State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou, China
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Chest Infections: Bronchieactasis
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM
PURPOSE: Pseudomonas aeruginosa (P. aeruginosa) confers significant adverse impacts on bronchiectasis, in which excessive matrix metalloproteinases (MMPs) release contributes to abnormal bronchial dilatation. We aimed to compare airway MMPs levels, derived from sputum and bronchial mucosa, in bronchiectasis based on sputum bacteriology; the incidence of and time to BEs when stratified by P. aeruginosa infection and MMPs levels; changes in MMPs during bronchiectasis exacerbations (BEs) in patients with or without chronic P. aeruginosa infection.
METHODS: Of 102 bronchiectasis patients recruited, baseline assessments included sputum inflammatory mediator and MMPs measurements, bacterial culture and spirometry. Bronchiectasis patients were followed-up for 1 year to determine the frequency of BEs. Changes in sputum MMPs during BEs and convalescence (1 week after completion of 14-day antibiotic therapy) were assessed in 36 bronchiectasis patients. Bronchial biopsy was performed in 20 bronchiectasis patients and 9 control subjects for immunohistochemistry assay.
RESULTS: P. aeruginosa infection was associated with higher levels of MMP-8 and MMP-9, both in sputum and bronchiectatic airway mucosa. P. aeruginosa infection and higher MMPs levels were associated with increased sputum TNF-α, poorer lung function, and a trend towards higher frequency and shorter time to repeated BEs. P. aeruginosa infection was not associated with more significant increase in MMPs during BEs than those without.
CONCLUSIONS: P. aeruginosa infection was linked to increased airway MMPs levels, which collectively contributed to poorer lung function and prognosis in bronchiectasis. P. aeruginosa infection did not elicit greater increase in MMPs duing BEs.
CLINICAL IMPLICATIONS: P. aeruginosa and increased MMP levels contribute synergistically to poorer lung function and more frequent exacerbations of bronchiectasis, which should raise alert for physicians to more actively seek intervention strategies to brake this “vicious cycle”.
DISCLOSURE: The following authors have nothing to disclose: Wei-jie Guan, Yong-hua Gao, Gang Xu, Yan Tang, Ying-ying Gu, Gui-hong Liu, Hui-min Li, Jin-ping Zheng, Rongchang Chen, Nanshan Zhong
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