Study design (if review, criteria of inclusion for studies)
As part of the BEAT trial, this is a longitudinal study
Participants
20 CF patients with normal pulmonary function (median FEV1 94% of predicted)
Interventions
bronchoalveolar lavage fluid at three times over a three year period.
Outcome measures
lung function, surfactant function and endobronchial inflammation
Main results
There was a progressive loss of surfactant function, assessed as minimal surface tension. The decline in surfactant function was negatively correlated to an increase in neutrophilic inflammation and a decrease in lung function, assessed by FEV1, MEF(75/25%VC), and MEF(25%VC). The concentrations of the surfactant specific proteins A, C and D did not change, whereas SP-B increased during this time period.
Authors' conclusions
There may be a link between loss of surfactant function driven by progressive airway inflammation and loss of small airway function in CF patients with limited lung disease.