Early intestinal manifestation in infants with cystic fibrosis – a pilot study

Introduction: Cystic fibrosis (CF) is inflammatory and destructive disease with differentiated clinical expression. Conducted studies revealed intestinal inflammation in CF patients. However, available results are limited to children, adolescents and young adults. There are no data assessing the initiation of intestinal inflammation at the youngest age. Therefore, the aim of the present study was been to assess whether intestinal inflammation is present at diagnosis in infants diagnosed in a CF neonatal screening programme.
Material and methods: Ten CF infants aged up to 3 months were introduced into the study. Twenty healthy infants served as a control group. Faecal calprotectin concentrations were determined in all studied subjects. In CF infants, nutritional status (standardized body weight), exocrine pancreatic function (faecal elastase-1 concentrations) and the expression of bronchopulmonary disease were also assessed.
Results: In a significant percentage of CF patients body weight deficit was present at diagnosis. In 7 patients (70%) clinical symptoms of exocrine pancreatic insufficiency were found. Faecal calprotectin concentrations ranged from 1.8 to 442 ng/ml (mean ±SEM: 99.0 ±17.0, median: 88.8) and were significantly higher than in healthy infants (mean ±SEM: 26.6 ±9.0, median: 12.5, p < 0.049). No significant correlation between intestinal inflammation and values of classic (r = 0.027) and conductometric (r = –0.037) sweat test, standardized body weight (r = –0.096), faecal elastase-1 concentrations (r = –0.207) and the expression of bronchopulmonary disease (r = 0.090) was found.
Conclusions: Intestinal inflammation is present in cystic fibrosis patients from early infancy. No correlation between intestinal inflammation and other parameters assessing the intensity of the disease has been found. However, due to the limited number of subjects, the obtained conclusion have limited value.