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Review
. 2007 Aug 1;4(4):406-17.
doi: 10.1513/pats.200703-044BR.

Sputum biomarkers of inflammation in cystic fibrosis lung disease

Scott D Sagel  1 , James F Chmiel, Michael W Konstan
Affiliations
Review

Sputum biomarkers of inflammation in cystic fibrosis lung disease

Scott D Sagel et al. Proc Am Thorac Soc. .

Abstract

Pulmonary biomarkers are being used more frequently to monitor disease activity and evaluate response to treatment in individuals with cystic fibrosis (CF). This article summarizes the current state of knowledge of biomarkers of inflammation relevant to CF lung disease, and the tools to measure inflammation, with specific emphasis on sputum. Sputum is a rich, noninvasive source of biomarkers of inflammation and infection. Sputum induction, through the inhalation of hypertonic saline, has expanded the possibilities for monitoring airway inflammation and infection, especially in individuals who do not routinely expectorate sputum. We critically examine the existing data supporting the validity of sputum biomarkers in CF, with an eye toward their application as surrogate endpoints or outcome measures in CF clinical trials. Further validation studies are needed regarding the variability of inflammatory biomarker measurements, and to evaluate how these biomarkers relate to disease severity, and to longitudinal changes in lung function and other clinical endpoints. We highlight the need to incorporate sputum collection, by induction if necessary, and measurement of sputum biomarkers into routine CF clinical care. In the future, pulmonary biomarkers will likely be useful in predicting disease progression, indicating the onset and resolution of a pulmonary exacerbation, and assessing response to current therapies or candidate therapeutics.

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Figures

<b>Figure 1.</b>
Figure 1.
Sputum neutrophil elastase activity measurements from the U.S. multicenter azithromycin clinical trial. Mean elastase levels in the azithromycin and placebo groups were similar at baseline. There was a significant difference in elastase levels between the two groups at the end of treatment, mainly due to an increase in sputum elastase in the placebo group. Adapted by permission from Reference 137.
<b>Figure 2.</b>
Figure 2.
Schematic of possible effects of drug candidates on sputum markers of inflammation and infection and associated clinical consequences.
See this image and copyright information in PMC

References

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