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Terlizzi V, Manti S, D'Amico F, Parisi GF, Chiappini E, Padoan R. Biochemical and genetic tools to predict the progression to Cystic Fibrosis in CRMS/CFSPID subjects: A systematic review. Paediatr Respir Rev 2024; 51:46-55. [PMID: 38309973 DOI: 10.1016/j.prrv.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/02/2024] [Accepted: 01/02/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Aim of this study was to identify risk factors for a progression to cystic fibrosis (CF) in individuals detected as CF Screening Positive, Inconclusive Diagnosis (CFSPID). METHODS This is a systematic review through literature databases (2015-2023). Blood immunoreactive trypsinogen (b-IRT) values, CFTR genotype, sweat chloride (SC) values, isolation of Pseudomonas aeruginosa (Pa) from respiratory samples, Lung Clearance Index (LCI) values in CFSPIDs who converted to CF (CFSPID > CF) and age at CF transition were assessed. RESULTS Percentage of CFSPID > CF varies from 5.3 % to 44 %. Presence of one CF-causing CFTR variant in trans with a variant with variable clinical consequences (VVCC), an initial SC ≥ 40 mmol/L, an increase of SC > 2.5 mmol/L/year and recurrent isolation of pseudomonas aeruginosa (Pa) from airway samples could allow identification of subjects at risk of progression to CF. CONCLUSIONS CFSPIDs with CF causing variant/VVCC genotype and first SC in the higher borderline range may require more frequent and prolonged clinical follow-up.
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Affiliation(s)
- Vito Terlizzi
- Department of Pediatric Medicine, Meyer Children's Hospital IRCCS, Cystic Fibrosis Regional Reference Center, Florence, Italy
| | - Sara Manti
- Department of Human Pathology of Adult and Evolutive Age "Gaetano Barresi", University of Messina, Messina, Italy.
| | - Federica D'Amico
- Department of Human Pathology of Adult and Evolutive Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Giuseppe F Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Elena Chiappini
- Infectious Diseases Unit, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Rita Padoan
- Italian Cystic Fibrosis Registry, Scientific Board, Rome, Italy
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Gilchrist FJ, Bui S, Gartner S, McColley SA, Tiddens H, Ruiz G, Stehling F, Alani M, Gurtovaya O, Bresnik M, Watkins TR, Frankovic B, Skov M. ALPINE2: Efficacy and safety of 14-day vs 28-day inhaled aztreonam for Pa eradication in children with cystic fibrosis. J Cyst Fibros 2024; 23:80-86. [PMID: 37455237 DOI: 10.1016/j.jcf.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Antibiotic eradication therapies recommended for newly isolated Pseudomonas aeruginosa (Pa) in people with cystic fibrosis (pwCF) can be burdensome. ALPINE2 compared the efficacy and safety of a shortened 14-day course of aztreonam for inhalation solution (AZLI) with 28-day AZLI in paediatric pwCF. METHODS ALPINE2 (a double-blind, phase 3b study) included children aged 3 months to <18 years with CF and new-onset Pa infection. Participants were randomized to receive 75 mg AZLI three times daily for either 28 or 14 days followed by 14 days' matched placebo. The primary endpoint was rate of primary Pa eradication (no Pa detected during the 4 weeks post AZLI treatment). Non-inferiority was achieved if the lower 95% CI bound of the treatment difference between the two arms was above -20%. Secondary endpoints included assessments of Pa recurrence during 108 weeks of follow-up after primary eradication. Safety endpoints included treatment-emergent adverse events (TEAEs). RESULTS In total, 149 participants were randomized (14-day AZLI, n = 74; 28-day AZLI, n = 75) and 142 (95.3%) completed treatment. Median age: 6.0 years (range: 0.3-17.0). Baseline characteristics were similar between treatment arms. Primary Pa eradication rates: 14-day AZLI, 55.9%; 28-day AZLI, 63.4%; treatment difference (CI), -8.0% (-24.6, 8.6%). Pa recurrence rates at follow-up end: 14-day AZLI, 54.1% (n = 20/37); 28-day AZLI, 41.9% (n = 18/43). TEAEs were similar between treatment arms. No new safety signals were observed. CONCLUSIONS Non-inferiority of 14-day AZLI versus 28-day AZLI was not demonstrated. Both courses were well tolerated, further supporting AZLI short-term safety in paediatric and adolescent pwCF. CLINICALTRIALS GOV: NCT03219164.
