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Article: Effect of antibiotics on sputum inflammatory contents in acute exacerbations of bronchiectasis

TitleEffect of antibiotics on sputum inflammatory contents in acute exacerbations of bronchiectasis
Authors
Issue Date1993
PublisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/rmed
Citation
Respiratory Medicine, 1993, v. 87 n. 6, p. 449-454 How to Cite?
AbstractWe studied the changes in sputum neutrophil chemotactic activity (NCA) and elastolytic activity (EA) in acute exacerbations of bronchiectasis before and after treatment with oral antibiotics. Twelve patients who chronically produced sputum were assessed in the stable state, and when they subsequently developed symptoms of acute exacerbations, prior to initiation of antibiotics, during 2 weeks of antibiotics, and at 2 and 6 weeks after stopping antibiotics. NCA was measured using modified Boyden's technique with multiwell chemotaxis chamber, and EA with N-succiny-trialanine-p-nitroanilide as elastase substrate. All 12 patients had NCA (49.3 ± 8.69% FMLP response) and EA (50.5 ± 17.1 mU per 100 μl) in their sputum in the stable state. At acute exacerbation, there was significant increase in NCA (P < 0.001) and EA (P < 0.05). All responded clinically after 1 week of antibiotics, and this was associated with a decrease in NCA and EA back to the levels in stable state. A further week of antibiotics did not result in further decline of NCA or EA. Three patients had another acute exacerbation clinically between 2-6 weeks after stopping antibiotics and their NCA and EA rose again. In the other nine patients, both NCA and EA at 2 and 6 weeks post-treatment were similar to pre-exacerbation levels. Our findings suggest that short course antibiotics effectively control the upsurge in inflammatory activity in acute axacerbations, but has little effect on chronic airway inflammation. This would challenge the validity of such a treatment strategy which is still the most common in clinical practice, when persistent airway inflammation is believed to lead to progressive lung destruction.
Persistent Identifierhttp://hdl.handle.net/10722/68082
ISSN
2015 Impact Factor: 3.036
2015 SCImago Journal Rankings: 1.396
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorIp, Men_HK
dc.contributor.authorShum, Den_HK
dc.contributor.authorLauder, Ien_HK
dc.contributor.authorLam, WKen_HK
dc.contributor.authorSo, SYen_HK
dc.date.accessioned2010-09-06T06:01:10Z-
dc.date.available2010-09-06T06:01:10Z-
dc.date.issued1993en_HK
dc.identifier.citationRespiratory Medicine, 1993, v. 87 n. 6, p. 449-454en_HK
dc.identifier.issn0954-6111en_HK
dc.identifier.urihttp://hdl.handle.net/10722/68082-
dc.description.abstractWe studied the changes in sputum neutrophil chemotactic activity (NCA) and elastolytic activity (EA) in acute exacerbations of bronchiectasis before and after treatment with oral antibiotics. Twelve patients who chronically produced sputum were assessed in the stable state, and when they subsequently developed symptoms of acute exacerbations, prior to initiation of antibiotics, during 2 weeks of antibiotics, and at 2 and 6 weeks after stopping antibiotics. NCA was measured using modified Boyden's technique with multiwell chemotaxis chamber, and EA with N-succiny-trialanine-p-nitroanilide as elastase substrate. All 12 patients had NCA (49.3 ± 8.69% FMLP response) and EA (50.5 ± 17.1 mU per 100 μl) in their sputum in the stable state. At acute exacerbation, there was significant increase in NCA (P < 0.001) and EA (P < 0.05). All responded clinically after 1 week of antibiotics, and this was associated with a decrease in NCA and EA back to the levels in stable state. A further week of antibiotics did not result in further decline of NCA or EA. Three patients had another acute exacerbation clinically between 2-6 weeks after stopping antibiotics and their NCA and EA rose again. In the other nine patients, both NCA and EA at 2 and 6 weeks post-treatment were similar to pre-exacerbation levels. Our findings suggest that short course antibiotics effectively control the upsurge in inflammatory activity in acute axacerbations, but has little effect on chronic airway inflammation. This would challenge the validity of such a treatment strategy which is still the most common in clinical practice, when persistent airway inflammation is believed to lead to progressive lung destruction.en_HK
dc.languageengen_HK
dc.publisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/rmeden_HK
dc.relation.ispartofRespiratory Medicineen_HK
dc.subject.meshAcute Diseaseen_HK
dc.subject.meshAnti-Bacterial Agents - therapeutic useen_HK
dc.subject.meshBronchiectasis - drug therapy - enzymology - physiopathologyen_HK
dc.subject.meshChemotaxis, Leukocyte - drug effectsen_HK
dc.subject.meshCross-Sectional Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLung - physiopathologyen_HK
dc.subject.meshNeutrophils - physiologyen_HK
dc.subject.meshPancreatic Elastase - analysisen_HK
dc.subject.meshSputum - cytology - drug effects - enzymologyen_HK
dc.titleEffect of antibiotics on sputum inflammatory contents in acute exacerbations of bronchiectasisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0954-6111&volume=87&spage=449&epage=454&date=1993&atitle=Effect+of+antibiotics+on+sputum+inflammatory+contents+in+acute+exacerbations+of+bronchiectasisen_HK
dc.identifier.emailIp, M:msmip@hku.hken_HK
dc.identifier.emailShum, D:shumdkhk@hkucc.hku.hken_HK
dc.identifier.authorityIp, M=rp00347en_HK
dc.identifier.authorityShum, D=rp00321en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/0954-6111(93)90072-8en_HK
dc.identifier.pmid8210615-
dc.identifier.scopuseid_2-s2.0-0027244674en_HK
dc.identifier.hkuros8108en_HK
dc.identifier.volume87en_HK
dc.identifier.issue6en_HK
dc.identifier.spage449en_HK
dc.identifier.epage454en_HK
dc.identifier.isiWOS:A1993LU73900009-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridIp, M=7102423259en_HK
dc.identifier.scopusauthoridShum, D=7004824447en_HK
dc.identifier.scopusauthoridLauder, I=35564928000en_HK
dc.identifier.scopusauthoridLam, WK=7203021937en_HK
dc.identifier.scopusauthoridSo, SY=7102397816en_HK

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