Measuring airway inflammation in asthma: Eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood

Pizzichini, Emílio; Pizzichini, M.M.M.; Efthimiadis, A.; Dolovich, J.; Hargreave, Frederick E.

doi:10.1016/s0091-6749(97)70082-4

Cited by 203 publications

(153 citation statements)

References 27 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…Despite the relatively low eosinophil numbers in sputum, these cells were shown to be associated with baseline FEV1 and asthma severity score, which is in accordance with previous studies [6,14,15]. In addition, it was demonstrated that eosinophils in sputum are related to ECP levels in sputum supernatants, suggesting activation of those cells within the airways.…”

Section: Discussionsupporting

confidence: 90%

“…When considering the relationship between sputum and airway physiology, it has been demonstrated that eosinophils and eosinophil cationic protein (ECP) in sputum are correlated with the degree of airway obstruction and symptom scores [6,14,15]. In addition, eosinophils in sputum are associated with bronchial hyperresponsiveness (BHR) when measured by methacholine [14] or histamine [15], but not by hypertonic saline [16].…”

mentioning

confidence: 99%

“…In addition, eosinophils in sputum are associated with bronchial hyperresponsiveness (BHR) when measured by methacholine [14] or histamine [15], but not by hypertonic saline [16]. Moreover, it has been shown in subjects with asthma that eosinophil numbers in sputum reflect those in bronchial washings, bronchoalveolar lavage fluid, and bronchial biopsies [17,18].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Induced sputum in adolescents with severe stable asthma. Safety and the relationship of cell counts and eosinophil cationic protein to clinical severity

Grootendorst¹,

Bos²,

Romeijn³

et al. 1999

Eur Respir J

View full text Add to dashboard Cite

This study examined the safety of sputum induction and the relation between sputum cell counts and clinical parameters in adolescents with severe persistent asthma.Within 5 days, induced sputum and reversibility in forced expiratory volume in one second (FEV1), quality of life, provocative concentration causing a 20% fall in FEV1 (PC20) of adenosine monophosphate and histamine, exercise-induced bronchoconstriction, overall asthma severity index, and blood eosinophils were collected in 20 atopic adolescents with moderate-to-severe persistent asthma (12±18 yrs of age, FEV1 65±110% of predicted, on 500±2,000 mg inhaled steroids daily).FEV1 was reversible by 13.32.3% pred. After sputum induction, FEV1 was still increased by 9.02.6% pred as compared to the pre-salbutamol baseline. Sputum contained, median (range): 12.4 (0.4±59.5)% squamous cells, 47.3 (6.8±84.0)% macrophages, 39.0 (4.6±84.8)% neutrophils, 4.8 (1.0±12.4)% lymphocytes, 0.4 (0±10.8)% eosinophils and 3.6 (0±23.4)% bronchial epithelial cells. Sputum eosinophils showed a trend towards a significant association with the overall asthma severity index (r=0.46, p=0.06) and correlated inversely with baseline FEV1 (r=-0.51, p=0.03).In conclusion, sputum can be induced safely in adolescents with moderate-to-severe persistent asthma, if pretreated with b 2 -agonists. Despite relatively low sputum eosinophil counts in these patients on inhaled steroids, the association of eosinophil numbers with baseline forced expiratory volume in one second and asthma severity index favours a role of induced sputum in monitoring adolescents with severe asthma. Eur Respir J 1999; 13: 647±653.

show abstract

Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Induced sputum in adolescents with severe stable asthma. Safety and the relationship of cell counts and eosinophil cationic protein to clinical severity

Grootendorst¹,

Bos²,

Romeijn³

et al. 1999

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…14,15,27,28 Similar to the findings from bronchial biopsies and bronchoalveolar lavage fluid examinations, the sputum of patients with asthma is characterized by an increase in proportion of eosinophils and the level of ECP. 29 Moreover, sputum examination has been demonstrated to be a more accurate diagnostic test than measurement of blood eosinophils or serum ECP in detecting airway eosinophilic inflammation, 29 suggesting a relevant role of sputum analysis in the identification and monitoring of airway inflammation in asthma. 12,14,30 Our results demonstrate that sputum eosinophils and ECP provide another unique dimension related to the status of patients with chronic bronchial asthma that was independent of both lung function and baseline BHR.…”

