Airway inflammation accelerates pulmonary exacerbations in cystic fibrosis.

Airway inflammation underlies cystic fibrosis (CF) pulmonary exacerbations. In a prospective multicenter study of randomly selected, clinically stable adolescents and adults, we assessed relationships between 24 inflammation-associated molecules and the future occurrence of CF pulmonary exacerbation using proportional hazards models. We explored relationships for potential confounding or mediation by clinical factors and assessed sensitivities to treatments including CF transmembrane regulator (CFTR) protein synthesis modulators. Results from 114 participants, including seven on ivacaftor or lumacaftor-ivacaftor, representative of the US CF population during the study period, identified 10 biomarkers associated with future exacerbations mediated by percent predicted forced expiratory volume in 1 s. The findings were not sensitive to anti-inflammatory, antibiotic, and CFTR modulator treatments. The analyses suggest that combination treatments addressing RAGE-axis inflammation, protease-mediated injury, and oxidative stress might prevent pulmonary exacerbations. Our work may apply to other airway inflammatory diseases such as bronchiectasis and the acute respiratory distress syndrome.

Influence of partial pork meat replacement by pulse flour on physicochemical and sensory characteristics of low-fat burgers.

BACKGROUND: Numerous non-meat ingredients, such as hydrocolloids, starches, and fibers, have been studied to improve texture characteristics and increase the ability to bind water in low-fat meat products. In this sense, pulses flours (lentil, chickpea, pea, and bean) were studied at two levels and various water:flour ratios to replace 10-44% pork meat in low-fat burgers and determine the effect on their sensory and technological properties (cooking yield, expressible liquid, diameter reduction, and color and texture profile). RESULTS: All pork-meat burgers that included pulse flour showed higher cooking yields, lower diameter reductions, and expressible liquids than all-meat burgers, which displayed better oil and water retention. Higher water additions resulted in burgers with less hardness. Burgers with 80 g kg-1 lentil flour in all water/flour ratios presented the lowest total color difference (ΔE) compared with the commercial control. Burgers with the higher level of all pulse flour tested and medium water levels showed acceptable sensory scores. CONCLUSIONS: Partial pork meat replacement by different legume flour (lentil, chickpea, pea, and bean), at levels of 80 and 150 g kg-1 and water/flour ratios of 1250, 1600, and 2000 g kg-1 resulted in low-fat burgers with adequate physicochemical characteristics. Moreover, the sensorial evaluation of the formulations with the maximum flour addition and intermediate water/flour ratio showed that they had good sensorial acceptability with no effect of flour type. © 2020 Society of Chemical Industry.

Prospective multicenter randomized patient recruitment and sample collection to enable future measurements of sputum biomarkers of inflammation in an observational study of cystic fibrosis.

BACKGROUND: Biomarkers of inflammation predictive of cystic fibrosis (CF) disease outcomes would increase the power of clinical trials and contribute to better personalization of clinical assessments. A representative patient cohort would improve searching for believable, generalizable, reproducible and accurate biomarkers. METHODS: We recruited patients from Mountain West CF Consortium (MWCFC) care centers for prospective observational study of sputum biomarkers of inflammation. After informed consent, centers enrolled randomly selected patients with CF who were clinically stable sputum producers, 12 years of age and older, without previous organ transplantation. RESULTS: From December 8, 2014 through January 16, 2016, we enrolled 114 patients (53 male) with CF with continuing data collection. Baseline characteristics included mean age 27 years (SD = 12), 80% predicted forced expiratory volume in 1 s (SD = 23%), 1.0 prior year pulmonary exacerbations (SD = 1.2), home elevation 328 m (SD = 112) above sea level. Compared with other patients in the US CF Foundation Patient Registry (CFFPR) in 2014, MWCFC patients had similar distribution of sex, age, lung function, weight and rates of exacerbations, diabetes, pancreatic insufficiency, CF-related arthropathy and airway infections including methicillin-sensitive or -resistant Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia cepacia complex, fungal and non-tuberculous Mycobacteria infections. They received CF-specific treatments at similar frequencies. CONCLUSIONS: Randomly-selected, sputum-producing patients within the MWCFC represent sputum-producing patients in the CFFPR. They have similar characteristics, lung function and frequencies of pulmonary exacerbations, microbial infections and use of CF-specific treatments. These findings will plausibly make future interpretations of quantitative measurements of inflammatory biomarkers generalizable to sputum-producing patients in the CFFPR.