{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:11:28Z","timestamp":1790629888827,"version":"4.1.0"},"reference-count":50,"publisher":"European Respiratory Society (ERS)","issue":"1","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000351","name":"British Lung Foundation","doi-asserted-by":"publisher","award":["GSK\/BLF Chair of Respiratory Research"],"award-info":[{"award-number":["GSK\/BLF Chair of Respiratory Research"]}],"id":[{"id":"10.13039\/501100000351","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Polyphor AG"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2019,1,25]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Neutrophil elastase (NE) has been linked to lung neutrophil dysfunction in bronchiectasis and cystic fibrosis (CF), making NE inhibition a potential therapeutic target. NE inhibitor trials have given mixed result perhaps because not all patients have elevated airway NE activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We tested whether a single baseline sputum NE measurement or a combination of clinical parameters could enrich patient populations with elevated NE activity for \u201cpersonalised medicine\u201d. Intra- and interindividual variations of total and active NE levels in induced sputum from patients with CF or bronchiectasis were monitored over 14\u2005days. Patients with established CF and bronchiectasis (n=5 per group) were recruited. NE was measured using three different methods: one total and two active NE assays. Subsequently, we analysed the association between clinical parameters and NE from a large bronchiectasis cohort study (n=381).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All three assays showed a high degree of day-to-day variability (0\u2013233% over 14\u2005days). There were strong correlations found between all assays (p&lt;0.0001). Despite high day-to-day variability, patients could be stratified into \u201chigh\u201d or \u201clow\u201d groups based on moderate cut-off levels. In the bronchiectasis cohort study, factors most associated with high sputum NE levels were:<jats:italic>Pseudomonas aeruginosa<\/jats:italic>infection (\u03b2-estimate 11.5, 95% CI \u22126.0\u201329.0), sputum colour (\u03b2-estimate 10.4, 95% CI 4.3\u201316.6), Medical Research Council dyspnoea score (\u03b2-estimate 6.4, 95% CI 1.4\u201311.4) and exacerbation history (\u03b2-estimate 3.4, 95% CI 1.4\u20135.3). Collectively,<jats:italic>P. aeruginosa<\/jats:italic>infection, sputum colour and exacerbation frequency provided the greatest specificity for \u201chigh\u201d NE (98.7%, 95% CI 7.0\u201399.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results show that patients with bronchiectasis and CF can be effectively divided into \u201chigh\u201d or \u201clow\u201d groups, based on sputum NE assays or clinical inclusion criteria.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00252-2018","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T13:55:17Z","timestamp":1553522117000},"page":"00252-2018","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Personalised anti-inflammatory therapy for bronchiectasis and cystic fibrosis: selecting patients for controlled trials of neutrophil elastase 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