Noninvasive biomarkers of airway inflammation in cystic fibrosis

Purpose of review Airway inflammation plays a central role in the lung disease of cystic fibrosis (CF). Biomarkers of inflammation may be useful for monitoring disease progression and evaluating response to therapy. Much of our knowledge of the chronic inflammatory process in the CF airway derives from studies of bronchoscopy and bronchoalveolar lavage. A number of noninvasive approaches have been recently developed to more readily assess airway inflammation including sputum induction, collection of exhaled air, analysis of systemic markers of inflammation, and computed tomography imaging. Recent findings While measurements of biomarkers of inflammation continue to advance our understanding of the underlying disease process, there is as yet no established role for these markers in clinical practice. This review summarizes the current state of knowledge of various inflammatory markers relevant to CF lung disease, with an eye towards application as surrogate outcome measures in CF clinical trials. Summary It is hoped that biomarkers obtained by noninvasive means will be useful in determining specific pathways of injury (ie, oxidative or proteolytic) in individual persons with CF and in assessing response to antiinflammatory treatments.