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The Role of the High-Sensitivity C-Reactive Protein in Patients with Stable Non-Cystic Fibrosis Bronchiectasis

DOI: 10.1155/2013/795140

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Abstract:

Study Objectives. The aim of this study is to investigate the correlation between serum high-sensitivity C-reactive protein (hs-CRP) and other clinical tools including high-resolution computed tomography (HRCT) in patients with stable non-CF bronchiectasis. Design. A within-subject correlational study of a group of patients with stable non-CF bronchiectasis, who were recruited from our outpatient clinic, was done over a two-year period. Measurements. Sixty-nine stable non-CF bronchiectasis patients were evaluated in terms of hs-CRP, 6-minute walk test, pulmonary function tests, and HRCT. Results. Circulating hs-CRP levels were significantly correlated with HRCT scores ( , , ) and resting oxygenation saturation ( , ). HRCT severity scores significantly increased in patients with hs-CRP level of 4.26?mg/L or higher (mean ± SD ) compared to those with hs-CRP level less than 4.26?mg/L ( , ). Oxygenation saturation at rest was lower in those with hs-CRP level of 4.26?mg/L or higher ( ) compared to those with hs-CRP level less than 4.26?mg/L ( , ). Conclusion. There was a good correlation between serum hs-CRP and HRCT scores in the patients with stable non-CF bronchiectasis. 1. Introduction Despite improvements in childhood immunization and tuberculosis control, bronchiectasis remains a significant clinical issue worldwide [1, 2]. It is a chronic, debilitating lung disease characterized by irreversible dilatation of the bronchi from airway remodeling due to chronic airway inflammation and infection. Underlying etiologies include autoimmune diseases, severe infections, genetic abnormalities, and acquired disorders; however, its pathogenesis and progression remain poorly understood [1–5]. Exacerbations occur at rates of 1.5–6.5 per patient per year [6, 7] and are associated with an increased risk of admission and readmission to hospitals and high healthcare costs [8]. High-resolution computed tomography (HRCT) is a proven, reliable, and noninvasive method for assessing bronchiectasis [9]. It can accurately diagnose bronchiectasis and localize and describe areas of parenchymal abnormality. A link between morphological HRCT parameters and clinical functional correlation has been established [9–14]. However, concerns over radiation exposure and high cost limit its frequent use in stable bronchiectasis patients. Inflammation in bronchiectasis is characterized by persistence and intensity. Airway inflammation is neutrophil-predominant, and inflammatory profiles show increased levels of proinflammatory cytokines such as IL-1, IL-6, and TNF-α and low levels of

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