The Experts below are selected from a list of 9405 Experts worldwide ranked by ideXlab platform
Peter J Barnes - One of the best experts on this subject based on the ideXlab platform.
-
quantitative analysis of potentially pathogenic microbes ppms in the Induced Sputum of non smoker copd ns copd subjects
European Respiratory Journal, 2016Co-Authors: Baisakhi Ghosh, Amit Agarwal, Akshay H Gaike, Shrikant S Bhute, Shreyas V Kumbhare, Kanchan Pyasi, Bill Brashier, Yogesh Shauche, Sundeep Salvi, Peter J BarnesAbstract:Background: We have previously reported that both tobacco-smoke associated COPD (TS-COPD) and NS-COPD subjects exhibit a decline in lung function and progressive airway inflammation. The association between load of PPMs and lung function tests is well demonstrated among TS-COPD subjects. However, there is lack of knowledge with respect to NS-COPD subjects. We aimed to investigate the load of PPMs in the lower respiratory tract of NS-COPD subjects among the rural Indian population and its association with lung function. Methods: Induced Sputum samples were collected from 19 healthy-nonsmoker (H-Nonsmokers), 8 healthy-smokers (H-smokers), 9 TS-COPD, and 12 NS-COPD to assess the load of P. aeruginosa (PA), S. pneumoniae (SP), H. influenzae (HI), and M. catarrhalis (MC) using SYBR-Green qPCR assay. Results: The load of PA, SP and HI was significantly higher in both TS-COPD and NS-COPD than healthy subjects (Figure 1). The load of MC was similar among all the groups. The load of PA and HI negatively correlated with FEV1 %predicted (PA: r=-0.136, P=0.02; HI: r=-0.326, P=0.03), and FVC %predicted (PA: r=-0.153, P=0.03; HI: r=-0.432; P=0.048). Conclusion: To the best of our knowledge, this is the first study to report that load of PA, SP and HI is higher among NS-COPD subjects as compared to healthy non-smokers. Also, this bacterial load negatively correlates with lung function data.
-
cxcr3 and ccr5 chemokines in Induced Sputum from patients with copd
Chest, 2008Co-Authors: Claudia Henrique Da Costa, Peter J Barnes, Rogerio Rufino, Suzanne L Traves, Jose Roberto Lapa E Silva, Louise E DonnellyAbstract:Background COPD is associated with increased numbers of CD4 + and CD8 + lymphocytes and macrophages in the small airways and lung parenchyma. The chemokines regulating T-cell recruitment into the lung are unknown but may involve CXCR3 and CCR5 chemoattractants. The aims of this study were to determine the concentrations of CXCR3 chemokines CXCL9, CXCL10, CXCL11, and the CCR5 chemokine CCL5 in Induced Sputum from patients with COPD, smokers, and nonsmokers, and to examine the relationship between chemokine expression, inflammatory cells, and airway obstruction. Methods Differential cell counts were performed and concentrations of CXCL9, CXCL10, CXCL11, and CCL5 were measured in Induced Sputum from nonsmokers (n = 18), smokers (n = 20), and COPD patients (n = 35) using an enzyme-linked immunosorbent assay. Results Concentrations of CXCL9, CXCL10, CXCL11, and CCL5 were significantly increased in the Sputum of patients with COPD when compared with nonsmokers but not smokers without obstruction: CXCL9 (median, 14.3 pg/mL; interquartile range [IQR], 6.5 to 99.3; vs median, 1.4 pg/mL; IQR, 0 to 10.4 [p 1 percentage of predicted, FEV 1 /FVC ratio, and percentage of macrophages, and all the chemokines analyzed. Neutrophil numbers correlated positively with the concentrations of chemokines. Conclusions CXCR3 chemokines and CCL5 are increased in Sputum from COPD patients compared with nonsmokers, and may be important in COPD pathogenesis.