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Affiliation(s)
- Francis J Gilchrist
- Paediatric Respiratory Services, Staffordshire Children's Hospital at Royal Stoke, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK; Institute of Applied Clinical Science, Keele University, Stoke-on-Trent, UK.
| | - Stephanie Bui
- Bordeaux University Hospital, Hôpital Pellegrin-Enfants, Paediatric Cystic Fibrosis Reference Center (CRCM), Centre d'Investigation Clinique (CIC 1401), Bordeaux, France.
| | - Silvia Gartner
- Paediatric Pulmonology and Cystic Fibrosis Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Susanna A McColley
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Pulmonary and Sleep Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| | - Harm Tiddens
- Department of Pediatric Pulmonology and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands.
| | - Gary Ruiz
- Department of Paediatric Respiratory Medicine, King's College Hospital NHS Foundation Trust, London, UK.
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University Duisburg-Essen, Essen, Germany.
| | - Muhsen Alani
- Gilead Sciences Inc., Foster City, CA, USA; Division of Rheumatology, University of Washington, Seattle, WA, USA.
| | | | | | | | | | - Marianne Skov
- CF Centre Copenhagen, Paediatric Pulmonary Service, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Lv Q, Gallardo-Estrella L, Andrinopoulou ER, Chen Y, Charbonnier JP, Sandvik RM, Caudri D, Nielsen KG, de Bruijne M, Ciet P, Tiddens H. Automatic analysis of bronchus-artery dimensions to diagnose and monitor airways disease in cystic fibrosis. Thorax 2023; 79:13-22. [PMID: 37734952 PMCID: PMC10803964 DOI: 10.1136/thorax-2023-220021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/11/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) lung disease is characterised by progressive airway wall thickening and widening. We aimed to validate an artificial intelligence-based algorithm to assess dimensions of all visible bronchus-artery (BA) pairs on chest CT scans from patients with CF. METHODS The algorithm fully automatically segments the bronchial tree; identifies bronchial generations; matches bronchi with the adjacent arteries; measures for each BA-pair bronchial outer diameter (Bout), bronchial lumen diameter (Bin), bronchial wall thickness (Bwt) and adjacent artery diameter (A); and computes Bout/A, Bin/A and Bwt/A for each BA pair from the segmental bronchi to the last visible generation. Three datasets were used to validate the automatic BA analysis. First BA analysis was executed on 23 manually annotated CT scans (11 CF, 12 control subjects) to compare automatic with manual BA-analysis outcomes. Furthermore, the BA analysis was executed on two longitudinal datasets (Copenhagen 111 CTs, ataluren 347 CTs) to assess longitudinal BA changes and compare them with manual scoring results. RESULTS The automatic and manual BA analysis showed no significant differences in quantifying bronchi. For the longitudinal datasets the automatic BA analysis detected 247 and 347 BA pairs/CT in the Copenhagen and ataluren dataset, respectively. A significant increase of 0.02 of Bout/A and Bin/A was detected for Copenhagen dataset over an interval of 2 years, and 0.03 of Bout/A and 0.02 of Bin/A for ataluren dataset over an interval of 48 weeks (all p<0.001). The progression of 0.01 of Bwt/A was detected only in the ataluren dataset (p<0.001). BA-analysis outcomes showed weak to strong correlations (correlation coefficient from 0.29 to 0.84) with manual scoring results for airway disease. CONCLUSION The BA analysis can fully automatically analyse a large number of BA pairs on chest CTs to detect and monitor progression of bronchial wall thickening and bronchial widening in patients with CF.
