Charcot-Leyden crystals and Curschmann spirals in asthmatic sputum.

Sakula, Alex

doi:10.1136/thx.41.7.503

Cited by 37 publications

(24 citation statements)

References 4 publications

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“…The relationship between sputum and bronchoscopic sampling has been investigated in several studies and although they generally report correlations between compartments these correlations are weak [Keatings et al 1997;Maestrelli et al 1995;Rutgers et al 2000]. The use of sputum cytology to explore airway inflammation has been in existence since the first descriptions by Ernst Leyden and Jean Charcot of Charcot-Leyden crystals [Sakula, 1986] and was used clinically in the 1950s by Dr Morrow-Brown [Brown, 1958] and then optimized in the 1990s by Freddy Hargreaves and colleagues [Pavord et al 1997]. Normal sputum eosinophil count ranges in large populations have been defined.…”

Section: Phenotyping the Heterogeneity Of Eosinophilic Airway Inflammmentioning

confidence: 99%

Eosinophilic airway inflammation: role in asthma and chronic obstructive pulmonary disease

George

Brightling²

2015

Therapeutic Advances in Chronic Disease

261

188

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Abstract:The chronic lung diseases, asthma and chronic obstructive pulmonary disease (COPD), are common affecting over 500 million people worldwide and causing substantial morbidity and mortality. Asthma is typically associated with Th2-mediated eosinophilic airway inflammation, in contrast to neutrophilic inflammation observed commonly in COPD. However, there is increasing evidence that the eosinophil might play an important role in 10-40% of patients with COPD. Consistently in both asthma and COPD a sputum eosinophilia is associated with a good response to corticosteroid therapy and tailored strategies aimed to normalize sputum eosinophils reduce exacerbation frequency and severity. Advances in our understanding of the multistep paradigm of eosinophil recruitment to the airway, and the consequence of eosinophilic inflammation, has led to the development of new therapies to target these molecular pathways. In this article we discuss the mechanisms of eosinophilic trafficking, the tools to assess eosinophilic airway inflammation in asthma and COPD during stable disease and exacerbations and review current and novel anti-eosinophilic treatments.

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Section: Phenotyping the Heterogeneity Of Eosinophilic Airway Inflammmentioning

confidence: 99%

Eosinophilic airway inflammation: role in asthma and chronic obstructive pulmonary disease

George

Brightling²

2015

Therapeutic Advances in Chronic Disease

261

188

View full text Add to dashboard Cite

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“…1 cannot produce sputum spontaneously. Cell counts and biochemical content of induced and spontaneous sputum Forty years ago Morrow Brown suggested that the microscopic examination of sputum might be clinically useful are similar with the exception of fibrinogen which is present in higher concentrations in spontaneous sputum.…”

mentioning

confidence: 97%

The use of induced sputum to investigate airway inflammation

Pavord¹,

Pizzichini²,

Pizzichini³

et al. 1997

Thorax

376

314

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Clinicians have been interested in the macroscopic and protocol (fig 1), based on that described by Pin et al 7 using a relatively low output ultrasonic nebuliser (output 0.9 ml/ microscopic appearance of sputum in asthma since the last half of the 19th century when Charcot-Leyden crystals, min, particle size 5.6 m), results in successful sputum induction in 76% of normal and asthmatic subjects who Curschmann's spirals, and their association with sputum eosinophilia was first recognised in patients with asthma. 1 cannot produce sputum spontaneously. Cell counts and biochemical content of induced and spontaneous sputum Forty years ago Morrow Brown suggested that the microscopic examination of sputum might be clinically useful are similar with the exception of fibrinogen which is present in higher concentrations in spontaneous sputum. 11 With by showing that the presence of eosinophils in a crude Leishman stained sputum smear identified patients whose salbutamol premedication and careful monitoring of forced expiratory volume in one second (FEV 1 ) during sputum wheeze was responsive to corticosteroids.2 Recently, with the recognition that even mild asthma is associated with induction in mild asthma significant bronchoconstriction rarely occurs, 7 but it is more common in patients with evidence of airway mucosal inflammation in bronchial biopsy specimens and bronchoalveolar lavage fluid, 3 4 there more severe or uncontrolled asthma. 12 In a recent study a third of sputum inductions in patients with asthma has been renewed interest in the use of sputum to assess airway inflammation non-invasively.exacerbations who were overusing inhaled 2 agonists were complicated by a >10% fall in FEV 1 which emphasises the This review describes the development over the last eight years of new and reliable techniques to assess airway need to perform the inductions carefully. 12 We and other investigators have induced sputum in asthma using similar inflammation using sputum differential cell counts and measurement of molecular markers of inflammation in concentrations of hypertonic saline delivered by ultrasonic nebulisers with a higher output and, whilst there might be the sputum fluid phase. We review studies where these measurements have been made in normal and diseased a higher success rate, this is at the expense of increased adverse effects including mild bronchoconstriction. [13][14][15] subjects and assess their validity, repeatability, and responsiveness. Finally we describe current, and speculate A recent preliminary report has suggested that the cellular and biochemical content of sputum induced by a high on future, applications of sputum measurements of airway inflammation in asthma in both research and clinical setoutput ultrasonic nebuliser changes with sequential inhalatings. Developments in methodologyEarly attempts to provide reliable sputum differential cell counts used smears of spontaneously produced sputum stained with May-Grunwald-Giemsa. 5 Additional staining with toluidine blue was required for accurate meta...

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“…In Ancient Greece phlegm was regarded by Hippocrates as one of the four humours fundamental to disease. Yet it was not until the nineteenth century that microscopy was used to demonstrate the presence of sputum eosinophilia in asthma [6], that was later shown to be associated with Charcot‐Leyden crystals and Curschmann's spirals [7]. In the 1950s sputum microscopy was used in the diagnosis and monitoring of asthmatic patients by researchers such as French Hansel [8] and Morrow Brown [9].…”

Section: Historical Perspectivementioning

confidence: 99%