-
effect of theophylline on Induced Sputum inflammatory indices and neutrophil chemotaxis in chronic obstructive pulmonary disease
American Journal of Respiratory and Critical Care Medicine, 2002Co-Authors: Sarah V Culpitt, Carmen De Matos, Richard Russell, Louise E Donnelly, Duncan F Rogers, Peter J BarnesAbstract:Chronic obstructive pulmonary disease (COPD) is characterized by a neutrophilic airway inflammation that can be demonstrated by examination of Induced Sputum. Theophylline has antiinflammatory effects in asthma, and in the present study we investigated whether a similar effect occurs in COPD patients treated with low doses of theophylline. Twenty-five patients with COPD were treated with theophylline (plasma level of 9–11 mg/L) for 4 weeks in a placebo-controlled, randomized, double-blind crossover study. Theophylline was well tolerated. Induced Sputum inflammatory cells, neutrophils, interleukin-8, myeloperoxidase, and lactoferrin were all significantly reduced by about 22% by theophylline. Neutrophils from subjects treated with theophylline showed reduced chemotaxis to N-formyl-met-leu-phe (∼ 28%) and interleukin-8 (∼ 60%). Neutrophils from a healthy donor showed reduced chemotaxis (∼ 30%) to Induced Sputum samples obtained during theophylline treatment. These results suggest that theophylline has antii...
-
effect of high dose inhaled steroid on cells cytokines and proteases in Induced Sputum in chronic obstructive pulmonary disease
American Journal of Respiratory and Critical Care Medicine, 1999Co-Authors: Sarah V Culpitt, Wasim Maziak, Stelios Loukidis, Julia A Nightingale, John L Matthews, Peter J BarnesAbstract:Inhaled corticosteroids are widely prescribed for the treatment of stable chronic obstructive pulmonary disease (COPD), despite lack of proven efficacy. Because COPD involves airway inflammation and probable protease-antiprotease imbalance, we examined the effect of high dose fluticasone propionate on markers of activity of both pathogenetic mechanisms. Thirteen patients with COPD were treated with fluticasone propionate (500 μ g twice a day) for 4 wk, delivered via MDI and spacer, in a double-blind crossover study. There was no clinical benefit in terms of lung function or symptom scores, and Induced Sputum inflammatory cells, percentage neutrophils, and IL-8 levels were unchanged. Sputum supernatant elastase activity, matrix metalloproteinase (MMP)-1, MMP-9, and the antiproteases secretory leukoprotease inhibitor (SLPI) and tissue inhibitor of metalloproteinase (TIMP)-1 were similarly unaffected by treatment. These results add to previous evidence that inhaled steroids have no anti-inflammatory action i...
-
granulocyte activation markers in Induced Sputum comparison between chronic obstructive pulmonary disease asthma and normal subjects
American Journal of Respiratory and Critical Care Medicine, 1997Co-Authors: Vera M Keatings, Peter J BarnesAbstract:Airway inflammation is present in asthma and is thought to play a significant part in the development of airflow obstruction. In chronic obstructive pulmonary disease (COPD), neutrophilic inflammation is present in the airway lumen, whereas the submucosa displays a lymphocytic infiltrate. Less is known about the nature and mechanisms of inflammation in COPD than in asthma. Induced Sputum allows noninvasive sampling of respiratory tract secretions from patients and control subjects, allowing characterization of cells and measurement of soluble markers. We exploited this technique in order to compare the presence and quantify specific markers of eosinophil and neutrophil activation in subjects with asthma or COPD, and control subjects. Differential cell counts showed significantly higher neutrophil percentages in the patients with COPD compared with other groups, while patients with asthma had higher numbers of eosinophils. The neutrophil markers myeloperoxidase (MPO), from primary granules in neutrophils, ...
Frederick E Hargreave - One of the best experts on this subject based on the ideXlab platform.
