Early markers of cystic fibrosis structural lung disease: follow-up of the ACFBAL cohort. Issue 4 (2nd April 2020)

• Record Type: Journal Article
• Authors: Wijker, Naomi E.; Vidmar, Suzanna; Grimwood, Keith; Sly, Peter D.; Byrnes, Catherine A.; Carlin, John B.; Cooper, Peter J.; Robertson, Colin F.; Massie, R. John; Kemner van de Corput, Mariette P.C.; Cheney, Joyce; Tiddens, Harm A.W.M.; Wainwright, Claire E.
• Other Names: author non-byline.; Wainwright Claire E. author non-byline.; Grimwood Keith author non-byline.; Cheney Joyce author non-byline.; George Narelle author non-byline.; Carlin John B. author non-byline.; Robertson Colin F. author non-byline.; Vidmar Suzanna author non-byline.; Carzino Rosemary author non-byline.; Moodie Marj author non-byline.; Armstrong David S. author non-byline.; Cooper Peter J. author non-byline.; Martin A. (James) author non-byline.; Whitehead Bruce author non-byline.; Byrnes Catherine A. author non-byline.; Tiddens Harm A.W.M. author non-byline.; author non-byline.; Wainwright Claire E. author non-byline.; Grimwood Keith author non-byline.; Sly Peter D. author non-byline.; Tiddens Harm A.W.M. author non-byline.; Rogers Geraint author non-byline.; Massie Richard (John) author non-byline.; Robertson Colin F. author non-byline.; Cooper Peter J. author non-byline.; Byrnes Catherine A. author non-byline.; Vidmar Suzanna author non-byline.; Martin A.(James) author non-byline.; Whitehead Bruce author non-byline.; Armstrong David author non-byline.; Carlin John B. author non-byline.; Wark Peter author non-byline.; author non-byline.; Gailer Nicholas author non-byline.; Smith Natalie author non-byline.; Moss Careana author non-byline.; Jess Katrina author non-byline.; Yarrow Peta author non-byline.; McArthur Merilyn author non-byline.; Forbes Sam author non-byline.; Selvadurai Hiran author non-byline.; Ranganathan Sarath author non-byline.; Robinson Phil author non-byline.; Zajakovski Natalie author non-byline.; Erasmus MC author non-byline.; Wiel Els Van Der author non-byline.;
• Is Part Of: European respiratory journal. Volume 55:Issue 4(2020)
• Publication Date: 2020-04-02
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01694-2019
• Languages: English
• ISSNs: 0903-1936

Abstract

Little is known about early predictors of later cystic fibrosis (CF) structural lung disease. This study examined early predictors of progressive structural lung abnormalities in children who completed the Australasian CF Bronchoalveolar Lavage (ACFBAL) clinical trial at age 5-years and participated in an observational follow-up study (CF-FAB). Eight Australian and New Zealand CF centres participated in CF-FAB and provided follow-up chest computed-tomography (CT) scans for children who had completed the ACFBAL study with baseline scans at age 5-years. CT scans were annotated using PRAGMA-CF scoring. Ordinal regression analysis and linear regression were used to investigate associations between PRAGMA-CF (Perth–Rotterdam Annotated Grid Morphometric Analysis for CF) outcomes at follow-up and variables measured during the ACFBAL study. 99 out of 157 ACFBAL children (mean±sd age 13±1.5 years) participated in the CF-FAB study. The probability of bronchiectasis at follow-up increased with airway disease severity on the baseline CT scan. In multiple regression (retaining factors at p<0.05) the extent of bronchiectasis at follow-up was associated with baseline atelectasis (OR 7.2, 95% CI 2.4–22; p≤ 0.001), bronchoalveolar lavage (BAL) log2 interleukin (IL)-8 (OR 1.2, 95% CI 1.05–1.5; p=0.010) and body mass index z-score (OR 0.49, 95% CI 0.24–1.00; p=0.05) at age 5 years. Percentage trapped air at follow-up was associated with BAL log2 IL-8 (coefficient 1.3, 95% CI 0.57–2.1; p<0.001) at age 5 years. The extent of airway disease, atelectasis, airway inflammation and poor nutritional status in early childhood are risk factors for progressive structural lung disease in adolescence. In children with cystic fibrosis, airways disease severity on chest computed tomography at age 5 years increased the risk of bronchiectasis in adolescence and its extent was predicted by poorer nutrition, airway inflammation, and atelectasis http://bit.ly/2Nnk8LW