Section: Discussionmentioning

confidence: 99%

Sputum analysis, bronchial hyperresponsiveness, and airway function in asthma: Results of a factor analysis

Rosi

Ronchi

Grazzini

et al. 1999

Journal of Allergy and Clinical Immunology

148

111

View full text Add to dashboard Cite

Background: Recent studies have shown weak associations among FEV 1 , bronchial hyperresponsiveness (BHR), sputum eosinophils, and sputum eosinophil cationic protein (ECP), suggesting that they are nonoverlapping quantities. The statistical method of factor analysis enables reduction of many parameters that characterize the disease to a few independent factors, with each factor grouping associated parameters. Objective: The purpose of this study was to demonstrate, by using factor analysis, that reversible airway obstruction, BHR, and eosinophilic inflammation of the bronchial tree, as assessed by cytologic and biochemical analysis of sputum, may be considered separate dimensions that characterize chronic bronchial asthma. Methods: Ninety-nine clinically stable patients with a previous diagnosis of asthma underwent spirometry, sputum induction, and histamine inhalation tests. Results: Most patients were nonobstructed (FEV 1 , 91% ± 20%); a low level of bronchial reversibility (FEV 1 increase after β 2 -agonist, 7.8% ± 9.2%) and BHR (histamine PC 20 FEV 1 geometric mean, 0.98 mg/mL) were found. Sputum eosinophil differential count (12.4% ± 17.7%) and sputum ECP (1305 ± 3072 µg/mL) were in the normal range of our laboratory in 38 and 22 patients, respectively. Factor analysis selected 3 different factors, explaining 74.8% of variability. Measurements of airway function and age loaded on factor I, PC 20 FEV 1 and β 2 -response loaded on factor II, and sputum ECP and eosinophils loaded on factor III. Additional post hoc factor analyses provided similar results when the sample was divided into 2 subgroups by randomization, presence of airway obstruction, degree of BHR, percentage of sputum eosinophils, or concentration of sputum ECP. Conclusions: We conclude that airway function, baseline BHR, and airway inflammation may be considered separate dimensions in the description of chronic asthma. Such evidence supports the utility of routine measurement of all these dimensions. (J Allergy Clin Immunol 1999;103:232-7.)

show abstract

“…Dans une autre étude, Leuppi a rapporté qu'un pourcentage d'éosinophiles supérieur au seuil de 6,3 % avait une sensibilité de 90 % et une spécificité de 63 % pour la prédiction d'une perte de contrôle de l'asthme lors du sevrage en corticostéroïdes inhalés [44] . L'inflammation éosinophilique des voies respiratoires qui persiste malgré un traitement antiinflammatoire intensif est associée à un asthme plus sévère [45,46] , des exacerbations plus fréquentes [47] et un déclin de la fonction respiratoire [48] . L'association d'une inflammation éosinophilique et neutrophilique (dans l'asthme mixte granulocytique) caracté-rise une maladie plus sévère [49,50] .…”

Section: Intérêt Dans L'évaluation Du Contrôle Et De La Sévérité De Lunclassified

Intérêt de la mesure de l’inflammation en clinique dans l’asthme

Schleich¹,

Louis²

2012

EMC - Pneumologie

View full text Add to dashboard Cite

Measuring airway inflammation in asthma: Eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood

Cited by 203 publications

References 27 publications

Induced sputum in adolescents with severe stable asthma. Safety and the relationship of cell counts and eosinophil cationic protein to clinical severity

Induced sputum in adolescents with severe stable asthma. Safety and the relationship of cell counts and eosinophil cationic protein to clinical severity

Sputum analysis, bronchial hyperresponsiveness, and airway function in asthma: Results of a factor analysis

Intérêt de la mesure de l’inflammation en clinique dans l’asthme

Contact Info

Product

Resources

About