Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2024.0078    [Accepted]
Published online January 14, 2025.
Increased neutrophil elastase in affected lobes of bronchiectasis and correlation of its levels between sputum and bronchial lavage fluid
Lam Nguyen-Ho1,2,3,4, Hoang Kim Tu Trinh5, Vu Le-Thuong1,2, Kieu Minh Le5, Van Thanh Niem Vo5, Diem My Vu5, Ngoc Tran-Van1,4, James D. Chalmers6
1Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
2University Medical Center Ho Chi Minh City, Ho Chi Minh city, Vietnam
3Respiratory department, Cho Ray’s hospital, Vietnam
4Ngoc Minh Clinic, Ho Chi Minh City, Vietnam
5Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
6Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
Correspondence:  Hoang Kim Tu Trinh, Tel: +84-906 927 123, 
Email: kim.tu.vn@ump.edu.vn
Diem My Vu, Tel: +84-919789811, 
Email: diemmyvu@ump.edu.vn
Received: 14 May 2024   • Revised: 8 October 2024   • Accepted: 13 January 2025
Abstract
Background
Neutrophil elastase (NE) has been proposed as a potential biomarker for evaluating the severity and prognosis of bronchiectasis. This study aimed to compare bronchial lavage quantification of NE levels and activities with those of sputum.
Methods
A cross-sectional study was conducted in which 24 Vietnamese adults with bronchiectasis were enrolled from June 2023 to August 2023. All participants underwent bronchoscopy to collect bronchial lavage fluid (BLF) from two bronchial locations: one in the region with the greatest bronchial dilatation and one in the normal bronchi or in patients with all lobes affected, the least abnormal lobe (ABLF and NBLF, respectively). Spontaneously expectorated sputum was also collected.
Results
Out of 24 cases, the prevalence of mild, moderate and severe bronchiectasis was 14/24 (58.4%), 5/24 (20.8%), and 5/24 (20.8%), respectively. NE concentration and activity were significantly higher in sputum and ABLF than in NBLF (p < 0.001). Sputum and ABLF were highly correlated (r = 0.841, p < 0.001) with no significant difference in NE activity between sputum and ABLF. Higher levels of NE activity were seen in more severe bronchiectasis than in mild bronchiectasis in all samples but were only statistically significant for NE activity in sputum (r = 0.418, p = 0.042).
Conclusion
NE activity and concentration are elevated in areas of the lung most affected by bronchiectasis. Sputum is a valid surrogate of pulmonary NE levels, as they correlate strongly with ABLF and confirm in a Vietnamese population the relationship between NE activity and disease severity.
Key Words: Bronchial lavage fluid, bronchiectasis, bronchoscopy, neutrophil elastase activity, neutrophil elastase concentration, sputum
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