Eosinophilic inflammation in sputum of poorly controlled asthmatics

Abstract

Despite full effective treatment, asthmatic patients often present with poorly controlled asthma. Airway eosinophilia is associated with asthma, but its relationship with asthma control is still undetermined.To investigate the relationship between airway eosinophilia and asthma control, cellular and biochemical markers of airway inflammation were measured in 19 subjects with poorly controlled asthma, 16 subjects with asthma under control and eight normal volunteers. The severity of asthma was mild-to-moderate persistent in 23 patients (14 poorly controlled) and severe prednisone-dependent in 12 subjects (five poorly controlled). Induced sputum was analysed for total and differential cell counts, leukotriene E4 (LTE 4 ), eosinophil cationic protein (ECP), regulated on activation, normal T-cell expressed and secreted (RANTES), and interleukin (IL)-8.Sputum eosinophils, LTE 4 , ECP and RANTES levels (but not IL-8) were significantly higher in patients with poorly controlled asthma as compared to patients with controlled asthma. By contrast, sputum cells and sputum inflammatory markers were not different among groups of patients with different severity of asthma.These results suggest that sputum eosinophilia is associated with poorly controlled asthma rather than with the severity of asthma.

Early Prescription of Inhalation Corticosteroid in Bronchial Asthma

“…Симптомы БА связаны не только с бронхоконстрикци-ей, но и с воспалением дыхательных путей (ДП) [4][5][6][7][8], и обе группы препаратов -как бета2-агонисты (Б2А), так и ингаляционные кортикостероиды (ИКС) обладают быстрым противовоспалительным действием.…”

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

“…Le [41] . Dans une étude transversale de patients asthmatiques [42] , Quaedvlieg et al ont montré des taux accrus d'éosinophiles dans les expectorations de patients dont l'asthme était non contrôlé sur base d'un score Asthma Control Questionnaire (ACQ) de Juniper [43] supérieur à 1,5.…”

Recent changes in the drug treatment of allergic asthma

“…High eosinophil counts in sputum are associated with poor asthma control, can predict future exacerbations and can help direct medication changes, 23,24 which make IL-5 an attractive target in allergic asthma.…”