Longitudinal study of oxidative status in 312 cystic fibrosis patients in stable state and during bronchial exacerbation

• Published in: Pediatric pulmonology Vol. 38; no. 1; pp. 43 - 49
• Main Authors: Lagrange-Puget, Marie, Durieu, Isabelle, Ecochard, René, Abbas-Chorfa, Fatima, Drai, Jocelyne, Steghens, Jean-Paul, Pacheco, Yves, Vital-Durand, Denis, Bellon, Gabriel
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-07-2004; Wiley-Liss; Wiley
• Subjects: Adolescent; Adult; antibiotics; antioxidants; Antioxidants - metabolism; Biological and medical sciences; Biomarkers - blood; BMI; Case-Control Studies; Child; Child, Preschool; cystic fibrosis; Cystic Fibrosis - blood; Cystic Fibrosis - diagnosis; Cystic Fibrosis - drug therapy; Female; FEV1; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Infant; infection; Life Sciences; Lipid Peroxidation; Lipid Peroxides - metabolism; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Longitudinal Studies; Male; Malondialdehyde - metabolism; Medical sciences; Middle Aged; Other; Other diseases. Semiology; Oxidation-Reduction; Oxidative Stress; Pneumology; Probability; Prognosis; Prospective Studies; Reference Values; Regression Analysis; Respiratory Function Tests; Risk Assessment; Severity of Illness Index; Vitamin E Deficiency - blood; Human; Pediatrics; Oxidative stress; Respiratory disease; antioxidants; Bronchus; Metabolic diseases; Cystic fibrosis; Antioxidant; Respiratory system; Genetic disease; Respiratory tract; Infection; Antibiotic; Digestive diseases; FEV1; antibiotics; Pancreatic disease; Pneumology; BMI
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.20041

In cystic fibrosis (CF), there is an imbalance in the oxidant/antioxidant system, leading to oxidative damage. The aim of this study was to assess antioxidant‐scavenger deficiencies and lipid peroxide variations in three clinical situations (stable status, acute exacerbation, and after intravenous antibiotic treatment). The objective was also to correlate oxidative stress with age, nutritional status, and respiratory function. The study included prospectively 312 consecutive patients and 53 controls. Antioxidants (vitamin A, vitamin E, carotenoids, and glutathione) and oxidative markers (malondialdehyde and lipid peroxides) were measured in plasma. Regression analyses were performed. Antioxidant levels were lower in CF patients than in controls. These levels decreased during acute exacerbation and increased after antibiotic treatment. Carotenoid levels were not modified by infection or age. Only vitamin A and carotenoid levels were positively correlated to body mass index. Antioxidant levels were correlated to forced expiratory volume at 1 sec. Lipid peroxidation markers were lower in patients than in controls. Their levels decreased during infection, and increased after antibiotic treatment. Impaired lung function was correlated with elevated malondialdehyde levels. In conclusion, this study demonstrates antioxidant deficiency in a very large cohort of CF patients. Carotenoid and vitamin E deficiencies occur early in the course of the disease. Antioxidants decrease with bronchial infection. By contrast, nutritional disorders did not modify antioxidant levels during acute exacerbations. Thus, pulmonary disorders rather than nutritional disorders seem to be essential in the imbalance of the oxidant/antioxidant system. Results concerning glutathione and oxidative‐marker levels highlighted the fact that their plasma values do not reflect oxidative stress in the respiratory tract. Pediatr Pulmonol. 2004; 38:43–49. © 2004 Wiley‐Liss, Inc.