Airway inflammation in steroid-naïve asthmatics: characteristics of induced sputum

Abstract

BACKGROUND: Airway inflammation, acknowledged as an important feature of asthma, can be assessed by the examination of induced sputum. OBJECTIVE: To determine the pattern of inflammatory cells in induced sputum from stable steroid-naïve asthmatics, in Florianópolis, Santa Catarina. METHOD: The induced sputum from 34 asthmatics using exclusively inhaled bronchodilators on demand was examined. The patients’ clinical characteristics were obtained at visit 1, and sputum was induced at visit 2. Differential cell count was performed on Giemsa-stained cytospins. Sputum was considered to be eosinophilic if there were ³ 3% eosinophils, and neutrophilic if there were ³ 65% neutrophils. RESULTS: Results are expressed by median and interquartile range. The total cell count was 3.4 (3.7) x 10(6) cells/ml, and cell viability was 80.0 (16.4) %. The proportion of neutrophils was 14.4 (22.1) %, of eosinophils 6.4 (17.2) %, of macrophages 60.3 (37.5) %, and of lymphocytes 1.1 (1.2) %. Eosinophilic sputum was observed in 24 subjects (70.6%); none of them had neutrophilic sputum. There were no significant differences between the eosinophilic and non-eosinophilic groups concerning the measured clinical outcomes, total cell count and proportions of cells in the sputum, except for the proportion of eosinophils (14.4 [19.3] vs 0.4 [1.1], p < 0.001). CONCLUSIONS: In our environment, steroid-naïve asthmatics present a higher proportion of sputum eosinophils, as compared to the established reference values. The clinical and physiological parameters analyzed were unable to predict the presence of eosinophilic inflammation of the airways

2021 Brazilian Thoracic Association recommendations for the management of severe asthma

“…O padrão inflamatório da asma não eosinofílica pode ser neutrofílico ou paucigranulocítico. (153) O fenótipo eosinofílico é o mais comum, sendo encontrado na maioria dos asmáticos virgens de tratamento (70%) (154,155) e em metade daqueles em tratamento com corticoides. (132,156) A asma grave ainda pode ser caracterizada de acordo com o fenótipo molecular (endotipo), o qual se relaciona à identificação de uma via fisiopatológica específica, responsável pelo fenótipo.…”

Effect of Oral Methyl Prednisolone on Different Radiological Patterns of Hypersensitivity Pneumonitis

“…Patients enrolled in the study were already newly diagnosed with HP at the parenchymal lung diseases department in Al-Kasr Al-Aini Hospital, according to the recent studies done by Raghu et al 17 the diagnosis was based on a combination of symptoms, which include dyspnea with or without cough which may appear shortly after exposure to antigen, malaise, flu-like symptoms in addition to CT findings, lung function test and having history of exposure to allergen either in work place or at their residence and BAL 18,19 and serology tests were carried out in some patients to exclude collagen vascular disease. All patients must be steroid naïve; have not been treated with oral or inhaled corticosteroids for at least two months 20 to be able to assess the corticosteroid effect. All were with the same causative factors which are birds like pigeons or poultry, to reduce any possible variables other than the effect of the treatment.…”