Clujul Med. 2014;87(3):171-6. doi: 10.15386/cjmed-284. Epub 2014 Aug 05.

The Value of Induced Sputum in the Diagnosis and Management of Children with Bronchial Asthma.

Clujul medical (1957)

Sorana Staticescu, Paraschiva Chereches-Panta, Gabriela Ichim, Madalina Valeanu, Mircea Victor Nanulescu

PMID: 26528019 PMCID: PMC4508587 DOI: 10.15386/cjmed-284

Abstract

BACKGROUND: Induced sputum in children with bronchial asthma represents a non-invasive method of bronchial inflammation assessment. The main objective of our study was to analyze the cellularity of sputum in patients with bronchial asthma according to the level of disease control and the controlling therapy (with/without inhaled glucocorticoids). The second objective was to establish the correlation between sputum cellularity and other indirect parameters used to evidence bronchial inflammation (exhaled nitric oxide) and obstruction (forced expiratory volume in 1 second).

METHODS: The study included children with bronchial asthma that were assessed clinically (physical exam, questionnaire on the control of bronchial asthma in children) and by medical tests (induced sputum, exhaled nitric oxide, spirometry).

RESULTS: In patients with partially controlled asthma and those with uncontrolled asthma, the eosinophils percentage in the sputum was higher than in patients with controlled asthma (19.8±26.4% respectively 9.2±20.5% versus 4.5±14.6%, p<0.001). Higher percentage of neutrophils in the sputum was found in the partially controlled and uncontrolled asthma than in the controlled asthma (43.9±20.1% respectively 51.6±38.3% versus 35±19.7%, p=0.009). We also evidenced a direct and statistically significant correlation between the exhaled nitric oxide and the neutrophils percentage in the sputum (r=0.67, p=0.0003). Also, an indirect, moderate to good correlation (r=-0.56, p=0.005) was evidenced between the values of the forced expiratory volume in 1 second and the high eosinophils percentage in the sputum.

CONCLUSIONS: In partially controlled and uncontrolled bronchial asthma the eosinophils and neutrophils count in the sputum is significantly higher than in patients with controlled asthma. There is an indirect correlation between the high eosinophils count in the sputum and the forced expiratory volume in 1 second, as well as a direct correlation between the neutrophils count and the exhaled nitric oxide, suggesting that induced sputum should be used in combination with other indirect parameters for the evidence of bronchial inflammation.

Keywords: bronchial asthma; child; eosinophils; induced sputum; inflammation

References

1. J Lab Clin Med. 2000 Jul;136(1):39-49 - PubMed
2. Thorax. 2000 Sep;55(9):768-74 - PubMed
3. Lancet. 2000 Oct 28;356(9240):1480-5 - PubMed
4. Mediators Inflamm. 2004 Aug;13(4):285-91 - PubMed
5. Am Rev Respir Dis. 1990 Mar;141(3):689-97 - PubMed
6. J Allergy Clin Immunol. 1995 Apr;95(4):843-52 - PubMed
7. Lancet. 1989 Jun 17;1(8651):1346-8 - PubMed
8. Eur Respir J. 1998 Apr;11(4):848-53 - PubMed
9. Eur Respir J. 2000 Jan;15(1):109-15 - PubMed
10. Eur Respir J. 1999 Mar;13(3):660-7 - PubMed
11. Thorax. 1992 Jan;47(1):25-9 - PubMed
12. Am J Respir Crit Care Med. 1998 Jul;158(1):36-41 - PubMed
13. Eur Respir J. 1995 Apr;8(4):559-65 - PubMed
14. Eur Respir J. 2001 Sep;18(3):444-50 - PubMed
15. Am J Respir Crit Care Med. 1998 Feb;157(2):665-8 - PubMed
16. J Allergy Clin Immunol. 2007 Nov;120(5 Suppl):S94-138 - PubMed
17. Sao Paulo Med J. 2003 Sep 1;121(5):213-9 - PubMed
18. Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1511-7 - PubMed
19. Am Rev Respir Dis. 1993 May;147(5):1126-31 - PubMed
20. J Investig Allergol Clin Immunol. 2011;21(3):216-21 - PubMed
21. Eur Respir J. 2000 Nov;16(5):1008-15 - PubMed
22. Am Rev Respir Dis. 1993 Sep;148(3):713-9 - PubMed
23. Chest. 2010 Jul;138(1):107-13 - PubMed
24. Medicina (B Aires). 2011;71(4):343-9 - PubMed
25. J Allergy Clin Immunol. 2003 Oct;112(4):709-16 - PubMed

Publication Types

• Journal Article