-
an effective strategy for diagnosing occupational asthma use of Induced Sputum
American Journal of Respiratory and Critical Care Medicine, 2004Co-Authors: Frederic Girard, Frederick E Hargreave, Simone Chaboillez, Andre Cartier, Johanne Cote, Manon Labrecque, Jeanluc Malo, Susan M Tarlo, Catherine LemiereAbstract:Monitoring airway inflammation by means of Induced Sputum cell counts seems to improve the management of asthma. We sought to assess whether such monitoring at the end of periods at and away from work combined with the monitoring of PEF could improve the diagnosis of occupational asthma. We enrolled subjects suspected of having occupational asthma. Serial monitoring of PEF was performed during 2 weeks at and away from work. At the end of each period, Induced Sputum was collected. Specific inhalation challenge was subsequently performed. PEF graphs were interpreted visually by five independent observers. Forty-nine subjects, including 23 with positive specific inhalation challenge, completed the study. The addition of Sputum cell counts to the monitoring of PEF increased the specificity of this test, respectively, by 18 (range [r] 13.7-25.5) or 26.8% (r 24.8-30.4) depending if an increase of Sputum eosinophils greater than 1 or 2% when at work was considered as significant. The sensitivity increased by 8.2% (r 4.1-13.4) or decreased by 12.3% (r 3.1-24.1) depending on the cutoff value in Sputum eosinophils chosen (greater than 1 or 2%, respectively). The addition of Sputum cell counts to PEF monitoring is useful to improve the diagnosis of occupational asthma.
-
a comparison of exhaled nitric oxide and Induced Sputum as markers of airway inflammation
The Journal of Allergy and Clinical Immunology, 2000Co-Authors: Graham Samuel Berlyne, Krishnan Parameswaran, Ann Efthimiadis, Dennis Kamada, Frederick E HargreaveAbstract:Abstract Background: Exhaled nitric oxide (ENO) has been proposed as a noninvasive marker of airway inflammation in asthma. Objective: We investigated the relationships among ENO, eosinophilic airway inflammation as measured by Induced Sputum, and physiologic parameters of disease severity (spirometry and methacholine PC 20 ). We also examined the effect of corticosteroid treatment and atopy on ENO levels and eosinophil counts in Induced Sputum. Methods: Measurements were taken on one day in 22 healthy nonatopic subjects, 28 healthy atopic subjects, 38 asthmatic subjects not taking inhaled steroids, 35 asthmatic subjects taking inhaled steroids, and 8 subjects with eosinophilic bronchitis without asthma. Results: ENO levels showed significant but weak correlations with eosinophil differential counts in the steroid-naive asthmatic and healthy atopic groups ( r s Conclusion: We conclude that ENO is likely to have limited utility as a surrogate clinical measurement for either the presence or severity of eosinophilic airway inflammation, except in steroid-naive subjects. (J Allergy Clin Immunol 2000;106:638-44.)
-
Induced Sputum examination diagnosis of pulmonary involvement in fabry s disease
Thorax, 2000Co-Authors: Margaret M Kelly, R Mckenzie, D Kamada, E H Ramsdale, Richard Leigh, Frederick E HargreaveAbstract:Fabry's disease is a rare inherited metabolic disorder caused by a deficiency in the enzyme α-galactosidase A. It can affect almost every organ, including the lungs. Confirmation of lung involvement has depended on invasive bronchial biopsy specimens or brushings to confirm the presence of typical lamellar inclusion bodies within bronchial epithelial cells. We report a patient with known Fabry's disease in whom these inclusion bodies were identified by examination of Induced Sputum.
-
Induced Sputum cell counts in healthy adults
American Journal of Respiratory and Critical Care Medicine, 2000Co-Authors: Jose Belda, Richard Leigh, Krishnan Parameswaran, Paul M Obyrne, Malcolm R Sears, Frederick E HargreaveAbstract:Induced Sputum cell counts provide a relatively noninvasive method to evaluate the presence, type, and degree of inflammation in the airways of the lungs. Their interpretation requires a knowledge of normal values from a healthy population. The objective was to examine the total and differential cell counts in Induced Sputum from a sample of healthy adults. A total of 118 healthy nonsmoking adults were studied. None had asthma or airflow obstruction (negative history, FEV1 ⩾ 80% predicted, ratio of FEV1 to vital capacity [FEV1/VC] ⩾ 80%, methacholine PC20 ⩾ 16 mg/ml). Forty-six were atopic. Sputum induction produced an adequate sample in 96 subjects [53 males, mean age (range) 36 (18 to 60) yr]. The expectorate was processed within 2 h; Sputum was selected, treated with dithiothreitol, filtered, and examined in a hemocytometer for total cell count and viability and on Wright-stained cytospins for a differential cell count. The mean, median (90th percentile) total cell count was 4.1, 2.4 (9.7) × 106 cells/...
