Euromedica 2011 Galina Shmarina Alexander Pukhalsky Vladimir Alioshkin relationship between anti-inflammatory therapy and hepatobiliary abnormalitiesin cystic fibrosis patients"

Galina Shmarina Alexander Pukhalsky Vladimir Alioshkin	RELATIONSHIP BETWEEN ANTI-INFLAMMATORY THERAPY AND HEPATOBILIARY ABNORMALITIES IN CYSTIC FIBROSIS PATIENTS
	Research Centre for Medical Genetics, Moscow, Russia G.N. Gabrichevsky Institute of Epidemiology and Microbiology, Moscow, Russia

Anti-inﬂammatory therapy is frequent but not obligatory component of cystic ﬁbrosis (CF) lung disease treatment. The study aimed to investigate the clinical course in CF patients who were treated with basic therapy only and those who received an additional therapy with anti-inﬂammatory drugs. This study involved review of hospital medical records of CF patients (N=183) younger than 19 years. Ninety-six patients were treated with basic therapy only and 87 individuals received besides basic therapy anti-inﬂammatory treatment with azithromycin (AZ; 48 patients) or prednisolone (PD; 39 patients) in the form of alternated course (0.3-0.5 mg/ kg body weight every other day). Plasma levels of ACTH and cytokines (TNF-α, IFNγ, IL-10, TGF-β1) in CF patients have been compared with those in healthy children. The lower frequency of hepatobiliary abnormalities in the subjects treated with PD or AZ in comparison with patients without ant-inﬂammatory therapy (WAT) has been demonstrated. Cirrhosis was diagnosed in 38 of 96 WAT patients whereas only 7 of 39 (p=0.007) and 4 of 48 (p=0.01) children treated with PD and AZ, respectively demonstrated such abnormality. Among 38 WAT patients with cirrhosis 24 individuals demonstrated ultrasound changes, 11 – portal hypertension, and 3 – biliary cirrhosis. All studied CF patients revealed the same tendencies to the change to ACTH and blood cytokine levels with the exception of IL-10, which was signiﬁcantly higher in WAT patients in comparison with normal children and anti-inﬂammatory drug treated CF individuals. In conclusion, anti-inﬂammatory therapy restores inﬂammation control and reduces the frequency of hepatobiliary abnormalities in CF patients.