Article

Induced sputum cell counts: their usefulness in clinical practice.

Dept of Medicine, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
European Respiratory Journal (impact factor: 5.89). 08/2000; 16(1):150-8.
Source: PubMed

ABSTRACT Airway inflammation is fundamental to the aetiology and persistence of asthma and other airway conditions. The presence and type of airway inflammation can be difficult to detect clinically, delaying the introduction of appropriate treatment. Induced sputum cell counts are a relatively noninvasive, safe and reliable method of identifying airway inflammation. They can accurately discriminate eosinophilic airway inflammation from noneosinophilic airway inflammation, and help guide therapy. Eosinophilic airway inflammation is steroid responsive whilst noneosinophilic (usually neutrophilic) inflammation generally is not. Macrophages containing haemosiderin can be useful in detecting left ventricular dysfunction and macrophages containing lipid are suggestive of oropharyngeal reflux with microaspiration, both of which can complicate or confuse assessment of airway disease. To date, studies using induced sputum are primarily observational. Management studies based on examination of induced sputum are now needed to validate the clinical utility of this test.

0 0
 · 
0 Bookmarks
 · 
36 Views
  • Article: A comparative study of the effects of an inhaled corticosteroid, budesonide, and a beta 2-agonist, terbutaline, on airway inflammation in newly diagnosed asthma: a randomized, double-blind, parallel-group controlled trial.
    L A Laitinen, A Laitinen, T Haahtela
    [show abstract] [hide abstract]
    ABSTRACT: We compared the effect of an inhaled corticosteroid, budesonide, and an inhaled beta 2-agonist, terbutaline, on clinical symptoms, lung function, and airway inflammation in 14 adult patients with newly diagnosed asthma. The study was conducted as a randomized, double-blind, parallel-group trial. Seven patients inhaled 600 micrograms, twice daily, of budesonide, the other seven patients inhaled 375 micrograms, twice daily, of terbutaline via identical metered-dose inhalers with a spacer. Bronchial biopsy specimens, obtained before randomization and after 3 months of treatment, were analyzed by electron microscopy. Both groups improved clinically budesonide was more effective than terbutaline in improving morning and evening peak expiratory flow rates, as well as bronchial responsiveness to inhaled histamine. Treatment with budesonide was accompanied by increased numbers of ciliated airway cells and intraepithelial nerves and fewer inflammatory cells, including eosinophils, especially in the epithelium, these changes were not observed in specimens from terbutaline-treated patients. We conclude that, in contrast to inhaled terbutaline, inhaled budesonide improved lung function and bronchial hyperreactivity in adult subjects with asthma treated for 3 months and that this corticosteroid was more effective in ameliorating abnormalities of the bronchial epithelium and decreasing inflammation in the airways.
    Journal of Allergy and Clinical Immunology 08/1992; 90(1):32-42. · 11.00 Impact Factor
  • Article: Airways remodelling in asthma: no doubt, no more?
    J Bousquet, A M Vignola, P Chanez, A M Campbell, G Bonsignore, F B Michel
    [show abstract] [hide abstract]
    ABSTRACT: Asthma is a chronic inflammatory disease of the airways invariably associated with healing. Remodelling of the airways can be demonstrated by the activation of airways macrophages, the release of growth factors and fibrogenic cytokines, the activation of fibroblasts and myofibroblast, elastolysis and elastosynthesis, collagen deposition, increased synthesis and release of extracellular matrix components, and an increased mass of smooth muscle and mucous glands. However, the control of remodelling is still poorly understood.
    International Archives of Allergy and Immunology 107(1-3):211-4. · 2.40 Impact Factor
  • Article: Inflammation and airway function in asthma: what you see is not necessarily what you get.
    K J Haley, J M Drazen
    American Journal of Respiratory and Critical Care Medicine 02/1998; 157(1):1-3. · 11.08 Impact Factor

Show more

Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Full-text

View
0 Downloads
Available from

Keywords

airway conditions
 
airway disease
 
airway inflammation
 
appropriate treatment
 
clinical utility
 
clinically
 
confuse assessment
 
detecting
 
Eosinophilic airway inflammation
 
guide therapy
 
induced sputum
 
Induced sputum cell counts
 
lipid
 
Macrophages
 
Management studies
 
noneosinophilic
 
noneosinophilic airway inflammation
 
oropharyngeal reflux
 
ventricular dysfunction
 

L Jayaram