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Hollsing, Annika
Publications (6 of 6) Show all publications
Krantz, C., Janson, C., Hollsing, A., Alving, K. & Malinovschi, A. (2017). Exhaled and nasal nitric oxide in relation to lung function, blood cell counts and disease characteristics in cystic fibrosis. Journal of Breath Research, 11(2), Article ID 026001.
Open this publication in new window or tab >>Exhaled and nasal nitric oxide in relation to lung function, blood cell counts and disease characteristics in cystic fibrosis
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2017 (English)In: Journal of Breath Research, ISSN 1752-7155, E-ISSN 1752-7163, Vol. 11, no 2, article id 026001Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with cystic fibrosis (CF) have similar or lower exhaled nitric oxide (FeNO) and lower nasal nitric oxide (nNO) levels than controls. There are divergent results on alveolar NO (CalvNO) concentrations in relation to CF. There are inconsistent results on correlation between different nitric oxide parameters and lung function and inflammation in CF.

AIM: To compare FeNO, CalvNO and nNO levels between subjects with CF, asthma and healthy controls and to study whether these parameters are related to lung function, blood cell counts or clinical characteristics in CF patients.

MATERIAL AND METHODS: Measurements of FeNO at multiple exhalation flow rates, nNO and spirometry were done in 38 patients (18 adults) with CF. Blood cell counts and CF clinical characteristics were recorded. Thirty-eight healthy controls and 38 asthma patients, gender- and age-matched, were included as reference groups.

RESULTS: FeNO levels were lower in CF patients (7.2 [4.7-11.2] ppb) than in healthy controls (11.4 [8.3-14.6] ppb) and asthma patients (14.7 [8.7-24.7] ppb) (both p < 0.005). These differences were consistent in adults. No difference in CalvNO was seen between the groups. nNO levels in CF patients (319 [193-447] ppb) were lower than in healthy controls (797 [664-984] ppb) and asthma patients (780 [619-961] ppb) (both p < 0.001). FeNO positively related to FEV1 (rho = 0.51, p = 0.001) in CF patients and this was consistent in both adults and children. A negative correlation was found between FeNO and blood neutrophil counts (rho = -0.37, p = 0.03) in CF patients.

CONCLUSION: CF patients have lower FeNO and nNO and similar CalvNO levels as healthy controls and asthma patients. Lower FeNO related to lower lung function in both adults and children with CF. Furthermore, in CF, lower FeNO also related to higher blood neutrophil counts.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-318187 (URN)10.1088/1752-7163/aa61aa (DOI)000413819300001 ()28220034 (PubMedID)
Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2018-01-31Bibliographically approved
Moen, I. E., Nilsson, K., Andersson, A., Fagerland, M. W., Fluge, G., Hollsing, A., . . . Hjelte, L. (2011). Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations. Food & Nutrition Research, 55, 7561
Open this publication in new window or tab >>Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations
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2011 (English)In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 7561-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Malnutrition is a well-known complication in cystic fibrosis (CF). There is good evidence that maintaining a normal body-weight correlates well with improved survival in CF. Energy intake in excess of 120% of the estimated average requirement (EAR) has been advised since 1980s.

OBJECTIVES:

To investigate the nutritional intake and status in the adult Scandinavian CF-population.

SUBJECTS/METHODS:

A cross-sectional multi-centre study was used to investigate the nutritional status of 456 adult CF-patients (2003 2006). Height and weight were measured and body mass index (BMI) and z-scores were calculated. Pulmonary function was examined by dynamic spirometry. A 7-day pre-coded food record (FR) obtained energy and nutrient intake data in 180 patients.

