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Routine & Advanced Lab Testing Comprehensive testing to uncover root causes and create personalized treatment plans based on accurate data

A better understanding of the molecular and cellular events involved in hyperoxia-induced lung injury will help to prevent/limit the iatrogenic consequences of O 2 treatment

2.6 Activation of inflammatory pathways The two main transcription factors that control cellular reactions to oxidative stress and inflammation are nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and nuclear factor-B (NF-B) (86)

Thus, the chronic colonization process that occurs in the respiratory tract of patients with BE is called pathogenic colonization60 and can be divided into three different phases: initial colonization (the first isolate of a microorganism), intermittent colonization (intermittent isolation of the same microorganism in cultures separated by, at least, a month, representing a chronic colonization process with a low bacterial load) and chronic colonization (three or more successive positive cultures for the same microorganism with, at least, one month apart, within a period of six months).60 Exacerbation is a clinical situation that can happen during any of the three scenarios mentioned above, and it has the potential to worsen lung function deterioration.60 The diagnosis of exacerbation in these patients is particularly difficult and is based on the acute development of manifestations such as changes in sputum characteristics (increased volume, purulence and viscosity), haemoptysis, breathlessness, worsening of cough, chest pain, fever, asthenia, anorexia, weight loss, physical changes in thoracic examination, desaturation, decline in lung function, radiologic signs of lower respiratory tract infection and elevation of systemic biomarkers of inflammation.4 Several microorganisms can be isolated from the respiratory tract of patients with non-CF BE and the acquisition and clearance of a strain is a complex, dynamic process involving host factors and receptor sites on the organism that may help define its ability to persist and damage airways