Fuchs, Susanne I., Schwerk, Nicolaus, Pittschieler, Klaus, Ahrens, Frank, Baden, Winfried, Bals, Robert, Faehndrich, Sebastian, Gleiber, Wolfgang, Griese, Matthias, Huelskamp, Georg, Koehnlein, Thomas, Reckling, Ludmilla, Rietschel, Ernst, Staab, Doris and Gappa, Monika (2016). Lung clearance index for monitoring early lung disease in alpha-1-antitrypsin deficiency. Respir. Med., 116. S. 93 - 100. LONDON: W B SAUNDERS CO LTD. ISSN 1532-3064

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Abstract

Patients with alpha-1-antitrypsin deficiency (AATD) and a PI-ZZ genotype are at high risk to develop severe emphysema during adulthood. However, little is known about early stages of emphysema and disease manifestation in other PI-types. Spirometry is commonly used for monitoring although early manifestation of emphysema is suspected within the peripheral airways that are not accessible by forced expiratory manoeuvres. We hypothesized that the Lung Clearance Index (LCI) derived from multiple breath nitrogen-washout (N-2-washout) is useful to bridge this diagnostic gap. Patients from age 4 years onward and different PI-types performed N-2-washout and spirometry. Results were compared to controls. 193 patients (4-79 years, 75% PI-ZZ) and 33 controls (8-60 years) were included. Mean (SD) LCI in patients was 9.1 (3.1) and 6.3 (0.6) in controls (p <= 0.001). 47% of adult patients with other than PI-ZZ genotypes and 39% of all patients with normal spirometry had abnormal LCIs. The LCI measured by N-2-washout discriminates between patients with AATD and controls, reflects AATD related lung disease in all stages and appears to identify early peripheral lung changes in younger age than spirometry. We conclude that a normal spirometry does not exclude presence of AATD related lung disease even in genotypes other than PI-ZZ. (C) 2016 Published by Elsevier Ltd.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Fuchs, Susanne I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwerk, NicolausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pittschieler, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ahrens, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baden, WinfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bals, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Faehndrich, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gleiber, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Griese, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huelskamp, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koehnlein, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reckling, LudmillaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rietschel, ErnstUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Staab, DorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gappa, MonikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-271257
DOI: 10.1016/j.rmed.2016.04.015
Journal or Publication Title: Respir. Med.
Volume: 116
Page Range: S. 93 - 100
Date: 2016
Publisher: W B SAUNDERS CO LTD
Place of Publication: LONDON
ISSN: 1532-3064
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OBSTRUCTIVE PULMONARY-DISEASE; MULTIPLE-BREATH WASHOUT; VENTILATION INHOMOGENEITY; RESPIRATORY SYMPTOMS; AUGMENTATION THERAPY; COMPUTED-TOMOGRAPHY; CLINICAL-TRIALS; YOUNG-CHILDREN; AGE; ABNORMALITIESMultiple languages
Cardiac & Cardiovascular Systems; Respiratory SystemMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27125

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