-
Induced Sputum cell counts in healthy adults
American Journal of Respiratory and Critical Care Medicine, 2000Co-Authors: Jose Belda, Richard Leigh, Krishnan Parameswaran, Paul M Obyrne, Malcolm R Sears, Frederick E HargreaveAbstract:Induced Sputum cell counts provide a relatively noninvasive method to evaluate the presence, type, and degree of inflammation in the airways of the lungs. Their interpretation requires a knowledge of normal values from a healthy population. The objective was to examine the total and differential cell counts in Induced Sputum from a sample of healthy adults. A total of 118 healthy nonsmoking adults were studied. None had asthma or airflow obstruction (negative history, FEV(1) >/= 80% predicted, ratio of FEV(1) to vital capacity [FEV(1)/VC] >/= 80%, methacholine PC(20) >/= 16 mg/ml). Forty-six were atopic. Sputum induction produced an adequate sample in 96 subjects [53 males, mean age (range) 36 (18 to 60) yr]. The expectorate was processed within 2 h; Sputum was selected, treated with dithiothreitol, filtered, and examined in a hemocytometer for total cell count and viability and on Wright-stained cytospins for a differential cell count. The mean, median (90th percentile) total cell count was 4.1, 2.4 (9.7) x 10(6) cells/g and cell viability was 69.6, 72.0 (89.7)%. The proportions of eosinophils were 0.4, 0.0 (1.1)%, neutrophils 37.5, 36.7 (64.0)%, macrophages 58.8, 60.8 (86.1)%, lymphocytes 1.0, 0.5 (2.6)%, metachromatic cells 0.0, 0.0 (0.04)%, and bronchial epithelial cells 1.6, 0.3 (4.4)%, respectively. Female gender and atopy were associated with a significant elevation of eosinophils; mean difference between male/female was 0.3% (p = 0.043) and between atopic/nonatopic 0.4% (p = 0.024). This study has identified reference values for total and differential cell counts in Induced Sputum of healthy adults.
Vera M Keatings - One of the best experts on this subject based on the ideXlab platform.
-
cellular profiles in asthmatic airways a comparison of Induced Sputum bronchial washings and bronchoalveolar lavage fluid
Thorax, 1997Co-Authors: Vera M Keatings, David J Evans, B J Oconnor, P J BarnesAbstract:BACKGROUND: Analysis of bronchoalveolar lavage fluid has improved our understanding of the pathogenesis of asthma. Safety issues and access to expert resources limit this techniques as a research tool. Induced Sputum is a non-invasive method of collecting airway fluid which is applicable to subjects with a range of severity of airflow obstruction. The method of Sputum collection and processing differs between groups. A study was undertaken to compare Induced Sputum with bronchoscopically collected fluid. METHODS: Sixteen patients with mild stable asthma underwent both Sputum induction and bronchoscopic examination with bronchial washings and bronchoalveolar lavage (BAL) in random order, with each procedure being separated by an interval of 12 days. Airway fluid was processed and stained for differential cell counting. RESULTS: Induced Sputum was relatively rich in neutrophils and eosinophils compared with bronchial washings and BAL fluid (mean (SE) 1.3 (0.4)%, 5.0 (2.7)%, and 36.4 (3.7)% neutrophils and 0.6 (0.1)%, 1.6 (0.6)%, and 3.3 (1.1)% eosinophils in BAL fluid, bronchial washings, and Induced Sputum, respectively). The proportions of cells obtained at Sputum induction correlated with those in bronchial washings but not BAL fluid (r = 0.6 and 0.7 for neutrophils and eosinophils, respectively, p < 0.05). By contrast, Induced Sputum had a lower proportion of lymphocytes and macrophages than bronchial washings or BAL fluid, without any correlation. CONCLUSION: Induced Sputum is rich in neutrophils and eosinophils and poor in lymphocytes, suggesting an origin in the larger airways. Induced Sputum adequately reflects the findings in fluid collected by direct bronchoscopy.
