alpha1-Antitrypsin inhalation reduces airway inflammation in cystic fibrosis patients

Griese, M; Latzin, P; Kappler, M; Weckerle, K; Heinzlmaier, T; Bernhardt, T; Hartl, D (2007). alpha1-Antitrypsin inhalation reduces airway inflammation in cystic fibrosis patients. European respiratory journal, 29(2), pp. 240-50. Sheffield, UK: European Respiratory Society 10.1183/09031936.00047306

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The airways of cystic fibrosis (CF) patients are characterised by neutrophils that release high amounts of elastase overwhelming the local antiprotease shield. Inhalation of alpha(1)-antitrypsin (AAT) may restore the protease-antiprotease balance and attenuate airway inflammation in CF airways. The aims of the present study were: 1) to assess the best deposition region for inhaled AAT by two different inhalation strategies; and 2) to examine the effect of 4 weeks of AAT inhalation on lung function, protease-antiprotease balance and airway inflammation in CF patients. In a prospective, randomised study, 52 CF patients received a daily deposition by inhalation of 25 mg AAT for 4 weeks targeting their peripheral or bronchial compartment. The levels of elastase activity, AAT, pro-inflammatory cytokines, neutrophils, immunoglobulin G fragments and the numbers of Pseudomonas aeruginosa were assessed in induced sputum before and after the inhalation period. Inhalation of AAT increased AAT levels and decreased the levels of elastase activity, neutrophils, pro-inflammatory cytokines and the numbers of P. aeruginosa. However, it had no effect on lung function. No difference was found between the peripheral and bronchial inhalation mode. In conclusion, although no effect on lung function was observed, the clear reduction of airway inflammation after alpha(1)-antitrypsin treatment may precede pulmonary structural changes. The alpha(1)-antitrypsin deposition region may play a minor role for alpha(1)-antitrypsin inhalation in cystic fibrosis patients.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
UniBE Contributor:	Latzin, Philipp
ISSN:	0903-1936
ISBN:	17050563
Publisher:	European Respiratory Society
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	04 Oct 2013 14:50
Last Modified:	05 Dec 2022 14:15
Publisher DOI:	10.1183/09031936.00047306
PubMed ID:	17050563
Web of Science ID:	000244283900006
URI:	https://boris.unibe.ch/id/eprint/20911 (FactScience: 4707)