ORIGINAL ARTICLE Early airway infection, inflammation, and lung function in cystic fibrosis

Aims: To determine the relation between lower airway infection and inflammation, respiratory symp-toms, and lung function in infants and young children with cystic fibrosis (CF). Methods: A prospective study of children with CF aged younger than 3 years, diagnosed by a new-born screening programme. All were clinically stable and had testing as outpatients. Subjects under-went bronchial lavage (BL) and lung function testing by the raised volume rapid thoracoabdominal compression technique under general anaesthesia. BL fluid was cultured and analysed for neutrophil count, interleukin 8, and neutrophil elastase. Lung function was assessed by forced expiratory volume in 0.5, 0.75, and 1 second. Results: Thirty six children with CF were tested on 54 occasions. Lower airway infection shown by BL was associated with a 10 % reduction in FEV0.5 compared with subjects without infection. No relation was identified between airway inflammation and lung function. Daily moist cough within the week before testing was reported on 20/54 occasions, but in only seven (35%) was infection detected. Inde-pendent of either infection status or airway inflammation, those with daily cough had lower lung func-tion than those without respiratory symptoms at the time of BL (mean adjusted FEV0.5 195 ml and 236 ml respectively)