RESULTS:

The mean energy intake was 114 (SD 30.0)% of EAR and thus significantly lower than the target of 120% EAR (p< 0.001) for patients with pancreatic insufficiency (PI) (n=136). Mean BMI was 22.0 (SD 2.9), the prevalence of BMI <18 was 13% and the prevalence of BMI ≥25 was 15% (n=136). Mean BMI was 20.8 (SD 2.4) in PI-patients with FEV(1) <70% and 23.2% (SD 3.0), in PI-patients with FEV(1) ≥70%, mean difference 2.4, (95% CI: 1.5, 3.3) (p<0.001), but there was no difference in energy intake. BMI ≥18.5 and a reported energy intake <120% were revealed in 54% of the PI-patients.

CONCLUSIONS:

The energy intake did not reach the recommended 120% EAR, but the prevalence of underweight was lower than reported in other studies. The recommendation may exceed the requirement for a number of CF-patients. The nutritional status must still be closely monitored and nutritional advice and intervention should be individualised and adjusted to actual needs.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-164839 (URN)10.3402/fnr.v55i0.7561 (DOI)22110412 (PubMedID)
Available from: 2011-12-29 Created: 2011-12-29 Last updated: 2017-12-08Bibliographically approved
Pincikova, T., Nilsson, K., Moen, I. E., Karpati, F., Fluge, G., Hollsing, A., . . . Hjelte, L. (2011). Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study. European Journal of Clinical Nutrition, 65(1), 102-109
Open this publication in new window or tab >>Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study
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2011 (English)In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 65, no 1, p. 102-109Article in journal (Refereed) Published
Abstract [en]

Background/Objectives: The hallmark of cystic fibrosis (CF) is chronic lung inflammation. The severity of lung disease is closely correlated with immunoglobulin G (IgG) levels. Beyond its contribution to the bone health, the importance of vitamin D has not been fully recognized owing to the lack of human studies providing evidence of its benefit. In the context of the recently described immunomodulatory functions of vitamin D, we aimed to assess the relationship between vitamin D and IgG levels. Subjects/Methods: Eight hundred and ninety-six CF patients were included (0.53-65.9 years) from seven centers in Denmark, Norway and Sweden. Serum 25-hydroxyvitamin D (25OHD) and total IgG were measured, spirometry was carried out and vitamin D intake data were gathered using a 7-day dietary food record. Multiple linear regression analyses were performed for IgG and forced expiratory volume in 1 lambda s (FEV1) as dependent variables, and serum 25OHD, daily food and supplemented vitamin D sources of intake as independent variables. The model was controlled for age, gender, genotype, CF-related diabetes, season, infection/colonization status, long-term oral corticosteroid treatment, long-term treatment with macrolide antibiotics, pancreatic insufficient phenotype and body mass index z-score. Results: Serum total IgG levels were negatively associated with serum 25OHD (adjusted R-2=0.376; beta = -0.02; P<0.001), supplemented vitamin D intake per kg bodyweight (adjusted R-2=0.375; beta = -0.82; P<0.001) and total vitamin D intake per kg bodyweight (adjusted R-2=0.398; beta = -0.60; P=0.002). Serum 25OHD was positively associated with FEV1 (adjusted R-2=0.308; beta=0.0007; P=0.025). Conclusions: Increasing vitamin D intake may positively modulate inflammation in CF. This study supports the proposed role of vitamin D in the immune system during infection and substantiates prospective studies.

Keywords
cystic fibrosis, food, forced expiratory flow rates, immunity, immunoglobulin G, vitamin D
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-149728 (URN)10.1038/ejcn.2010.194 (DOI)000285960300016 ()20859300 (PubMedID)
Available from: 2011-03-22 Created: 2011-03-22 Last updated: 2017-12-11Bibliographically approved
Pincikova, T., Nilsson, K., Moen, I. E., Fluge, G., Hollsing, A., Knudsen, P. K., . . . Hjelte, L. (2011). Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. Diabetologia, 54(12), 3007-3015
Open this publication in new window or tab >>Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study
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2011 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 54, no 12, p. 3007-3015Article in journal (Refereed) Published
Abstract [en]

AIMS/HYPOTHESIS: Many cystic fibrosis patients are vitamin D-insufficient. Cystic fibrosis-related diabetes is a major complication of cystic fibrosis. The literature suggests that vitamin D might possess certain glucose-lowering properties. We aimed to assess the relationship between vitamin D and cystic fibrosis-related glucose intolerance.

