{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:26:30Z","timestamp":1790717190229,"version":"4.1.0"},"reference-count":26,"publisher":"European Respiratory Society (ERS)","issue":"6","license":[{"start":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T00:00:00Z","timestamp":1559260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"DOI":"10.13039\/501100000351","name":"British Lung Foundation","doi-asserted-by":"publisher","award":["GSK\/BLF Chair"],"award-info":[{"award-number":["GSK\/BLF Chair"]}],"id":[{"id":"10.13039\/501100000351","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008593","name":"European Respiratory Society","doi-asserted-by":"publisher","award":["EMBARC2"],"award-info":[{"award-number":["EMBARC2"]}],"id":[{"id":"10.13039\/100008593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2019,3,14]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neutrophil elastase activity in sputum can identify patients at high risk of airway infection and exacerbations in bronchiectasis. Application of this biomarker in clinical practice is limited, because no point-of-care test is available. We tested whether a novel semi-quantitative lateral flow device (neutrophil elastase airway test stick \u2013 NEATstik\u00ae) can stratify bronchiectasis patients according to severity, airway infection and exacerbation risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sputum samples from 124 patients with stable bronchiectasis enrolled in the UK and Spain were tested using the NEATstik\u00ae, which scores neutrophil elastase concentration from 0 (&lt;8\u2005\u00b5g\u00b7mL<jats:sup>\u22121<\/jats:sup>elastase activity) to 10 (maximum detectable neutrophil elastase activity). High neutrophil elastase activity was regarded as a NEATstik\u00ae grade &gt;6. Severity of disease, airway infection from sputum culture and exacerbations over the 12\u2005months were recorded. An independent validation was conducted in 50 patients from Milan, Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and main results<\/jats:title><jats:p>Patients had a median age of 69\u2005years and forced expiratory volume in 1\u2005s (FEV<jats:sub>1<\/jats:sub>) 69%. High neutrophil elastase activity was associated with worse bronchiectasis severity using the bronchiectasis severity index (p=0.0007) and FEV<jats:sub>1<\/jats:sub>(p=0.02). A high NEATstik\u00ae grade was associated with a significant increase in exacerbation frequency, incident rate ratio 2.75 (95% CI 1.63\u20134.64, p&lt;0.001). The median time to next exacerbation for patients with a NEATstik\u00ae grade &gt;6 was 103\u2005days compared to 278\u2005days. The hazard ratio was 2.59 (95% CI 1.71\u20133.94, p&lt;0.001). Results were confirmed in the independent validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A novel lateral flow device provides assessment of neutrophil elastase activity from sputum in minutes and identifies patients at increasing risk of airway infection and future exacerbations.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00303-2019","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T12:24:11Z","timestamp":1559305451000},"page":"1900303","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":88,"title":["A point-of-care neutrophil elastase activity assay identifies bronchiectasis severity, airway infection and risk\u00a0of\u00a0exacerbation"],"prefix":"10.1183","volume":"53","author":[{"given":"Amelia","family":"Shoemark","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Cant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Carreto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Oriano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly R.","family":"Keir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Perea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Canto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Terranova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Vidal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Moffitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0090-4531","authenticated-orcid":false,"given":"Stefano","family":"Aliberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4833-6713","authenticated-orcid":false,"given":"Oriol","family":"Sibila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Chalmers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2019,5,31]]},"reference":[{"key":"2024102100525591000_53.6.1900303.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2006.11.008"},{"key":"2024102100525591000_53.6.1900303.2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208481"},{"key":"2024102100525591000_53.6.1900303.3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01312-2015"},{"key":"2024102100525591000_53.6.1900303.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00026313"},{"key":"2024102100525591000_53.6.1900303.5","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01269-2018"},{"key":"2024102100525591000_53.6.1900303.6","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201506-333OC"},{"key":"2024102100525591000_53.6.1900303.7","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01953-2017"},{"key":"2024102100525591000_53.6.1900303.8","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201203-0487OC"},{"key":"2024102100525591000_53.6.1900303.9","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1164\/rccm.201711-2202OC","article-title":"Characterization of the \u201cfrequent exacerbator phenotype\u201d in bronchiectasis","volume":"197","author":"Chalmers","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102100525591000_53.6.1900303.10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-1961"},{"key":"2024102100525591000_53.6.1900303.11","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00629-2017"},{"key":"2024102100525591000_53.6.1900303.12","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00051-2017"},{"key":"2024102100525591000_53.6.1900303.13","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201605-1027OC"},{"key":"2024102100525591000_53.6.1900303.14","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201311-1932OC"},{"key":"2024102100525591000_53.6.1900303.15","doi-asserted-by":"publisher","DOI":"10.1165\/ajrcmb\/4.1.26"},{"key":"2024102100525591000_53.6.1900303.16","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s12931-017-0691-x","article-title":"Neutrophil elastase in bronchiectasis","volume":"18","author":"Gramegna","year":"2017","journal-title":"Respir Res"},{"key":"2024102100525591000_53.6.1900303.17","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.2.420"},{"key":"2024102100525591000_53.6.1900303.18","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/resp.12219","article-title":"The Sputum Colour Chart as a predictor of lung inflammation, proteolysis and damage in non-cystic fibrosis bronchiectasis: a case-control analysis","volume":"19","author":"Goeminne","year":"2014","journal-title":"Respirology"},{"key":"2024102100525591000_53.6.1900303.19","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00081-2015"},{"key":"2024102100525591000_53.6.1900303.20","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.142778"},{"key":"2024102100525591000_53.6.1900303.21","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S2213-2600(18)30053-5","article-title":"Bronchiectasis: new therapies and new perspectives","volume":"6","author":"Chalmers","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2024102100525591000_53.6.1900303.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2013.05.035"},{"key":"2024102100525591000_53.6.1900303.23","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02052-2017"},{"key":"2024102100525591000_53.6.1900303.24","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02053-2017"},{"key":"2024102100525591000_53.6.1900303.25","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02444-2017"},{"key":"2024102100525591000_53.6.1900303.26","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02086-2016"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.00303-2019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T07:38:40Z","timestamp":1740382720000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.00303-2019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,31]]},"references-count":26,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,13]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1183\/13993003.00303-2019"],"URL":"https:\/\/doi.org\/10.1183\/13993003.00303-2019","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,31]]}}}