tailieunhanh - Báo cáo y học: " State of the Art: Why do the lungs of patients with cystic fibrosis become infected and why can't they clear the infection?"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: State of the Art: Why do the lungs of patients with cystic fibrosis become infected and why can't they clear the infection | Respiratory Research BioMed Central Review Open Access State of the Art Why do the lungs of patients with cystic fibrosis become infected and why can t they clear the infection James F Chmiel and Pamela B Davis Address Department of Pediatrics Case Western Reserve University School of Medicine at Rainbow Babies and Children s Hospital Cleveland OH Email James F Chmiel - jxc34@ Pamela B Davis - pbd@ Corresponding author Published 27 August 2003 Received 27 May 2003 Accepted 27 August 2003 Respiratory Research 2003 4 8 This article is available from http content 4 1 8 2003 Chmiel and Davis licensee BioMed Central Ltd. This is an Open Access article verbatim copying and redistribution of this article are permitted in all media for any purpose provided this notice is preserved along with the article s original URL. Abstract Cystic Fibrosis CF lung disease which is characterized by airway obstruction chronic bacterial infection and an excessive inflammatory response is responsible for most of the morbidity and mortality. Early in life CF patients become infected with a limited spectrum of bacteria especially P. aeruginosa. New data now indicate that decreased depth of periciliary fluid and abnormal hydration of mucus which impede mucociliary clearance contribute to initial infection. Diminished production of the antibacterial molecule nitric oxide increased bacterial binding sites . asialo GM-1 on CF airway epithelial cells and adaptations made by the bacteria to the airway microenvironment including the production of virulence factors and the ability to organize into a biofilm contribute to susceptibility to initial bacterial infection. Once the patient is infected an overzealous inflammatory response in the CF lung likely contributes to the host s inability to eradicate infection. In response to increased IL-8 and leukotriene B4 production neutrophils infiltrate the lung where they release mediators such as .