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Affiliation(s)
- Qianting Lv
- Department of Paediatric Pulmonology and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Yuxin Chen
- Department of Paediatric Pulmonology and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Rikke Mulvad Sandvik
- CF Center Copenhagen, Paediatric Pulmonary Service, Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- University of Copenhagen, Graduate School of Health and Medical Sciences, Copenhagen, Denmark
| | - Daan Caudri
- Department of Paediatric Pulmonology and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Kim Gjerum Nielsen
- CF Center Copenhagen, Paediatric Pulmonary Service, Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - Marleen de Bruijne
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Pierluigi Ciet
- Department of Paediatric Pulmonology and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Pediatric Pulmonology, Erasmus Medical Center- Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Harm Tiddens
- Department of Paediatric Pulmonology and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Thirona, Nijmegen, The Netherlands
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McNally P, Linnane B, Williamson M, Elnazir B, Short C, Saunders C, Kirwan L, David R, Kemner-Van de Corput MPC, Tiddens HAWM, Davies JC, Cox DW. The clinical impact of Lumacaftor-Ivacaftor on structural lung disease and lung function in children aged 6-11 with cystic fibrosis in a real-world setting. Respir Res 2023; 24:199. [PMID: 37568199 PMCID: PMC10416528 DOI: 10.1186/s12931-023-02497-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Data from clinical trials of lumacaftor-ivacaftor (LUM-IVA) demonstrate improvements in lung clearance index (LCI) but not in FEV1 in children with Cystic Fibrosis (CF) aged 6-11 years and homozygous for the Phe508del mutation. It is not known whether LUM/IVA use in children can impact the progression of structural lung disease. We sought to determine the real-world impact of LUM/IVA on lung structure and function in children aged 6-11 years. METHODS This real-world observational cohort study was conducted across four paediatric sites in Ireland over 24-months using spirometry-controlled CT scores and LCI as primary outcome measures. Children commencing LUM-/IVA as part of routine care were included. CT scans were manually scored with the PRAGMA CF scoring system and analysed using the automated bronchus-artery (BA) method. Secondary outcome measures included rate of change of ppFEV1, nutritional indices and exacerbations requiring hospitalisation. RESULTS Seventy-one participants were recruited to the study, 31 of whom had spirometry-controlled CT performed at baseline, and after one year and two years of LUM/IVA treatment. At two years there was a reduction from baseline in trapped air scores (0.13 to 0.07, p = 0.016), but an increase from baseline in the % bronchiectasis score (0.84 to 1.23, p = 0.007). There was no change in overall % disease score (2.78 to 2.25, p = 0.138). Airway lumen to pulmonary artery ratios (AlumenA ratio) were abnormal at baseline and worsened over the course of the study. In 28 participants, the mean annual change from baseline LCI2.5 (-0.055 (-0.61 to 0.50), p = 0.85) measurements over two years were not significant. Improvements from baseline in weight (0.10 (0.06 to 0.15, p < 0.0001), height (0.05 (0.02 to 0.09), p = 0.002) and BMI (0.09 (0.03 to 0.15) p = 0.005) z-scores were seen with LUM/IVA treatment. The mean annual change from baseline ppFEV1 (-2.45 (-4.44 to 2.54), p = 0.66) measurements over two years were not significant. CONCLUSION In a real-world setting, the use of LUM/IVA over two years in children with CF aged 6-11 resulted in improvements in air trapping on CT but worsening in bronchiectasis scores. Our results suggest that LUM/IVA use in this age group improves air trapping but does not prevent progression of bronchiectasis over two years of treatment.
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Affiliation(s)
- Paul McNally
- Respiratory Department, Children's Health Ireland, Crumlin, Dublin, Ireland
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Barry Linnane
- University of Limerick School of Medicine, Limerick, Ireland
| | - Michael Williamson
- Respiratory Department, Children's Health Ireland, Crumlin, Dublin, Ireland
| | - Basil Elnazir
- Respiratory Department, Children's Health Ireland, Crumlin, Dublin, Ireland
- Trinity College, Dublin, Ireland
| | - Christopher Short
- NHLI, Imperial College, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' Trust, London, UK
| | - Clare Saunders
- NHLI, Imperial College, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' Trust, London, UK
| | - Laura Kirwan
- Cystic Fibrosis Registry of Ireland, Dublin, Ireland
| | - Rea David
- Respiratory Department, Children's Health Ireland, Crumlin, Dublin, Ireland
| | - Mariette P C Kemner-Van de Corput
- Department of Paediatric Pulmonology and Allergology, Department of Radiology and Nuclear Medicine, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Harm A W M Tiddens
- Respiratory Department, Children's Health Ireland, Crumlin, Dublin, Ireland
| | - Jane C Davies
- NHLI, Imperial College, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' Trust, London, UK
| | - Des W Cox
- Respiratory Department, Children's Health Ireland, Crumlin, Dublin, Ireland.
- University College Dublin, Dublin, Ireland.
