Nasal eosinophilia: an indicator of eosinophilic inflammation in asthma

Amorim, Maria Marta; Araruna, A.; Caetano, Lilian Ballini; Cruz, Alessandro Carvalho; Santoro, Ilka Lopes; Fernandes, Ana Luísa Godoy

doi:10.1111/j.1365-2222.2009.03623.x

Cited by 12 publications

(17 citation statements)

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“…Nose is an easy and accessible airway that shares aspects of the lower airways; the nasal mucosa is similar to that of the lower airways and inflammatory processes in the nose reflect those in the lower airways. 32,33 Nasal lavage is a non-invasive and cost-effective procedure. It is well suited for fluid-phase component analysis such as leucocyte cell counts.…”

Section: Phenotyping Asthmamentioning

confidence: 99%

Nasal lavage, blood or sputum: Which is best for phenotyping asthma?

et al. 2016

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Background and objective: Determination of asthma phenotypes, particularly inflammatory phenotypes, helps guide treatment and management of this heterogeneous disease. Induced sputum cytology has been the gold standard for determination of inflammatory phenotypes, but sputum induction is fairly invasive and technically challenging. Blood and nasal lavage cytology have been suggested as substitutes, but have not been fully verified. The aim of this study is to determine the accuracy of blood and nasal lavage cytometry as indicators of inflammatory phenotypes in asthma. Methods: Clinical evaluation, Asthma Control Questionnaire (ACQ) and spirometry were performed for 121 adult asthma patients, and blood, nasal lavage and induced sputum samples were taken. Eosinophils and neutrophils were counted in three samples from each subject. Inflammatory phenotypes (eosinophilic, neutrophilic, mixed and paucicellular) and cells counts were analysed using Venn diagram and receiver operating characteristic (ROC) curve, respectively. Results: ACQ score, spirometry and bronchodilator response did not differ among subjects with different inflammatory phenotypes. Inflammatory phenotypes defined by nasal lavage cytometry were in better concordance than those defined by blood cell counts with phenotypes determined by sputum cytology, and were significantly correlated with sputum phenotypes. For eosinophilia, nasal lavage cytology showed better accuracy than blood cytology (area under the curve (AUC): 0.89 vs 0.65). For all phenotypes, sensitivity and positive and negative predictive power were higher for nasal lavage cytometry than for blood. Blood cell counts gave a high level of false positives for all inflammatory phenotypes. Conclusion: We recommend nasal lavage cytology over blood cell count as a substitute for sputum cytology to identify inflammatory phenotypes in asthma.

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Section: Phenotyping Asthmamentioning

confidence: 99%

Nasal lavage, blood or sputum: Which is best for phenotyping asthma?

et al. 2016

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“…Adolescents are more inclined to risk-taking behaviours that put them at risk for fatal allergic reactions. Even if they describe living with food allergy as a way of life, they find it burdensome and they tend to feel frustrated because of their disease (7,8).…”

Section: Psychological Care Of Food-allergic Children and Their Familmentioning

confidence: 99%

“…Asthma and AR share airways eosinophilic inflammation (7). The FeNO measurement may be reasonably considered a surrogate biomarker of airway eosinophilic inflammation, mainly in allergic patients (2).…”

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confidence: 99%

Exhaled nitric oxide in children with allergic rhinitis: A potential biomarker of asthma development

Cara¹,

Marcucci²,

Palomba³

et al. 2015

Pediatric Allergy Immunology

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“…Surrogate biomarkers of airways inflammation have been long investigated. The importance of monitoring and managing asthma based on biomarkers is especially important for patients with discordance between symptoms and eosinophilic airway inflammation [2,3]. Although the sputum eosinophil count has been proposed for phenotyping severe and uncontrolled asthma, it is crucial to identify a biomarker to evaluate the future risk in controlled asthma patients.…”

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confidence: 99%