Am. J. Respir. Cell Mol. Biol., Volume 23, Number 2, August, 2000 121-127

RAPID COMMUNICATION
Inflammation and Infection in Naive Human Cystic Fibrosis Airway Grafts

Rabindra Tirouvanziam, Sophie de Bentzmann, Cédric Hubeau, Jocelyne Hinnrasky, Jacky Jacquot, Bruno Péault, and Edith Puchelle

Institut d'Embryologie Cellulaire et Moléculaire du CNRS et du Collège de France, Nogent-sur-Marne; and INSERM U514, Reims, France

Exacerbated inflammation is now recognized as an important component of cystic fibrosis (CF) airway disease. Whether inflammation is part of the basic defect in CF or a response to persistent infection remains controversial. We addressed this question using human fetal tracheal grafts in severe combined immunodeficient mice. This model yields histologically mature, and most importantly, naive CF and non-CF surrogate airways. Significant inflammatory imbalance was found in naive CF airway grafts, including a highly increased intraluminal interleukin 8 content (CF: 10.1 ± 2.2 ng/ml; non-CF: 1.2 ± 0.6 ng/ml; P < 0.05) and consistent accumulation of leukocytes in the subepithelial region (P < 0.001). CF airway grafts were not histologically affected until challenged with Pseudomonas aeruginosa, which provoked: (1) early (before 3 h) and massive leukocyte transepithelial migration, (2) intense epithelial exfoliation, and (3) rapid progression of bacteria toward the lamina propria. In non-CF grafts, these three sets of events were not observed before 6 h. Using a model of naive human airways, we thus demonstrate that before any infection, CF airways are in a proinflammatory state. After infection, the basal inflammatory imbalance contributes to exert severe damage to the mucosa, paving the way for bacterial colonization and subsequent steps of CF airway disease.

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