-
granulocyte activation markers in Induced Sputum comparison between chronic obstructive pulmonary disease asthma and normal subjects
American Journal of Respiratory and Critical Care Medicine, 1997Co-Authors: Vera M Keatings, Peter J BarnesAbstract:Airway inflammation is present in asthma and is thought to play a significant part in the development of airflow obstruction. In chronic obstructive pulmonary disease (COPD), neutrophilic inflammation is present in the airway lumen, whereas the submucosa displays a lymphocytic infiltrate. Less is known about the nature and mechanisms of inflammation in COPD than in asthma. Induced Sputum allows noninvasive sampling of respiratory tract secretions from patients and control subjects, allowing characterization of cells and measurement of soluble markers. We exploited this technique in order to compare the presence and quantify specific markers of eosinophil and neutrophil activation in subjects with asthma or COPD, and control subjects. Differential cell counts showed significantly higher neutrophil percentages in the patients with COPD compared with other groups, while patients with asthma had higher numbers of eosinophils. The neutrophil markers myeloperoxidase (MPO), from primary granules in neutrophils, ...
-
granulocyte activation markers in Induced Sputum comparison between chronic obstructive pulmonary disease asthma and normal subjects
American Journal of Respiratory and Critical Care Medicine, 1997Co-Authors: Vera M Keatings, Peter J BarnesAbstract:Airway inflammation is present in asthma and is thought to play a significant part in the development of airflow obstruction. In chronic obstructive pulmonary disease (COPD), neutrophilic inflammation is present in the airway lumen, whereas the submucosa displays a lymphocytic infiltrate. Less is known about the nature and mechanisms of inflammation in COPD than in asthma. Induced Sputum allows noninvasive sampling of respiratory tract secretions from patients and control subjects, allowing characterization of cells and measurement of soluble markers. We exploited this technique in order to compare the presence and quantify specific markers of eosinophil and neutrophil activation in subjects with asthma or COPD, and control subjects. Differential cell counts showed significantly higher neutrophil percentages in the patients with COPD compared with other groups, while patients with asthma had higher numbers of eosinophils. The neutrophil markers myeloperoxidase (MPO), from primary granules in neutrophils, and human neutrophil lipocalin (HNL), released from secondary granules, were elevated in patients with asthma and COPD compared with control subjects but markedly more so in COPD. The difference between COPD and asthma was more marked for HNL than for MPO suggesting that HNL may be a better marker for discriminating between these conditions. Concentrations of the eosinophil granule protein, eosinophil cationic protein (ECP), and the eosinophil granule-derived enzyme, eosinophil peroxidase (EPO) were raised in the patients with asthma and those with COPD.
-
differences in interleukin 8 and tumor necrosis factor alpha in Induced Sputum from patients with chronic obstructive pulmonary disease or asthma
American Journal of Respiratory and Critical Care Medicine, 1996Co-Authors: Vera M Keatings, Paul D Collins, Denise M Scott, Peter J BarnesAbstract:Asthma and chronic obstructive pulmonary disease are characterized by chronic airway inflammation. Studies using bronchoalveolar lavage (BAL) have shown an increased proportion of eosinophils in the BAL fluid from asthmatics compared with that from normal subjects, whereas studies of chronic obstructive pulmonary disease (COPD) have shown increased numbers of neutrophils. Induced Sputum allows sampling of respiratory tract secretions from patients and control subjects, providing a noninvasive method of studying airway secretions and allowing characterization of cells and measurement of soluble markers. We investigated whether Induced Sputum was a useful method of studying airway fluid from patients with moderate to severe COPD and whether it could be used to compare inflammation in this condition with that in asthma. An initial reproducibility study was undertaken. Sputum was Induced twice in 13 patients with severe COPD at a 14-d interval. Total and differential cell counts were carried out and were foun...
