Systematic Review of Blood Biomarkers in Cystic Fibrosis Pulmonary Exacerbations.

Link to article at PubMed

Systematic Review of Blood Biomarkers in Cystic Fibrosis Pulmonary Exacerbations.

Chest. 2013 Jul 18;

Authors: Hakimi Shoki A, Mayer-Hamblett N, Wilcox PG, Sin DD, Quon BS

Abstract
ABSTRACT BACKGROUND: Biomarkers reflective of disease activity in cystic fibrosis (CF) have the potential to improve patient care, particularly during CF pulmonary exacerbations (CFPE). While blood-based biomarkers have been studied in CFPE for nearly three decades, none have been integrated into routine clinical practice. To facilitate progress in this area, we performed a systematic review evaluating blood-based biomarkers during CFPE.
METHODS: MEDLINE, EMBASE and CENTRAL were searched to identify relevant studies published from January 1995 to August 2012. We included all full-text studies examining systemic (blood-based) biomarkers to aid in diagnosis of CFPE, predict outcomes of CFPE, and/or monitor response to CFPE treatment.
RESULTS: Seventy-eight unique blood-based biomarkers have been studied to date, mainly inflammatory cytokines, acute phase reactants, and markers of oxidative stress. C-reactive protein (CRP) consistently correlated with disease activity with a statistically significant increase from stable to exacerbation state in five of six studies, and changes in response to CFPE treatment with a statistically significant decrease from the beginning to the end of CFPE treatment in eighteen of twenty studies. Other promising biomarkers of CFPE disease activity include neutrophil elastase anti-proteinase complex (NEAPC), interleukin (IL)-6, myeloperoxidase (MPO), lactoferrin, and calprotectin.
CONCLUSIONS: Although there are several blood-based biomarkers with evidence for application within the CFPE setting, CRP has been the most widely studied biomarker demonstrating the potential for clinical utility. Further validation studies and clinical trials are required to determine whether blood-based biomarkers can be used to ultimately improve health outcomes in the setting of a CFPE.

PMID: 23868694 [PubMed - as supplied by publisher]

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