RT Journal Article
SR Electronic
T1 LATE-BREAKING ABSTRACT: The heterogeneity of systemic inflammation in bronchiectasis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA4487
DO 10.1183/13993003.congress-2015.OA4487
VO 46
IS suppl 59
A1 A. Saleh
A1 J. Chalmers
A1 A. de Soyza
A1 T. Fardon
A1 S. Koustas
A1 J. Scott
A1 J. Simpson
A1 J. Brown
A1 J. Hurst
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/OA4487.abstract
AB Rationale: Systemic inflammation in bronchiectasis is poorly studied in relation to disease aetiology and severity.Method: We assayed blood concentrations of 31 proteins from 90 patients with bronchiectasis (derivation cohort) and conducted PCA to examine relationships between these markers, disease aetiology and severity. Key results were validated in two separate cohorts of 97 and 79 patients.Results: There was significant heterogeneity in protein concentrations across the derivation cohort. Increasing severity of bronchiectasis (BSI) was associated with increasing fibrinogen concentration (rho=0.34, p=0.001 – validated in a second cohort), and higher fibrinogen was associated with worse lung function, Pseudomonas colonisation and impaired health status. There were generally similar patterns of inflammation in patients with idiopathic and post-infectious disease. Patients with primary immunodeficiency had exaggerated IL-17 responses, validated in a second cohort (immunodeficient 12.82 vs. idiopathic/post-infectious 4.95pg/ml, p=0.001), and thus IL-17 was able to discriminate primary immunodeficiency from other aetiologies (ROC AUC 0.769 (95%CI 0.661-0.877)).Conclusion: Bronchiectasis is associated with heterogeneity of systemic inflammatory proteins not adequately explained by differences in disease aetiology or disease severity. More severe disease is associated with an enhanced acute-phase response and we provide proof-of-principle that assay of systemic proteins may aid the diagnosis of specific conditions. Plasma fibrinogen was associated with bronchiectasis severity in two cohorts, Pseudomonas colonisation and health status, and offers potential as a useful biomarker.