-
differences in interleukin 8 and tumor necrosis factor alpha in Induced Sputum from patients with chronic obstructive pulmonary disease or asthma
American Journal of Respiratory and Critical Care Medicine, 1996Co-Authors: Vera M Keatings, Paul D Collins, Denise M Scott, Peter J BarnesAbstract:Asthma and chronic obstructive pulmonary disease are characterized by chronic airway inflammation. Studies using bronchoalveolar lavage (BAL) have shown an increased proportion of eosinophils in the BAL fluid from asthmatics compared with that from normal subjects, whereas studies of chronic obstructive pulmonary disease (COPD) have shown increased numbers of neutrophils. Induced Sputum allows sampling of respiratory tract secretions from patients and control subjects, providing a noninvasive method of studying airway secretions and allowing characterization of cells and measurement of soluble markers. We investigated whether Induced Sputum was a useful method of studying airway fluid from patients with moderate to severe COPD and whether it could be used to compare inflammation in this condition with that in asthma. An initial reproducibility study was undertaken. Sputum was Induced twice in 13 patients with severe COPD at a 14-d interval. Total and differential cell counts were carried out and were found to be reproducible over this period. Sputum was then Induced in 14 patients with COPD, 23 patients with asthma, 12 healthy cigarette smokers, and 16 normal nonsmoking control subjects. We found a significant increase in neutrophils and increased concentrations of tumor necrosis factor-alpha (TNF alpha) and interleukin-8 (IL-8) in the patients with COPD compared with the smoking and nonsmoking control subjects. Interleukin-8, but not TNF alpha, was significantly higher in the COPD group than in the asthmatic group. We conclude that the cytokines TNF alpha and IL-8 may be involved in the inflammation in COPD.
Peter G. Gibson - One of the best experts on this subject based on the ideXlab platform.
-
transcriptional phenotypes of asthma defined by gene expression profiling of Induced Sputum samples
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Katherine J Baines, Jodie L Simpson, Lisa Wood, Rodney J Scott, Peter G. GibsonAbstract:BACKGROUND: Previous studies have identified clinical or inflammatory phenotypes of asthma on the basis of clinical and demographic parameters or Sputum cell counts; however, few studies have defined transcriptional phenotypes of asthma. OBJECTIVE: To investigate asthma phenotypes at a transcriptional level by using gene expression profiling of Induced Sputum. METHODS: Induced Sputum samples were collected from 59 people with asthma with a mean age of 58 years and an FEV(1)% predicted of 76%, and 69% were taking inhaled corticosteroids. Thirteen healthy controls without asthma were also assessed. Inflammatory cell counts were performed, and RNA was extracted from selected Sputum. Transcriptional profiles were generated (Illumina Humanref-8 V2) and analyzed by using GeneSpring GX11. RESULTS: Unsupervised hierarchical clustering of gene expression profiles in asthma revealed 3 distinct groups. The first transcriptional phenotype (n = 21) had lower FEV(1)% predicted and higher asthma control questionnaire scores, exhaled nitric oxide, and Sputum eosinophils. The second transcriptional phenotype (n = 14) had lower FEV(1)% predicted and forced vital capacity % predicted and higher Sputum neutrophils compared with a third transcriptional phenotype (n = 24) that had higher Sputum macrophages and resembled healthy controls. Differentially expressed genes between transcriptional asthma phenotypes were related to inflammatory and immune responses. Genes in the IL-1 and TNF-α/nuclear factor-κB pathways were overexpressed and correlated with clinical parameters and neutrophilic airway inflammation. CONCLUSION: Gene expression profiling provides a novel means to investigate the molecular mechanisms and classifications of asthma phenotypes. There are 3 distinct transcriptional phenotypes of asthma that relate to both clinical and inflammatory parameters.
