Does Pseudomonas aeruginosa Colonization Affect Exercise Capacity in Cystic Fibrosis?, 2019, Hatziagorou et al

Andy

Retired committee member
Introduction. Cardio-Pulmonary Exercise Testing (CPET) has been recognized as a valuable method in assessing disease burden and exercise capacity among CF patients.

Aim
. To evaluate whether Pseudomonas aeruginosa colonization status affects Exercise Capacity, LCI and High-Resolution Computed Tomography (HRCT) indices among patients with CF; to check if Pseudomonas colonization can predict exercise intolerance.

Subjects
. Seventy-eight (78) children and adults with CF (31 males) mean (range) age 17.08 (6.75; 24.25) performed spirometry, Multiple Breath Washout (MBW) and CPET along with HRCT on the same day during their admission or follow up visit.

Results
. 78 CF patients (mean FEV1: 83.3% mean LCI: 10.9 and mean VO2 peak: 79.1%) were evaluated: 33 were chronically colonized with Pseudomonas aeruginosa, 24 were intermittently colonized whereas 21 were Pseudomonas free. Statistically significant differences were observed among the three groups in: peak oxygen uptake % predicted (VO2 peak% (), LCI (), as well as FEV1% () and FVC% (). Pseudomonas colonization could predict VO2 peak% (, : −0.395).

Conclusion
. Exercise capacity as reflected by peak oxygen uptake is reduced in Pseudomonas colonized patients and reflects lung structural damages as shown on HRCT. Pseudomonas colonization could predict exercise limitation among CF patients.
Open access, https://new.hindawi.com/journals/pm/2019/3786245/
 
I think they are saying that colonisation with pseudomonas even if it is not actually causing infection can still impact exercise capacity and be causing damage to the lungs.

It is an important finding for a terrible disease but has no relevance for us as far as I can see.

Though when I think about it, the idea that bacteria, and then maybe viruses, can be having an impact on patients even if there is no active infection might be important for us. Those who developed ME after an infection may still be suffering.

Then, there is the wider implication. An infection is recognised by the signs that come from the immune system fighting off the invader. Maybe there are bacteria and viruses which cause as much damage in the body but the immune system does not recognise them so none of the usual signs of infection are there. Enteroviruses spring to mind ....
 
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