The relationship between sputum inflammatory cells and
asthma state in children
Xiong
Z-Y, Ren
Y-X, Zhao S-Y, Li Z, Zhang Q, He B, Nagai L*, Liu S-Y
Beijing Research
Institute of Pediatrics, Beijing, China
*National Oshima
Seisho Hospital, Kagawa, Japan
Objective: To evaluate the clinical applications of the
detection of sputum inflammatory cells reflecting the state of airway
inflammation in asthmatic children.
Methods: Sputum samples of 105 asthmatic children was obtained
by spontaneously expectoration or by hypertonic saline aerosol induction.
Sputum smear was stained by May-Gr¨¹nwald¡¯s+Gimsa and Papanicolaou¡¯s.
Differential inflammatory cells counts were performed by counting 500 cells
under the light microscope, while patients were tested for allergy by skin
print test and pulmonary function.
Results: The percentage of eosinophils in sputum of asthmatic
children with respiratory infection cause was significantly lower than that
without respiratory infection cause (mean 5.52% vs 20.59%, P=0.007).
Contrarily, the percentage of neutrophils in sputum of children with cause
of respiratory tract infection was significantly higher compared with
asthmatic children of non-infection cause (63.61% vs 34.24%, P=0.004).
Sputum eosinophils in patients with inhaled corticosteroids as background
asthma therapy (3.82%) was significantly different from sputum eosinophils
in patients with irregular inhaled preventer (21.87%, P=0.009) or
non-preventer therapy (16.81%, P=0.03). While, sputum neutrophils of
patients with background preventer therapy was significantly higher
compared to that with irregular preventer therapy (56.95% vs 33.11%,
P<0.05). The inflammatory cells during asthma exacerbations were of 3
patterns: eosinophils (48n, 45.7%), mixed eosinophilic/neutrophilic (E/N;
18n, 17.2%), or noneosinophilic (39n, 37.1%). 12/18 (66.7%) patients in the
mixed E/N group were with moderate and severe asthma attach, and had lower
FEV1%pred than that in eosinophilic group or noneosinophilic group (66.09%
vs 84.16% or 84.90%, P<0.02).
Conclusion: Sputum inflammatory cells may be a useful marker
reflecting the state of airway inflammtion and assessing the therapeutic
efficacy.