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    The impact of local and systemic inflammation on the frequency of exacerbations in adult patients with bronchiectasis
    (Maltepe Üniversitesi, 2019) Suska, K.; Boiko, O.
    Introduction: Bronchiectasis (B) is a chronic irreversible inflammatory airway disease characterized by cough with sputum and frequent bacterial and virus infections. One of the most important clinical sign is exacerbation frequency (EF). Patients (pts) who have 3 or more exacerbations during the year are considered as frequent exacerbators. Pts with a large number of annual exacerbations need more careful monitoring and prophylactic treatment, therefore it is quite important to identify such pts. The aim of the study was to identify the impact of local and systemic inflammation on the EF in adult pts with B. Materials and Methods: The study included 25 pts with B in stable phase. The presence of B was confirmed by high-resolution computed tomography. Daily amount of sputum was measured by laboratory scales of high accuracy class (? 0.002 g). The level of C-reactive protein (CRP) was determined in sera with the latexturbidimetric method. Data about exacerbations frequency were found in medical documentation of the patients. The methods of descriptive statistics and non-parametric statistics were used to process the results. Results: The median age (IQR) was 41 (37; 58) years, 7 (28%) were males. We divided the patients into two groups: G1 – Frequent exacerbators (?3 exacerbations per year) and G2 – non-Frequent exacerbators (‹3 exacerbations per year). G1: the median level of CRP was 11.4 (5.5; 26.7) mg/l, the median daily amount of sputum was 50 (30; 100) ml. G2: the median level of CRP was 7.04 (5.07; 15.2) mg/l, the median daily amount of sputum was 15 (5; 30) ml. We found that the amount of daily sputum in the G1 was statistically significantly higher than in the G2 (p=0.04 by Mann-Whitney U test), but there was no statistically significant difference between the levels of CRP in both groups (p=0.39 by Mann- Whitney U test). Conclusions. 1) Most patients produce sputum and have an increased CRP level, which indicates the presence of local and systemic inflammation even in the stable phase of B. 2) More sputum as a sign of local inflammation is more likely to be a predictor of exacerbations than CRP.