Early cystic fibrosis lung disease detected by bronchoalveolar lavage and lung clearance index

January 27, 2012

The lung clearance index (LCI) is a sensitive non-invasive marker of early lung disease in young children with cystic fibrosis (CF), according to a new study from Australian researchers.

"We found that LCI is elevated early in with CF, especially in the presence of and aeruginosa," said Yvonne Belessis, MBBS, MPH, PhD, respiratory staff specialist at the Sydney Children's Hospital. "LCI may not only be a marker of early CF lung disease, but may be useful as an objective outcome measure in future studies of young children with CF."

The findings were published online ahead of print publication in the American Thoracic Society's .

LCI was determined after multiple breath washout (MBW) testing in 47 presymptomatic/minimally symptomatic infants and young children with CF (mean age 1.55 years) and 25 healthy control children (mean age 1.26 years). Bronchoalveolar lavage (BAL) was also performed in the children with CF.

Mean (SD) LCI in children with CF was 7.21 (0.81), compared with 6.45 (0.49) in control children (P<.001). The upper limit of normal for LCI was 7.41. Among the 47 children with CF, 15 (32%) had an elevated LCI. Measurements of LCI were repeatable and reproducible.

Airway infection (≥105 cfu/mL BAL fluid) was detected in 17 (36%) children with CF, including 7 (15%) children who had Pseudomonas aeruginosa infection. LCI in children with Pseudomonas was 7.92 (1.16), compared with 7.02 (0.56) in children without Pseudomonas (P=.038). LCI was significantly correlated with the BAL inflammatory markers interleukin-8 and neutrophil count.

There were some limitations to the study, including the lack of a robust measure of structural lung disease and a higher diagnostic threshold for airway infection than has been used in other BAL studies.

"We obtained reproducible measurements of LCI at the bedside of sedated infants and young children using a portable MBW system," said Dr. Belessis. "Compared with healthy controls, LCI was elevated in well infants and young children with CF, and abnormal LCI was associated with Pseudomonas aeruginosa infection and airway inflammation.

"Our results show that the LCI is a feasible, sensitive and repeatable non-invasive marker of early in well infants and young children with CF. Longitudinal assessment of the LCI taking into consideration changes in inflammation and airway infection over time are needed to confirm these findings."

Explore further: Bacterial infection alone not an indicator of poor lung function in adolescents with CF

Related Stories

Bacterial infection alone not an indicator of poor lung function in adolescents with CF

May 16, 2011
Children with cystic fibrosis (CF) who have poor lung function early in life are more likely also to have poor lung function in adolescence, regardless of whether they are exposed to a common infection caused by the bacteria ...

Invasive diagnostic procedure for children with cystic fibrosis does not improve outcomes

July 12, 2011
Compared to a standard diagnostic procedure, infants with cystic fibrosis who received treatment based on a diagnostic procedure involving obtaining and culturing fluid samples from the lungs did not have a lower prevalence ...

Study shows new medication effectively treats underlying cause of cystic fibrosis

November 2, 2011
A new study has confirmed that the drug, ivacaftor (VX-770), significantly improves lung function in some people with cystic fibrosis (CF). The results of the phase III clinical trial study, "A CFTR Potentiator in Patients ...

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.