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Microstructural alterations of sputum in cystic fibrosis lung disease
Gregg A. Duncan, James Jung, Andrea Joseph, Abigail L. Thaxton, Natalie E. West, Michael P. Boyle, Justin Hanes, Jung Soo Suk
Gregg A. Duncan, James Jung, Andrea Joseph, Abigail L. Thaxton, Natalie E. West, Michael P. Boyle, Justin Hanes, Jung Soo Suk
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Research Article Pulmonology

Microstructural alterations of sputum in cystic fibrosis lung disease

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Abstract

The stasis of mucus secretions in the lungs of cystic fibrosis (CF) patients leads to recurrent infections and pulmonary exacerbations, resulting in decreased survival. Prior studies have assessed the biochemical and biophysical features of airway mucus in individuals with CF. However, these measurements are unable to probe mucus structure on microscopic length scales relevant to key players in the progression of CF-related lung disease, namely, viruses, bacteria, and neutrophils. In this study, we quantitatively determined sputum microstructure based on the diffusion of muco-inert nanoparticle probes in CF sputum and found that a reduction in sputum mesh pore size is characteristic of CF patients with reduced lung function, as indicated by measured FEV1. We also discovered that the effect of ex vivo treatment of CF sputum with rhDNase I (Pulmozyme) on microstructure is dependent upon the time interval between the most recent inhaled rhDNase I treatment and the sample collection. Microstructure of mucus may serve as a marker for the extent of CF lung disease and as a parameter for assessing the effectiveness of mucus-altering agents.

Authors

Gregg A. Duncan, James Jung, Andrea Joseph, Abigail L. Thaxton, Natalie E. West, Michael P. Boyle, Justin Hanes, Jung Soo Suk

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Figure 6

Effect of rhDNase treatment on cystic fibrosis sputum microstructure.

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Effect of rhDNase treatment on cystic fibrosis sputum microstructure.
(A...
(A and B) 3D xy projections from confocal imaging of a cystic fibrosis (CF) sputum sample with and without ex vivo rhDNase treatment at final concentration of 7 μg/ml (scale bar: 2 μm). Measured void volume fraction or porosity (ϕ) is also shown in each image. The patient’s last Pulmozyme administration was >24 hours before sputum collection. (C) Box-and-whisker plots of log10[MSD1s] of 100-nm muco-inert nanoparticles (MIP) in sputum samples from 9 CF patients without (gray bars) and with (white bars) ex vivo rhDNase treatment at a final concentration of 7 μg/ml. Maximum whisker length is 1.5 times the interquartile range, and outliers are shown as dots. The log10[MSD1s] values are grouped based on the approximate time interval between the patients’ most recent Pulmozyme inhalation and the sputum collection. Mann-Whitney test was used to determine statistically significant differences between rhDNase-treated and untreated controls for each patient (not significant, P > 0.05; *P < 0.05; **P < 0.01).

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