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5
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Svedberg M, Imberg H, Gustafsson PM, Tiddens H, Davies G, Lindblad A. Longitudinal lung clearance index and association with structural lung damage in children with cystic fibrosis. Thorax 2023; 78:176-182. [PMID: 35277449 PMCID: PMC9872247 DOI: 10.1136/thoraxjnl-2021-218178] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/11/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Marcus Svedberg
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Henrik Imberg
- Departmemt of Mathematical Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Per Magnus Gustafsson
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Pediatrics, Central Hospital, Skoevde, Sweden
| | - Harm Tiddens
- Department of Pediatric Pulmonology and Allergology, ErasmusMC-Sophia Children's hospital, Rotterdam, Netherlands
| | - Gwyneth Davies
- UCL Great Ormond Street Institute of Child Health, UCL, London, UK.,Department of Respiratory Medicine, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Anders Lindblad
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Tiddens HAWM, Chen Y, Andrinopoulou ER, Davis SD, Rosenfeld M, Ratjen F, Kronmal RA, Hinckley Stukovsky KD, Dasiewicz A, Stick SM. The effect of inhaled hypertonic saline on lung structure in children aged 3-6 years with cystic fibrosis (SHIP-CT): a multicentre, randomised, double-blind, controlled trial. THE LANCET. RESPIRATORY MEDICINE 2022; 10:669-678. [PMID: 35286860 DOI: 10.1016/s2213-2600(21)00546-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND In the Saline Hypertonic in Preschoolers (SHIP) study, inhaled 7% hypertonic saline improved the lung clearance index in children aged 3-6 years with cystic fibrosis, but it remained unclear whether improvement is also seen in structural lung disease. We aimed to assess the effect of inhaled hypertonic saline on chest CT imaging in children aged 3-6 years with cystic fibrosis. METHODS Children with cystic fibrosis were enrolled in this multicentre, randomised, double-blind, controlled study at 23 cystic fibrosis centres in Spain, Denmark, the Netherlands, Italy, France, Belgium, the USA, Canada, and Australia. Eligible participants were children aged 3-6 years who were able to cooperate with chest CT imaging and comply with daily nebuliser treatment. Participants were randomly assigned 1:1 to receive inhaled 2 puffs of 100 μg salbutamol followed by 4mL of either 7% hypertonic saline or 0·9% isotonic saline twice per day for 48 weeks. Randomisation was stratified by age in North America and Australia, and by age and country in Europe. Chest CTs were obtained at baseline and 48 weeks and scored using the Perth-Rotterdam Annotated Grid Morphometric Analysis for Cystic Fibrosis (PRAGMA-CF) method. The primary outcome was the difference between groups in the percentage of total lung volume occupied by abnormal airways (PRAGMA-CF %Disease) measured by chest CT at 48 weeks. Analysis was by intention-to-treat. This study is registered with Clinicaltrials.gov, NCT02950883. FINDINGS Between May 24, 2016, and Dec 18, 2019, 134 children were assessed for inclusion. 18 patients were excluded (nine had incomplete or unsuccessful chest CT at enrolment visit, two could not comply with CT training, two had acute respiratory infection, two withdrew consent, two for reasons unknown, and one was already on hypertonic saline). 116 participants were enrolled and randomly assigned to hypertonic saline (n=56) or isotonic saline (n=60). 12 patients dropped out of the study (seven in the hypertonic saline group and five in the isotonic saline group). Mean PRAGMA-CF %Disease at 48 weeks was 0·88% (95% CI 0·60-1·16) in the hypertonic saline group and 1·55% (1·25-1·84) in the isotonic saline group (mean difference 0·67%, 95% CI 0·26-1·08; p=0·0092) based on a linear regression model adjusted for baseline %Disease values and baseline age. Most adverse events in both groups were rated as mild, and the most common adverse event in both groups was cough. INTERPRETATION Inhaled hypertonic saline for 48 weeks had a positive effect on structural lung changes in children aged 3-6 years with cystic fibrosis relative to isotonic saline. This is the first demonstration of an intervention that alters structural lung disease in children aged 3-6 years with cystic fibrosis. FUNDING Cystic Fibrosis Foundation.
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Affiliation(s)
- Harm A W M Tiddens
- Department of Paediatrics, Division of Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands.
| | - Yuxin Chen
- Department of Paediatrics, Division of Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands
| | | | - Stephanie D Davis
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Felix Ratjen
- Division of Respiratory Medicine, Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, ON, Canada
| | - Richard A Kronmal
- Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA USA
| | | | - Alison Dasiewicz
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
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Svedberg M, Imberg H, Gustafsson P, Brink M, Caisander H, Lindblad A. Chest X-rays are less sensitive than multiple breath washout examinations when it comes to detecting early cystic fibrosis lung disease. Acta Paediatr 2022; 111:1253-1260. [PMID: 35181935 PMCID: PMC9306859 DOI: 10.1111/apa.16302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
AIM Annual chest X-ray is recommended as routine surveillance to track cystic fibrosis (CF) lung disease. The aim of this study was to investigate the clinical utility of chest X-rays to track CF lung disease. METHODS Children at Gothenburg's CF centre who underwent chest X-rays, multiple breath washouts and chest computed tomography examinations between 1996 and 2016 were included in the study. Chest X-rays were interpreted with Northern Score (NS). We compared NS to lung clearance index (LCI) and structural lung damage measured by computed tomography using a logistic regression model. RESULTS A total of 75 children were included over a median period of 13 years (range: 3.0-18.0 years). The proportion of children with abnormal NS was significantly lower than the proportion of abnormal LCI up to the age of 4 years (p < 0.05). A normal NS and a normal LCI at age 6 years were associated with a median (10-90th percentile) total airway disease of 1.8% (0.4-4.7%) and bronchiectasis of 0.2% (0.0-1.5%). CONCLUSION Chest X-rays were less sensitive than multiple breath washout examinations to detect early CF lung disease. The combined results from both methods can be used as an indicator to perform chest computed tomography less frequently.
