) was considered to reflect digestion and absorption of lipids. The values are expressed as means (medians). The values of CPDR before and after antibiotic therapy did not differ in the whole studied group [4.6(3.3) % vs. 5.7(5.3) %, p = 0.100] as well as in the subgroup receiving them intravenously [4.6(3.2) % vs. 5.7(5.3) %, p = 0.327] or in that with oral drug administration [4.6(3.4) % vs. 5.7(5.4) %, p = 0.167]. In conclusion, antibiotic therapy applied routinely in the course of pulmonary exacerbation in CF patients does not seem to result in an improvement of fat digestion and absorption.


1989 ◽  
Vol 102 (2) ◽  
pp. 205-214 ◽  
Author(s):  
Christiane Wolz ◽  
Gerd Kiosz ◽  
John W. Ogle ◽  
Michael L. Vasil ◽  
Urs Schaad ◽  
...  

SUMMARYTo investigate cross-colonization with and persistence ofPseudomonas aeruginosain cystic fibrosis (CF). 181 isolates from 76 CF patients were typed using aP. aeruginosa-specific DNA probe. Whereas sibling pairs predominantly harboured genotypically identicalP. aeruginosastrains, all of the other patients harboured different strains. Seventy-nine per cent (22/31) of the infected CF patients harboured the same strains at the beginning and the end of a summer camp. A change of strains was seen in 10% (3/31) of the patients at the end of the camp. Forty-six per cent (6/13) of the patients who were apparently initially uninfected, acquiredP. aeruginosaby the end of the period. Genotyping proved that strain change or acquisition was due to cross-colonization in four of nine cases. Very littleP. aeruginosawas isolated from the inanimate environment. Persistence ofP. aeruginosaafter a temporary loss due to antibiotic therapy was seen in 12/16 paired patient strains before and after antibiotic therapy. Thus, suppression followed a flare-up seemed to occur in these patients rather than eradication and a new infection. When 35 patients were followed over a period of 6 months, 7 (20%) changed the strain in their sputum. Only one of 43 patients harboured two differentP. aeruginosastrains simultaneously over a long period.


2005 ◽  
Vol 40 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Carla Colombo ◽  
Diana Costantini ◽  
Alessia Rocchi ◽  
Lisa Cariani ◽  
Maria Laura Garlaschi ◽  
...  

2021 ◽  
Vol 31 (2) ◽  
pp. 197-206
Author(s):  
E. I. Kondratyeva ◽  
A. Yu. Voronkova ◽  
S. V. Trishina ◽  
N. S. Snetkova ◽  
T. I. Safonova ◽  
...  

Study of efficacy, safety, and patient satisfaction with inhaled tobramycin (Tobramycin-Gobbi) in children with cystic fibrosis and pseudomonas infectionAim of the study was to assess efficacy and safety of Tobramycin-Gobbi in CF, as well as the patients’ satisfaction with the treatment.Methods. 35 children from 6 to 18 years with CF were enrolled in this non-interventional prospective cohort multicenter study. All children had P. aeruginosa in the respiratory tract (newly diagnosed, recurrent, or chronic infection). The children received inhalation treatment with Tobramycin-Gobbi in the following cycles: 28-day treatment/28-day break, for 6 months. The studied parameters included respiratory function, bacterial cultures of the respiratory tract with a bacterial count, growth and body weight, antibiotic therapy for the respiratory episodes. The children and parents filled in a questionnaire “Treatment satisfaction assessment” and assessed their state of health on the visual-analog scale before and after each treatment cycle.Results. P. aeruginosa was eradicated in 17.7% of cases (6 patients, including 2 newly diagnosed, 3 recurrent infections, and 1 chronic infection), reduced bacterial count, decreased number of courses of antibiotic therapy, improvement of FEV1. Adverse reactions were reported by one patient.Conclusion. The efficacy, safety, and tolerability of Tobramicine Gobbi were confirmed in the patients with newly diagnosed, recurrent, and chronic infection caused by P. aeruginosa.


2017 ◽  
Vol 16 (6) ◽  
pp. 5-13 ◽  
Author(s):  
I. A. Shaginyan ◽  
M. Yu. Chernukha ◽  
L. R. Avetisyan ◽  
E. A. Siyanova ◽  
D. G. Kulyastova ◽  
...  

Relevance. Life expectancy of cystic fibrosis patients mostly depends on the degree of respiratory system damage caused by opportunistic microorganisms, which is due to the fact that 90-95% of deaths of cystic fibrosis patients are caused by lung infections. Goal. To define epidemiologic characteristics of chronic lung infection caused by the most common agents (S. aureus, P. aeruginosa, B. cepacia-like bacteria (Bcc) and Achromobacter spp.) using a novel chronic lung infection in cystic fibrosis patients microbiological diagnosis algorithm. Materials and methods. Over a period of 7 years (2008-2016) 300 children with cystic fibrosis living in Moscow, Moscow region and several other regions of Russian Federation have been checked-up. 260 sputum samples from 100 adult patients, who were under care at the Pulmonology Research Institute, were studied. Sputum samples from children were taken before and after antibiotic therapy with intervals of 15-45 days and over 6 months. 30 of the children were also subjected to a microbiologic monitoring of the state of chronic infection in the period between 4 and 15 months. Sputum sample from adult patients were also taken before and after antibiotic therapy with intervals of 0, 15-45 days and over 6 months. Results. P. aeruginosa, S. aureus, H. influenzae and Burkholderia cepacia-like bacteria were confirmed to be the most common agents of lung infection in cystic fibrosis patients. Children with cystic fibrosis over the years develop foci of chronic lung infection, mainly caused by P. aeruginosa and S. aureus. Conclusions. Chronic lung infection can be caused by community-acquired or nosocomial S. aureus и P. aeruginosa. Chronic lung infection is a complex, dynamically changing disease which requires constant monitoring and is mainly caused by S. aureus, P. aeruginosa, Bcc bacteria and Achromobacter spp. As populations of the agents can be diverse, it is necessary to study all colonies with differing phenotypes (mucoid and non-mucoid variants, small colony variants, variants with different pigments) and to take samples of several colonies when testing antibiotic resistance. Bcc and Achromobacter spp. cannot be eradicated with antibiotics, thus the only effective measure against these bacteria can only be vaccination which requires developing a vaccine.


