Protease-antiprotease imbalance in the lungs of children with cystic fibrosis

P. Birrer, N. G. Mcelvaney, A. Rüdeberg, C. Wirz Sommer, S. Liechti-Gallati, R. Kraemer, R. Hubbard, Ronald Crystal

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Abstract

Cystic fibrosis (CF) is characterized in the lung by chronic purulent bronchitis culminating in pulmonary insufficiency. There is evidence to suggest that neutrophil elastase (NE) released by neutrophils on the respiratory epithelial surface plays a major role in the pathogenesis of this lung disease. This study sought to determine the age of onset of the chronic neutrophil-dominated inflammation in CF and the consequences to the NE-anti- NE screen on the respiratory epithelial surface of the CF lung. NE and anti- NE defensive molecules were evaluated in respiratory epithelial lining fluid (ELF) in 27 children with stable CF (1 to 18 yr of age). Despite normal antigenic concentrations of α1-antitrypsin (α1AT) and secretory leukoprotease inhibitor (SLPI), 25 of 27 children with CF had neutrophil- dominated inflammation (>500 neutrophils/μl ELF). Active NE was found in ELF in 20 of 27 children, including two of four aged 1 yr. Western blot analysis showed the majority of α1AT and SLPI molecules to be complexed and/or degraded. These observations demonstrate that a chronic imbalance of the NE- anti-NE protective screen develops early on the respiratory epithelial surface in persons with CF and is likely well established by 1 yr of age, with resultant potential for lung damage.

Original languageEnglish
Pages (from-to)207-213
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume150
Issue number1
DOIs
Publication statusPublished - 1 Jan 1994
Externally publishedYes

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Birrer, P., Mcelvaney, N. G., Rüdeberg, A., Wirz Sommer, C., Liechti-Gallati, S., Kraemer, R., Hubbard, R., & Crystal, R. (1994). Protease-antiprotease imbalance in the lungs of children with cystic fibrosis. American Journal of Respiratory and Critical Care Medicine, 150(1), 207-213. https://doi.org/10.1164/ajrccm.150.1.7912987