Colonization of CF patients’ upper airways with S. aureus contributes more decisively to upper airway inflammation than P. aeruginosa

In cystic fibrosis (CF) patients’ airways, inflammatory processes decisively contribute to remodeling and pulmonary destruction. The aims of this study were to compare upper airway (UAW) inflammation in the context of Staphylococcus aureus and Pseudomonas aeruginosa colonization in a longitudinal se...

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Bibliographic Details
Published in:Medical microbiology and immunology 2016-10, Vol.205 (5), p.485-500
Main Authors: Janhsen, Wibke Katharina, Arnold, Christin, Hentschel, Julia, Lehmann, Thomas, Pfister, Wolfgang, Baier, Michael, Böer, Klas, Hünniger, Kerstin, Kurzai, Oliver, Hipler, Uta-Christina, Mainz, Jochen Georg
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Airway management
Biomedical and Life Sciences
Biomedicine
Child
Cystic fibrosis
Cystic Fibrosis - complications
Cystic Fibrosis - pathology
Cytokines - analysis
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunology
Inflammation
Inflammation - pathology
Longitudinal Studies
Male
Medical Microbiology
Middle Aged
Nasal Lavage
Nasal Lavage Fluid - chemistry
Original Investigation
Peptide Hydrolases - analysis
Pseudomonas aeruginosa
Pseudomonas aeruginosa - isolation & purification
Pseudomonas Infections - microbiology
Pseudomonas Infections - pathology
Respiratory Tract Infections - microbiology
Respiratory Tract Infections - pathology
Staphylococcal Infections - microbiology
Staphylococcal Infections - pathology
Staphylococcus aureus
Staphylococcus aureus - isolation & purification
Staphylococcus infections
Virology
Young Adult
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Summary:In cystic fibrosis (CF) patients’ airways, inflammatory processes decisively contribute to remodeling and pulmonary destruction. The aims of this study were to compare upper airway (UAW) inflammation in the context of Staphylococcus aureus and Pseudomonas aeruginosa colonization in a longitudinal setting, and to examine further factors influencing UAW inflammation. Therefore, we analyzed soluble inflammatory mediators in noninvasively obtained nasal lavage (NL) of CF patients together with microbiology, medication, and relevant clinical parameters. NL, applying 10 mL of isotonic saline per nostril, was serially performed in 74 CF patients (326 samples). Concentrations of the inflammatory mediators’ interleukin (IL)-1β, IL-6, IL-8, matrix metalloproteinase (MMP)-9, and its anti-protease TIMP-1 were quantified by bead-based multiplexed assay, neutrophil elastase (NE) via ELISA. Culture-based microbiology of the upper and lower airways (LAW), as well as serological and clinical findings, were compiled. Our results indicate that UAW colonization with S. aureus significantly impacts the concentration of all measured inflammatory mediators in NL fluid except TIMP-1, whereas these effects were not significant for P. aeruginosa. Patients with S. aureus colonization of both the UAW and LAW showed significantly increased concentrations of IL-1β, IL-6, IL-8, MMP-9, and slightly elevated concentrations of NE in NL fluid compared to non-colonized patients. This work elaborates a survey on S. aureus’ virulence factors that may contribute to this underestimated pathology. Serial assessment of epithelial lining fluid by NL reveals that colonization of the UAW with S. aureus contributes more to CF airway inflammatory processes than hitherto expected.
ISSN:0300-8584
1432-1831
DOI:10.1007/s00430-016-0463-0