Investigation of inflammatory and oxidative stress markers in bronchiectasis patients with and wi̇thout cystic fibrosis

Bronchiectasis is a progressive respiratory disease characterized by abnormal and irreversible enlargement of the bronchi. Cystic fibrosis (CF), one of the causes of bronchiectasis; is an autosomal recessive gene disease that affects in the lungs, pancreas, intestines and sweat glands. Although newborn screening tests are performed for the diagnosis of CF, there may be undiagnosed CF patients among adult bronchiectasis patients. CF and non-CF bronchiectasis often include chronic inflammation and oxidative stress caused by infection. Apart from infection, there are different pathways that trigger these two conditions in CF patients. Therefore, more inflammation is expected in CF patients than in non-CF bronchiectasis during infection-free periods. The aim of the study was to investigate the diagnostic value of inflammatory and oxidative stress markers in the differentiation of CF and non-CF bronchiectasis in the non-infectious period. Thus, a blood test that gives fast results, is inexpensive, and has diagnostic value has been investigated. Our study included 21 CF and 29 non-CF bronchiectasis patients followed in our clinic and 31 healthy volunteers. Samples from CF and non-CF bronchiectasis patients were taken during the period when there was no infection and their symptoms were stable. Gender, age, body mass index (VKİ), smoking and chronic disease history, drugs used, colonization status, number of hospitalizations in the last 1 year, and number of attacks in the last 1 year were recorded in the patients included in the study. Blood count, erythrocyte sedimentation rate (ESH), C-reactive protein (CRP), Prostaglandin F2 alpha (PGF2 alpha), malondialdehyde (MDA), glutathione (GSH), Nuclear factor E2-related factor 2 (Nrf 2), interlokın (IL) 17 and IL 22 and fecal elastase results were evaluated for all three groups. We found leukocytes, neutrophils and CRP higher in CF patients than in healthy volunteers and non-CF bronchiectasis patients. The sedimentation rate was higher in both CF and non-CF bronchiectasis patients compared to healthy volunteers. No significant difference was found between non-CF bronchiectasis and CF for PGF2 alpha (p:0,513). Malondialdehyde was found to be higher in the CF group among CF and non-CF bronchiectasis patients (p:0.01). Glutathione was found to be statistically significantly lower in CF patients compared to non-CF bronchiectasis (p:0.045). Although IL 17, IL 22 and fecal elastase were found to be higher in CF patients than non-CF bronchiectasis, this difference was not statistically significant (p:0.869, p:0.859, p:0.545). The significant difference between MDA and GSH in CF and non-CF bronchiectasis suggests that they can be used in the differential diagnosis. However, there is a need for studies with more participants to investigate these and similar inflammatory-oxidative stress markers that can be used in differential diagnosis.