Comparison Between Allergen-Induced and Exercise-Induced Asthma with Respect to the Late Asthmatic Response, Airway Responsiveness, and Creola Bodies in Sputum

Tateishi, Kinji; Motojima, Seiji; Kushima, Atsushi; Fukuda, Takeshi; Makino, Sohei

doi:10.1016/s1081-1206(10)63261-9

Cited by 12 publications

(12 citation statements)

References 31 publications

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“…Bronchial epithelial desquamation is classically recognised as the presence of Creola bodies in sputum. 23 The epithelium is now considered a major focus of airway damage in asthma. Epithelial loss occurs when the desmosomal connections between basal and columnar epithelial cells are disrupted, 24 25 and this can be induced by eosinophil granule proteins.…”

Section: Discussionmentioning

confidence: 99%

Relationship between induced sputum eosinophils and the clinical pattern of childhood asthma

Gibson

2003

Thorax

102

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Background:The relationship between the clinical pattern of asthma and airway inflammation in childhood asthma is poorly characterised, yet underpins the treatment recommendations in current asthma guidelines. A study was undertaken to examine the relationship between airway inflammation and clinical asthma in children. Methods: Children with asthma (n=146) and healthy controls (C, n=37) were recruited from primary and specialist clinics. Sputum induction and hypertonic saline challenge were performed. Results: As the frequency of asthma episodes in the past 12 months increased, there were significant increases in sputum eosinophils (median; infrequent episodic (IE) 1.5%, frequent episodic (FE) 2.3%, persistent (P) 3.8%, control (C) 1.0%; p=0.002), sputum eosinophil cationic protein (ECP) (IE 113 ng/ ml, FE 220, P 375, C 139; p=0.003), and desquamated bronchial epithelial cells (IE 2.0%, FE 6.0%, P 5.0%, C 2.5%; p=0.04). Treatment intensity was also associated with increased sputum eosinophils (p=0.005). The relationships between other severity markers (current symptoms, lung function) were less strong. Conclusion: Children with more frequent episodes of clinical asthma exhibit increasing airway inflammation that is characterised by sputum eosinophilia and bronchial epithelial desquamation. The results support clinical assessment by frequency of wheezing episodes over the past 12 months when determining anti-inflammatory treatment requirements, and indicate that current symptoms are determined by mechanisms in addition to sputum eosinophilia.

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Section: Discussionmentioning

confidence: 99%

Relationship between induced sputum eosinophils and the clinical pattern of childhood asthma

Gibson

2003

Thorax

102

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“…ECP levels in saliva were not increased after challenge. No such increase was seen after exercise provocation [ 99]. In asthmatics the sputum ECP levels seem to correlate with serum levels of ECP, sputum eosinophil percentage [ 95] or number [ 94], bronchial hyperresponsiveness [ 100, 101], lung function and clinical score [ 90, 101, 102].…”

Section: Ecp Measurements In Various Body Fluidsmentioning

confidence: 99%

Eosinophil cationic protein (ECP): molecular and biological properties and the use of ECP as a marker of eosinophil activation in disease

Venge¹,

Byström²,

Carlson³

et al. 1999

Clin Experimental Allergy

262

219

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“…The presence of Creola bodies (CrB + ) in the induced sputum or bronchoalveolar lavage (BAL) fluid from adult patients with acute exacerbation of asthma has been recognized as a correlate to epithelial damage in the airways [5][6][7][13][14][15]. In the referred studies, the presence of CrB + has correlated with eosinophils in induced sputum and also with bronchial reactivity [5][6][7]. It is not known whether patients with paediatric asthma resemble adult patients in this sense.…”

Section: Introductionmentioning

confidence: 99%

Association of epithelial damage and signs of neutrophil mobilization in the airways during acute exacerbations of paediatric asthma

Yoshihara

Yamada

Abe

et al. 2006

Clinical and Experimental Immunology

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SummaryWe examined whether epithelial damage is associated with mobilization of neutrophils or eosinophils in the airway lumen during acute exacerbations of paediatric asthma. Aspirated sputum samples were harvested from 65 paediatric patients (mean age 3·4 ± ± ± ± 0·4 years) during acute exacerbations of asthma. Patients with signs of infection were excluded. The presence of conglomerates of epithelial cells (i.e. 'Creola bodies) in the aspirated sputum was utilized as a marker of epithelial damage. Among the paediatric asthma patients, 60% displayed Creola bodies (CrB + + + + : n = = = = 39) in their sputum samples whereas the remaining patients did not (CrB-: n = = = = 26). CrB + + + + patients displayed more than a 20-fold increase in the concentration of the neutrophilmobilizing cytokine interleukin (IL)-8 (pg/ml) and of the neutrophil product neutrophil elastase (NE, g/l), respectively, compared with CrB-patients (IL-8: 7468·2 ± ± ± ± 1953·6 versus 347·9 ± ± ± ± 72·6, P < < < < 0·01; NE: 2072·4 ± ± ± ± 419·0 versus 438·5 ± ± ± ± 125·7, P < < < < 0·01). Even though not statistically significant, a corresponding trend was observed for the relative number of sputum neutrophils. In contrast, the concentration of the eosinophil-mobilizing cytokine IL-5 and the esoinophil product ECP tended to be lower in CrB + + + + than in CrB-patients ( P > > > > 0·05). In conclusion, as indicated by the analysis of aspirated sputum, epithelial damage is associated with a locally enhanced chemotactic signal for and activity of neutrophils, but not eosinophils, during acute exacerbations of paediatric asthma. It remains to be determined whether these indirect signs of neutrophil mobilization in the airway lumen mirror an increased number of neutrophils in the surrounding airway tissue.

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Comparison Between Allergen-Induced and Exercise-Induced Asthma with Respect to the Late Asthmatic Response, Airway Responsiveness, and Creola Bodies in Sputum

Cited by 12 publications

References 31 publications

Relationship between induced sputum eosinophils and the clinical pattern of childhood asthma

Relationship between induced sputum eosinophils and the clinical pattern of childhood asthma

Eosinophil cationic protein (ECP): molecular and biological properties and the use of ECP as a marker of eosinophil activation in disease

Association of epithelial damage and signs of neutrophil mobilization in the airways during acute exacerbations of paediatric asthma

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