Chest
Original ResearchGenetic and Developmental DisordersSystematic Review of Blood Biomarkers in Cystic Fibrosis Pulmonary Exacerbations
Section snippets
Study Population
Our population of interest was defined as patients of all ages who were given a diagnosis of CF based on sweat chloride testing and/or CF transmembrane conductance regulator genotyping. Studies examining circulating (blood-based) biomarkers in patients with CF in the setting of CFPE were chosen for inclusion in this study. These biomarkers were evaluated according to their ability to aid in the diagnosis of CFPE, predict CFPE outcomes, and monitor response to CFPE treatment (Table 1). Studies
Study Selection
Our search strategy identified 5,596 potentially relevant abstracts and articles. Fifty studies were included in this review, and the process of study inclusion and exclusion is illustrated in Figure 1.
Study and Patient Characteristics
The characteristics of the included studies are detailed in Table 3. Most studies were conducted in the United Kingdom (46%), and the sample sizes were small, with just 10% of the studies involving > 50 participants with blood biomarker measurement.
The characteristics of patients included in the
Discussion
Current CFPE management is suboptimal because about one-quarter of patients fail to recover their previous baseline lung function despite therapy.7 Biomarkers of disease activity have the potential to aid in diagnosing CFPE earlier, predicting CFPE outcomes, and monitoring response to CFPE treatment. In this systematic review, we examined the use of blood-based biomarkers for each of these clinically relevant applications.
An ideal biomarker for use in CF should possess several characteristics.
Conclusions
In conclusion, to assist in knowledge dissemination and translation, we conducted an exhaustive review of the literature to identify promising blood-based biomarkers for clinical application in CFPEs. Although we identified several potential candidate blood biomarkers of disease activity, we also highlighted many of the research challenges that must be overcome prior to bringing these candidate biomarkers into clinical practice. Future studies of blood biomarkers will need to be larger with
Acknowledgments
Author contributions: Dr Quon had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Mr Shoki: contributed to the study design, literature search, and data extraction; data analysis and interpretation; and drafting and review of the manuscript for important intellectual content.
Dr Mayer-Hamblett: contributed to the data analysis and interpretation and drafting and review of the manuscript for important intellectual content.
Dr Wilcox:
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Funding/Support: Dr Quon was supported by a Canadian Institute of Health Research (CIHR) Fellowship Award funded by the University of British Columbia and the Government of Canada.
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