Role of airway glucose in bacterial infections in chronic obstructive pulmonary disease

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Title: Role of airway glucose in bacterial infections in chronic obstructive pulmonary disease
Author(s): Tregoning, JS
Mallia, P
Webber, J
Gill, SK
Trujillo-Torralbo
Calderazzo, MA
Finney, L
Bakhsoliani, E
Farne, H
Singanayagam, A
Footitt, J
Hewitt, R
Kebadze
Aniscenko, J
Padmanaban, V
Molyneaux, PL
Adcock
Barnes, PJ
Ito, K
Elkin, SL
Kon, OM
Cookson, WO
MOffatt, MF
Johnston, SL
Item Type: Journal Article
Abstract: Background Patients with chronic obstructive pulmonary disease (COPD) have increased susceptibility to respiratory tract infection, which contributes to disease progression and mortality, but mechanisms of increased susceptibility to infection remain unclear. Objectives The aim of this study was to determine whether glucose concentrations were increased in airway samples (nasal lavage fluid, sputum, and bronchoalveolar lavage fluid) from patients with stable COPD and to determine the effects of viral infection on sputum glucose concentrations and how airway glucose concentrations relate to bacterial infection. Methods We measured glucose concentrations in airway samples collected from patients with stable COPD and smokers and nonsmokers with normal lung function. Glucose concentrations were measured in patients with experimentally induced COPD exacerbations, and these results were validated in patients with naturally acquired COPD exacerbations. Relationships between sputum glucose concentrations, inflammatory markers, and bacterial load were examined. Results Sputum glucose concentrations were significantly higher in patients with stable COPD compared with those in control subjects without COPD. In both experimental virus-induced and naturally acquired COPD exacerbations, sputum and nasal lavage fluid glucose concentrations were increased over baseline values. There were significant correlations between sputum glucose concentrations and sputum inflammatory markers, viral load, and bacterial load. Airway samples with higher glucose concentrations supported more Pseudomonas aeruginosa growth in vitro. Conclusions Airway glucose concentrations are increased in patients with stable COPD and further increased during COPD exacerbations. Increased airway glucose concentrations might contribute to bacterial infections in both patients with stable and those with exacerbated COPD. This has important implications for the development of nonantibiotic therapeutic strategies for the prevention or treatment of bacterial infection in patients with COPD.
Publication Date: 1-Sep-2018
Date of Acceptance: 11-Oct-2017
URI: http://hdl.handle.net/10044/1/55776
DOI: https://dx.doi.org/10.1016/j.jaci.2017.10.017
ISSN: 0091-6749
Publisher: Elsevier
Start Page: 815
End Page: 823.e6
Journal / Book Title: Journal of Allergy and Clinical Immunology
Volume: 142
Issue: 3
Sponsor/Funder: Imperial College Healthcare Charity
Medical Research Council (MRC)
Wellcome Trust
Imperial College Healthcare NHS Trust
Wellcome Trust
National Institute for Health Research
British Medical Association
Funder's Grant Number: T02
G0600879
083567/Z/07/Z
DHRBA_P17549
093080/Z/10/Z
NF-SI-0514-10092
H C ROSCOE (2015) GRANT
Copyright Statement: © 2017 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: Science & Technology
Life Sciences & Biomedicine
Allergy
Immunology
Chronic obstructive pulmonary disease
glucose
viral infection
airway inflammation
bacterial infection
RHINOVIRUS INFECTION
BLOOD-GLUCOSE
EXACERBATIONS
HYPERGLYCEMIA
COPD
FIBROSIS
PATHOGENESIS
INCREASES
TRANSPORT
METFORMIN
Chronic obstructive pulmonary disease
airway inflammation
bacterial infection
glucose
viral infection
1107 Immunology
Allergy
Publication Status: Published
Online Publication Date: 2018-01-05
Appears in Collections:National Heart and Lung Institute
Airway Disease
Department of Medicine
Faculty of Medicine



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