Sputum neutrophil elastase in bronchiectasis: a Southern European cohort study.

Bronchiectasis is a chronic respiratory disease with neutrophilic airway inflammation playing a prominent role in its pathophysiology [1]. The inflammatory process depends on the release of neutrophil elastase (NE) and subsequent formation of neutrophil extracellular traps to facilitate the neutralisation of pathogens. An excessive release of NE can lead to several damaging lung effects, including mucus gland stimulation, increase in sputum production, impairment in ciliary beat frequency, and extracellular matrix and airway epithelia destruction. The activity of NE (aNE) has been previously evaluated in sputum samples of a Scottish cohort of bronchiectasis patients [2]. The authors demonstrated that increased levels of aNE in sputum are associated with disease severity and poor clinical outcomes. This experience identified NE as one of the most promising biomarkers in bronchiectasis and, subsquently, a point-of-care assay for aNE was validated [3]. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Gramegna has nothing to disclose. Conflict of interest: Prof. Aliberti reports grants and personal fees from Bayer Healthcare, grants and personal fees from Aradigm Corporation, grants and personal fees from Grifols, personal fees from Astra Zeneca, personal fees from Basilea, personal fees from Zambon, personal fees from Novartis, personal fees from Raptor, grants and personal fees from Chiesi, personal fees from Actavis UK Ltd, personal fees from Horizon, grants and personal fees from INSMED, outside the submitted work. Dr. Aliberti reports grants and personal fees from Bayer Healthcare, grants and personal fees from Aradigm Corporation, grants and personal fees from Grifols, personal fees from Astra Zeneca, personal fees from Basilea, personal fees from Zambon, personal fees from Novartis, personal fees from Raptor, grants and personal fees from Chiesi, personal fees from Actavis UK Ltd, personal fees from Horizon, grants and personal fees from INSMED, outside the submitted work. Dr. Aliberti reports grants and personal fees from Bayer Healthcare, grants and personal fees from Aradigm Corporation, grants and personal fees from Grifols, personal fees from Astra Zeneca, personal fees from Basilea, personal fees from Zambon, personal fees from Novartis, personal fees from Raptor, grants and personal fees from Chiesi, personal fees from Actavis UK Ltd, personal fees from Horizon, grants and personal fees from INSMED, outside the submitted work. Conflict of interest: Dr. Sibila has nothing to disclose. Conflict of interest: Dr. Di Francesco has nothing to disclose. Conflict of interest: Dr. Sotgiu has nothing to disclose. Conflict of interest: Dr. Perea has nothing to disclose. Conflict of interest: Dr. Terranova has nothing to disclose. Conflict of interest: Dr. Oriano has nothing to disclose. Conflict of interest: Dr. Pilocane has nothing to disclose. Conflict of interest: Dr. Saderi has nothing to disclose. Conflict of interest: Dr. Chalmers reports grants and personal fees from Astrazeneca, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Glaxosmithkline, grants and personal fees from Insmed, personal fees from Zambon, grants from Gilead Sciences, outside the submitted work. Conflict of interest: Dr. Marchisio has nothing to disclose. Conflict of interest: Dr. Blasi reports grants and personal fees from astrazeneca, grants from bayer, grants and personal fees from chiesi, grants and personal fees from gsk, personal fees from guidotti, personal fees from grifols, grants and personal fees from insmed, personal fees from menarini, personal fees from mundipharma, personal fees from novartis, grants and personal fees from pfizer, personal fees from zambon, outside the submitted work.