Elevated eosinophils, IL5 and IL8 in induced sputum in asthma patients with accelerated FEV1 decline

Persistence of both reversible airway obstruction and higher blood eosinophils may predict lung function decline in severe asthma

“…Therefore, lung function decline requires the association of a marked airway narrowing and eosinophilic inflammation. Studies have recently found an association between higher blood/ sputum eosinophil counts and lung function decline among asthmatics, [8][9][10][11][12][13] which, according to our results, may affect approximately 23% of patients receiving a step-5 treatment associated with omalizumab. It is not clear how eosinophilic inflammation affects lung function decline.…”

“…In fact, a recent study has shown the existence of an association between high levels not only of eosinophils but also of IL-5 (in induced sputum) and accelerated FEV 1 decline. 11 Anti-IL-5 treatment in asthma patients was associated with a significant reduction in the numbers of airway eosinophils expressing mRNA for TGF-β1 and the concentration of TGF-β1 in BAL fluid. 25 Furthermore, a 12-month treatment with anti-IL5 resulted in improvements in exacerbations, systemic and local eosinophil counts and reductions of the total airway area and of the airway wall area on CT, compared to findings in the placebo group.…”

“…Furthermore, some studies confirm that higher blood/sputum eosinophils and an elevated FENO level are associated not only with a greater airflow obstruction, but also with an enhanced lung function decline. [8][9][10][11][12][13] Actually, some asthmatics present an accelerated lung function decline. Such decline is probably a functional reflection of airway remodelling, a consequence of inflammation induced structural and functional changes in the airways due to injury and repair processes of the airway tissue.…”

“…14 As already said, some studies have shown a correlation between a greater FEV 1 decline and the elevated levels of inflammatory cells (sputum or blood eosinophils and neutrophils, bronchial CD8+ T cells) and cytokines (serum periostin, IL5 and IFN γ). [8][9][10][11][12][13] The reversible airflow obstruction (RAO) prevalence and its relationship with asthma control are not well known in severe asthmatics under maximal step-5 treatment. It is also unclear whether RAO persistence might be linked with a constantly higher BE counts and whether both conditions can be also associated to an accelerated lung function decline in treated severe asthmatics.…”

T2-high Asthma, Classified by Sputum mRNA Expression of IL4, IL5, and IL13, is Characterized by Eosinophilia and Severe Phenotype

“…Sputum was induced and processed as described previously [5,21]. Briefly, subjects inhaled nebulized 4.5% hypertonic saline for three 5-min periods.…”