Redox Profile, Inflammatory and Cardiac Autonomic Nervous Activity of Children and Adolescents With Cystic Fibrosis
Ana Carla Lima de França, Mateus Duarte Ribeiro, Ana Carolina Freitas Meireles, Lydiane Tavares Toscano, Larissa Araújo Maia, Constantino Giovanni Braga Cartaxo, Gilvan da Cruz Barbosa Araújo, Maria da Conceição Rodrigues Gonçalves, José Luiz de Brito Alves, Alexandre Sérgio SilvaABSTRACT
Background
Cystic fibrosis (CF) is a genetic disease in which oxidative stress, chronic inflammation, and autonomic imbalance drive the pathophysiology; however, their interplay in children and adolescents with CF remains unclear. This study aimed to compare the cardiometabolic profile of children and adolescents with CF and healthy controls, and to investigate associations between heart rate variability (HRV), Forced Expiratory Volume in the first second (FEV 1 ), oxidative stress, and inflammation.
Methods
This cross‐sectional study included 12 patients with CF and 12 healthy controls (5–18 years). Were analyzed for oxidative stress markers (total antioxidant capacity‐CAOx, malondialdehyde‐MDA), and inflammatory (hs‐CRP, IL‐2, IL‐4, IL‐6, IL‐10, IL‐17A, IFN‐γ, and TNF‐α). HRV was assessed using a Bluetooth heart rate monitor.
Results
Mean age was similar between groups (CF: 11.7 ± 4.5 years vs. CONT: 12.5 ± 4.2 years, p = 0.68). Mean FEV 1 in the CF group was 78.7%. CF group, MDA was significantly elevated (CF: 3.8 ± 1.4 μM vs. CONT: 2.8 ± 0.3 μM, p = 0.03), while CAOx was lower (CF: 33.0% ± 4.3% vs. CONT: 45.3% ± 13.6%, p = 0.01); CRP (CF: 4.6 ± 5.67 mg/L vs. CONT: 0.6 ± 0.7 mg/L, p = 0.03), IL‐6 (CF: 53.0 ± 47.37 pg/mL vs. CONT: 25.1 ± 43.8 pg/mL, p = 0.02), and IL‐17 (CF: 89.3 ± 53.37 pg/mL vs. CONT: 41.4 ± 42.5 pg/mL, p = 0.03) were significantly elevated; Time‐domain variables were lower: SDNN (CF: 52 ± 24 ms vs. CONT: 88 ± 31 ms, p = 0.04), RMSSD (CF: 41 ± 21 ms vs. CONT: 68 ± 34 ms, p = 0.02), pNN50 (CF: 20% ± 16.3% vs. CONT: 35% ± 19.1%, p = 0.03); in the frequency domain, only low frequency (LF) was lower (CF: 1061 ± 1335 ms 2 vs. CONT: 2979 ± 4896 ms 2 , p = 0.04).
Conclusion
Children and adolescents with CF exhibit increased oxidative stress, systemic inflammation, and reduced sympathetic and parasympathetic activity, as well as associations among lung function, HRV, and antioxidant capacity.