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Affiliation(s)
- Marcus Svedberg
- Department of Pediatrics Institute of Clinical Science at The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Queen Silvia's Children Hospital Gothenburg Sweden
| | - Henrik Imberg
- Department of Mathematical Sciences Chalmers University of Technology and University of Gothenburg Gothenburg Sweden
- Statistiska Konsultgruppen Gothenburg Sweden
| | - Per Gustafsson
- Department of Pediatrics Institute of Clinical Science at The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Central Hospital Skoevde Sweden
| | - Mela Brink
- Department of Pediatric Radiology Queen Silvia's Children Hospital Gothenburg Sweden
| | - Håkan Caisander
- Department of Pediatric Radiology Queen Silvia's Children Hospital Gothenburg Sweden
| | - Anders Lindblad
- Department of Pediatrics Institute of Clinical Science at The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Queen Silvia's Children Hospital Gothenburg Sweden
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Weng W, Hu Z, Pan Y. Macrophage Extracellular Traps: Current Opinions and the State of Research regarding Various Diseases. J Immunol Res 2022; 2022:7050807. [PMID: 35036449 PMCID: PMC8759907 DOI: 10.1155/2022/7050807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022] Open
Abstract
Macrophages are an important component of the human immune system and play a key role in the immune response, which can protect the body against infection and regulate the development of tissue inflammation. Some studies found that macrophages can produce extracellular traps (ETs) under various conditions of stimulation. ETs are web-like structures that consist of proteins and DNA. ETs are thought to immobilize and kill microorganisms, as well as play an important role in tissue damage, inflammatory progression, and autoimmune diseases. In this review, the structure, identification, mechanism, and research progress of macrophage extracellular traps (METs) in related diseases are reviewed.
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Affiliation(s)
- Weizhen Weng
- Division of Rheumatology, Department of Internal Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Zuoyu Hu
- Division of Rheumatology, Department of Internal Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Yunfeng Pan
- Division of Rheumatology, Department of Internal Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
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Fretzayas A, Loukou I, Moustaki M, Douros K. Correlation of computed tomography findings and lung function in children and adolescents with cystic fibrosis. World J Pediatr 2021; 17:221-226. [PMID: 34033063 DOI: 10.1007/s12519-020-00388-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND The timely and appropriate monitoring of pulmonary status is of utmost importance for patients with cystic fibrosis (CF). Computed tomography (CT) has been used in clinical and research settings for tracking lung involvement in CF patients. However, as CT delivers a considerable amount of radiation, its sequential use in CF patients remains a concern. The application of CT, therefore, should take into account its potential risks. This review aims to understand whether and to what extent the CT findings correlate with the findings from other monitoring tools in CF lung disease. DATA SOURCES PubMed was searched for articles about the correlation of chest CT findings with spirometric indices and with lung clearance index in children and adolescents with CF. The most relevant articles were reviewed and are presented herein. RESULTS Most studies have shown that forced expiratory volume in the first second (FEV1) and other spirometric indices correlate moderately with CT structural lung damage. However, at the individual level, there were patients with FEV1 within the normal range and abnormal CT and vice versa. Furthermore, longitudinal studies have indicated that the deterioration of structural lung damage does not occur in parallel with the progression of lung function. Lung clearance index is a better predictor of CT findings. CONCLUSIONS In general, the existing studies do not support the use of lung function tests as surrogates of chest CT.
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Affiliation(s)
- Andrew Fretzayas
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. .,Department of Pediatrics, Athens Medical Center, 5-7 Distomou str, 151 25, Marousi, Greece.
| | - Ioanna Loukou
- Department of Cystic Fibrosis, "Agia Sofia", Children's Hospital, Athens, Greece
| | - Maria Moustaki
- Department of Cystic Fibrosis, "Agia Sofia", Children's Hospital, Athens, Greece
| | - Konstantinos Douros
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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