We conclude that hypertonicity does not affect sputum cell composition, suggesting that inflammatory cells in hypertonic saline-induced sputum are probably preexisting and not acutely recruited in the airways by the hypertonic stimulus. However, the bronchoconstriction and the increase in bronchial hyper-responsiveness after hypertonic saline inhalation may imply the release of inflammatory mediators. This fact must be considered in the evaluation of soluble markers of inflammation in hypertonic saline-induced sputum.

Salbutamol pretreatment reduces the severity of bronchoconstriction induced by HS inhalation without significantly affecting the percentages of inflammatory cells and the levels of soluble mediators in induced sputum.

The aim of the study was to assess, on a large group of spontaneous or induced sputum samples, the difference in quality between slides processed by two different methods, and the relationship between quality assessment and some clinical and functional characteristics of the examined subjects. We examined 631 sputum samples obtained from 337 subjects with proven (n = 291) or suspected bronchial asthma. Of these, 467 samples were processed using the whole-sample method (Group I), while 164 samples were processed using the plug method (Group II). Salivary contamination, cell distribution on the slide, and cell borders were evaluated, and samples were classified as inadequate, adequate, or good. Inadequate samples were equally represented in both groups, while good samples were represented more in Group II. No significant difference in most clinical and functional findings was observed between the different quality categories of both groups. A higher proportion of inadequate samples was observed in Group I samples spontaneously collected. Mild intermittent asthmatics produced a better quality of slides in comparison with other groups of asthma severity. In conclusion, sputum quality partially depends on the different methods of sputum collection and/or processing, although the percentage of inadequate samples is similar for the two methods of processing. Sputum quality is only marginally affected by clinical and functional characteristics of asthma, or by asthma severity.

Inhaled corticosteroids and long-acting b 2 -agonists effectively control asthma symptoms and improve airway function. The effects of beclomethasone were compared with those of salmeterol on markers of eosinophilic inflammation in induced sputum in steroid-naïve asthmatic subjects with moderate asthma.Fifteen moderate asthmatics were treated with either beclomethasone dipropionate (500 mg b.i.d) or salmeterol (50 mg b.i.d) for 4 weeks, according to a randomised, double-blind, parallel-group study design. All patients underwent spirometry, methacholine test, sputum induction, and blood sampling before and after 2 and 4 weeks of treatment. They also recorded daily symptoms and peak expiratory flow (PEF).Sputum eosinophils, eosinophil cationic protein (ECP) and eosinophil protein X (EPX), and blood eosinophils, as well as the forced expiratory volume in one second (FEV1) and morning PEF, significantly improved after beclomethasone but not after salmeterol. PEF variability, the symptom score and rescue b 2 -agonist use significantly improved after both treatments, although the improvement in the symptom score tended to be greater after beclomethasone. After 2 and 4 weeks of beclomethasone treatment, both serum ECP and EPX decreased. With salmeterol, only serum EPX decreased, after 4 weeks. Bronchial hyperresponsiveness to methacholine did not change after either treatment.The authors conclude that beclomethasone, but not salmeterol, substantially improves airway inflammation in asthma. Beclomethasone also had an overall greater clinical effect, although the improvement in symptoms and peak expiratory flow variability was similar after both treatments. Eur Respir J 2002; 20: 66-72.

The median percentage of nights with no asthma symptoms rose from 14% in both groups at baseline to 71% with salmeterol and to 46% with theophylline (p=0.044). There was also a significant increase for salmeterol in the median percentage of nights with no rescue salbutamol use (from 36 to 86%) compared with theophylline (from 71 to 78%; p=0.002). The mean morning PEF increased from 337 L·min -1 in the salmeterol group and 332 L·min -1 in the theophylline group to 372 and 357 L·min -1 , respectively. No significant difference between the two treatments was observed for PEF, symptoms or additional salbutamol medication during the day. The incidence of gastrointestinal symptoms (gastric irritation, nausea and vomiting) was greater among patients receiving theophylline (11%) than with salmeterol (3%).These findings suggest that inhaled salmeterol is more effective in relieving symptoms of asthma, and better tolerated than theophylline in patients with moderateto-severe asthma. Eur Respir J., 1996Respir J., , 9, 1689Respir J., -1695 The clinical efficacy of salmeterol, the first of a new class of long-acting β 2 -agonists, has been demonstrated in comparison with other short-acting β 2 -agonists, such as salbutamol and terbutaline [1,2]. As oral theophylline is an asthma drug widely used in many countries, especially in Europe, this study was planned to compare the effects of salmeterol with oral slow-release theophylline. The new slow-release preparations of oral theophylline allow quite stable levels of serum theophylline concentration with one or two daily administrations, and they are commonly accepted for treatment of chronic reversible airway obstruction [3]. In this respect, the comparison between oral slow-release theophylline and salmeterol, both drugs with a long-lasting (up to 12 h) bronchodilation achieved by twice daily administration, seems of particular interest for long-term treatment of reversible airway obstruction. In a previous study, the effect of salmeterol was compared with theophylline over 2 weeks in a double-blind, cross-over study [4], showing that salmeterol produced a better effect on asthma symptoms and peak expiratory flow (PEF) values than theophylline in subjects with moderate asthma. Salmeterol was also shown to be more effective than a combination of slow-release theophylline and ketotifen in producing disappearance of nocturnal symptoms, lung function and rescue salbutamol use, during a 2 week period of treatment in 115 patients with nocturnal asthma [5].This large multicentre study was conducted in 24 European Centres, in order to compare the efficacy and tolerability of salmeterol with oral theophylline in the treatment of moderate-to-severe asthma. Subjects and methods SubjectsTwo hundred and forty three patients with moderateto-severe asthma were recruited into the study. Inclusion criteria were: 1) male or female aged 18-70 yrs; 2) symptoms of asthma (dyspnoea, wheeze, cough) for at least 1 year; 3) reversible airway obstruction (forced expiratory volume in one second (FEV1)...