METHODS: We enrolled 898 cystic fibrosis patients from Sweden, Norway and Denmark. Vitamin D intake was assessed using a seven-day food record. Serum 25-hydroxyvitamin D (s25OHD) and HbA(1c) were measured, and an OGTT was carried out. Multiple linear and logistic regressions were used for HbA(1c) and cystic fibrosis-related diabetes/OGTT result as outcome variables, respectively. Each model was controlled for country, and for known cystic fibrosis-related diabetes risk factors: age, sex, genotype, liver dysfunction, long-term corticosteroid treatment, and lung and pancreatic function.

RESULTS: Degree of vitamin D insufficiency (OR 1.36; p = 0.032) and s25OHD < 30 nmol/l (OR 1.79; p = 0.042) were significant risk factors for cystic fibrosis-related diabetes. Accordingly, HbA(1c) value was positively associated with s25OHD < 30 nmol/l and < 50 nmol/l, as well as with degree of vitamin D insufficiency (adjusted R (2) = 20.5% and p < 0.05 in all). In subgroup analyses, s25OHD < 30 nmol/l determined the HbA(1c) value in paediatric patients (adjusted R (2) = 20.2%; p = 0.017), but not in adults.

CONCLUSIONS/INTERPRETATION: Vitamin D status is associated with HbA(1c) and diabetes in cystic fibrosis, particularly in children. The study justifies prospective studies on the proposed role of vitamin D deficiency in the pathophysiology of diabetes mellitus.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-164837 (URN)10.1007/s00125-011-2287-1 (DOI)000297740000006 ()21901282 (PubMedID)
Available from: 2011-12-29 Created: 2011-12-29 Last updated: 2017-12-08Bibliographically approved
Gilljam, M., Schersten, H., Silverborn, M., Jonsson, B. & Hollsing, A. (2010). Lung transplantation in patients with cystic fibrosis and Mycobacterium abscessus infection. Journal of Cystic Fibrosis, 9(4), 272-276
Open this publication in new window or tab >>Lung transplantation in patients with cystic fibrosis and Mycobacterium abscessus infection
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2010 (English)In: Journal of Cystic Fibrosis, ISSN 1569-1993, E-ISSN 1873-5010, Vol. 9, no 4, p. 272-276Article in journal (Refereed) Published
Abstract [en]

Mycobacterium abscessus lung disease is difficult to treat and has been considered a strong relative contraindication to lung transplantation. We performed double lung transplantation in three cystic fibrosis patients with ongoing, and a fourth with recent treatment for Mycobacterium abscessus lung infection. Despite prolonged antibiotic courses and adjustment of immunosuppressive therapy the first three patients developed skin infection and abscesses. At follow-up after 1, 3, 5 and 7 years respectively no patient had evidence of M abscessus infection and all had stable lung function. Lung transplantation in patients with M abscessus lung infection is feasible but may involve severe complications.

Keywords
Cystic fibrosis, Lung transplantation, Mycobacterium Complication, Abscess
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-147198 (URN)10.1016/j.jcf.2010.03.008 (DOI)000280009500007 ()
Available from: 2011-02-25 Created: 2011-02-24 Last updated: 2017-12-11Bibliographically approved
Pincikova, T., Nilsson, K., Moen, I., Fluge, G., Hollsing, A., Knudsen, P., . . . Hjelte, L. (2010). Suboptimal vitamin D status as a risk factor for CF-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. Diabetologia, 53
Open this publication in new window or tab >>Suboptimal vitamin D status as a risk factor for CF-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study
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2010 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 53Article in journal, Meeting abstract (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-138326 (URN)
Available from: 2010-12-17 Created: 2010-12-17 Last updated: 2017-12-11Bibliographically approved
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