2020 ◽  
Vol 9 (12) ◽  
pp. 3802
Author(s):  
Beatrice Hanusch ◽  
Folke Brinkmann ◽  
Sebene Mayorandan ◽  
Kristine Chobanyan-Jürgens ◽  
Anna Wiemers ◽  
...  

Alterations in the L-arginine (Arg)/nitric oxide (NO) pathway have been reported in cystic fibrosis (CF; OMIM 219700) as the result of various factors including systemic and local inflammatory activity in the airways. The aim of the present study was to evaluate the Arg/NO metabolism in pediatric CF patients with special emphasis on lung impairment and antibiotic treatment. Seventy CF patients and 78 healthy controls were included in the study. CF patients (43% male, median age 11.8 years) showed moderately impaired lung functions (FEV1 90.5 ± 19.1% (mean ± SD); 21 (30%) had a chronic Pseudomonas aeruginosa (PSA) infection, and 24 (33%) had an acute exacerbation). Plasma, urinary, and sputum concentrations of the main Arg/NO metabolites, nitrate, nitrite, Arg, homoarginine (hArg), and asymmetric dimethylarginine (ADMA) were determined in pediatric CF patients and in healthy age-matched controls. Clinical parameters in CF patients included lung function and infection with PSA. Additionally, the Arg/NO pathway in sputum samples of five CF patients was analyzed before and after routine antibiotic therapy. CF patients with low fractionally exhaled NO (FENO) showed lower plasma Arg and nitrate concentrations. During acute exacerbation, sputum Arg and hArg levels were high and dropped after antibiotic treatment: Arg: pre-antibiotics: 4.14 nmol/25 mg sputum vs. post-antibiotics: 2.33 nmol/25 mg sputum, p = 0.008; hArg: pre-antibiotics: 0.042 nmol/25 mg sputum vs. post-antibiotics: 0.029 nmol/25 mg sputum, p = 0.035. The activated Arg/NO metabolism in stable CF patients may be a result of chronic inflammation. PSA infection did not play a major role regarding these differences. Exacerbation increased and antibiotic therapy decreased sputum Arg concentrations.


PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e104080 ◽  
Author(s):  
Massimo Conese ◽  
Stefano Castellani ◽  
Silvia Lepore ◽  
Orazio Palumbo ◽  
Antonio Manca ◽  
...  

1990 ◽  
Vol 29 (05) ◽  
pp. 215-220 ◽  
Author(s):  
R. Benning ◽  
K. Nagel ◽  
M. Jugenheimer ◽  
S. Fischer ◽  
S. Worthmann ◽  
...  

A new 99mTc-labelled tracer (99mTc-Sestanriibi) was used for the first time to demonstrate the perfusion of the skeletal muscle. In 16 patients with obstructive atherosclerosis of the lower limbs the change of perfusion of thigh and lower leg was studied with SPECT before and after vascular surgery (n = 11) or percutaneous transluminal angioplasty (n = 5). Comparative results of scintigraphic measurements and clinical observations (ancle-arm pressure, treadmill test) in 10 surgical patients (14 operated legs) showed correct positive or negative results in 86% (12/14).


Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 16-25
Author(s):  
N. S. Karpova ◽  
O. S. Brusov ◽  
I. V. Oleichik ◽  
M. I. Faktor ◽  
N. S. Levchenko ◽  
...  

Background: currently, it has been proven that the pathogenesis of endogenous mental disorders is associated with the process of neuroinflammation in the brain of patients. It is also known that chronic neuroinflammation, accompanied by a violation the permeability of the blood-brain barrier. It is accompanied by the activation of platelets that generate procoagulant microparticles, which leads to a disturbance of the hemostasis system, causing an increase in blood clotting in patients. Objective: to investigate the dynamics of procoagulant activity of blood in patients with endogenous mental disorders before and after psychopharmacotherapy.Patients and methods: the study included 185 patients aged 16 to 64 years with the following mental disorders: schizophrenia with attack-like/attack-progressive/continuous type of course (F20.00–2), affective disease (F31.1–5; F32.0–3; F33.0–3), schizotypal disorder with affective fluctuations (F21.3–4). The thrombodynamic test (TD) was performed on T-2 Trombodynamis device according to the manufacturer’s instructions (Hemacore LLC, Moscow, Russia). All patients received standard pharmacotherapy according to their condition.Results: a significant decrease of procoagulant activity of spontaneous clots in the patients’ blood after psychopharmacological treatment is observed. Our data on the positive dynamics of changes in the values of TD test’s indicators in most of the examined patients suggest that a decrease in the coagulation activity of the patients’ blood as a result of treatment may be associated with the anti- inflammatory effect of antipsychotics and antidepressants.Conclusion: for the first time, it was shown that there is a positive dynamic in changing the values of the main parameters of the TD test in most patients with endogenous mental diseases. The results of TD tests can be the basis for monitoring the response to therapy.


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