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Mediators of Inflammation
Volume 2015, Article ID 626530, 16 pages
Research Article

Changes of Proteases, Antiproteases, and Pathogens in Cystic Fibrosis Patients’ Upper and Lower Airways after IV-Antibiotic Therapy

1Department of Pediatrics, Cystic Fibrosis Center, Jena University Hospital, 07740 Jena, Germany
2Septomics Research Center, Friedrich Schiller University, 07745 Jena, Germany
3Leibniz Institute for Natural Product Research and Infection Biology, Hans Knoell Institute, Jena, Germany
4Department of Dermatology, Jena University Hospital, 07740 Jena, Germany
5Department of Pediatric Hematology and Oncology, Jena University Hospital, 07740 Jena, Germany
6Institute of Medical Microbiology, University of Jena, 07740 Jena, Germany
7Institute for Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, 07740 Jena, Germany
8Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, 07740 Jena, Germany

Received 19 December 2014; Accepted 18 March 2015

Academic Editor: Christian Taube

Copyright © 2015 Ulrike Müller et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. In cystic fibrosis (CF) the upper (UAW) and lower airways (LAW) are reservoirs for pathogens like Pseudomonas aeruginosa. The consecutive hosts’ release of proteolytic enzymes contributes to inflammation and progressive pulmonary destruction. Objectives were to assess dynamics of protease : antiprotease ratios and pathogens in CF-UAW and LAW sampled by nasal lavage (NL) and sputum before and after intravenous- (IV-) antibiotic therapy. Methods. From 19 IV-antibiotic courses of 17 CF patients NL (10 mL/nostril) and sputum were collected before and after treatment. Microbiological colonization and concentrations of NE/SLPI/CTSS (ELISA) and MMP-9/TIMP-1 (multiplex bead array) were determined. Additionally, changes of sinonasal symptoms were assessed (SNOT-20). Results. IV-antibiotic treatment had more pronounced effects on inflammatory markers in LAW, whereas trends to decrease were also found in UAW. Ratios of MMP-9/TIMP-1 were higher in sputum, and ratios of NE/SLPI were higher in NL. Remarkably, NE/SLPI ratio was 10-fold higher in NL compared to healthy controls. SNOT-20 scores decreased significantly during therapy . Conclusion. For the first time, changes in microbiological patterns in UAW and LAW after IV-antibiotic treatments were assessed, together with changes of protease/antiprotease imbalances. Delayed responses of proteases and antiproteases to IV-antibiotic therapy were found in UAW compared to LAW.