In the American Journal of Respiratory and Critical Care Medicine article, James D. Chalmers and colleagues report on a study to test the hypothesis that elevated sputum neutrophil elastase and the related biomarker, circulating desmosine, are associated with increased exacerbations and lung function decline in bronchiectasis.

In their prospective cohort study of bronchiectasis patients, 433 provided blood samples for desmosine measurement and 381 provided sputum samples for baseline elastase measurement. Over three years, participants with elevated elastase activity were more likely to have exacerbations and severe ones required hospitalizations.

Sputum elastase activity was also independently associated with lung function decline. Increased circulating desmosine was associated with a higher risk of severe exacerbations.

“As few clinical parameters have been shown to be associated with bronchiectasis outcomes,” the authors write, “sputum neutrophil elastase and circulating desmosine may be useful adjuncts to clinical assessment, or to patient evaluation in clinical trials.” The artilce is titled, "Neutrophil Elastase Activity Is Associated with Exacerbations and Lung Function Decline in Bronchiectasis."