-
inflammatory subtypes in asthma assessment and identification using Induced Sputum
Respirology, 2006Co-Authors: Jodie L Simpson, Rodney J Scott, Michael J Boyle, Peter G. GibsonAbstract:Objective: The authors sought to investigate the detection of non-eosinophilic asthma using Induced Sputum. Although this is an important subtype of clinical asthma, its recognition is not standardized. Methods: Adult non-smokers with asthma and healthy controls underwent Sputum induction and hypertonic saline challenge. Non-eosinophilic asthma was defined as symptomatic asthma with normal Sputum eosinophil counts. The normal range for Sputum eosinophil count was determined using the 95th percentile from the healthy control group as a cut-off point. Results: The recognition of non-eosinophilic asthma using eosinophil proportion was in agreement with a definition based on absolute eosinophil count (kappa 0.67). Non-eosinophilic asthma was a stable subtype over both the short term (4 weeks) and longer term (5 years, kappa 0.77). Airway inflammation in asthma could be categorized into four inflammatory subtypes based on Sputum eosinophil and neutrophil proportions. These subtypes were neutrophilic asthma, eosinophilic asthma, mixed granulocytic asthma and paucigranulocytic asthma. Subjects with increased neutrophils (neutrophilic asthma and mixed granulocytic asthma) were older and had an increased total cell count and cell viability compared with other subtypes. Conclusion: Induced Sputum eosinophil proportion is a good discriminator for eosinophilic asthma, providing a reproducible definition of a homogenous group. The remaining non-eosinophilic subjects are heterogeneous and can be further classified based on the presence of neutrophils. These inflammatory subtypes have important implications for the investigation and characterization of airway inflammation in asthma.
-
Induced Sputum 8 isoprostane concentrations in inflammatory airway diseases
American Journal of Respiratory and Critical Care Medicine, 2005Co-Authors: Lisa Wood, Jodie L Simpson, Manohar L Garg, Trevor A Mori, Kevin D Croft, Peter A B Wark, Peter G. GibsonAbstract:Induced Sputum 8-iso-prostaglandin F2α (PGF2α) concentrations may be a useful marker of oxidative stress in airways disease. This study examines oxidative stress (measured by 8-iso-PGF2α) in airway disease according to disease type (asthma and bronchiectasis), disease activity (stable and acute asthma), and disease pattern (intermittent, mild, moderate, and severe persistent asthma). We compared subjects with stable asthma (n = 71) and bronchiectasis (n = 23) with healthy control subjects (n = 29). Another group of patients with asthma (n = 39) were assessed during and after acute exacerbation. Induced Sputum 8-iso-PGF2α concentrations were validated and found to be elevated in subjects with stable asthma and bronchiectasis versus control subjects (median [interquartile range] 216 [103–389] and 698 [264–1,613] ng/L vs. 123 [41–290] ng/L, p < 0.001) and increased as clinical asthma pattern worsened (intermittent 115 [42–153], mild persistent 116 [89–229] ng/L, moderate persistent 183 [110–317] ng/L, severe...
-
noninvasive assessment of airway inflammation in children Induced Sputum exhaled nitric oxide and breath condensate
European Respiratory Journal, 2000Co-Authors: Peter G. Gibson, R L Henry, Paul S ThomasAbstract:Noninvasive markers of airway inflammation are needed for use in research and clinical practice in childhood asthma. Induced Sputum and exhaled nitric oxide are well established as direct markers of inflammation for use in asthma research. Sputum can be Induced from children of >6 yrs using inhalation of hypertonic saline, and, if appropriate, can be combined with an assessment of airway responsiveness to hypertonic saline. The success rate of Sputum induction in children is 68-100%. Most studies have processed Sputum using the plug selection method, and show that the dominant cell in Sputum from normal children is the macrophage, and that the upper normal limit for Sputum eosinophils in children is 2.5%. The inflammatory response in childhood asthma is characterized by elevated numbers of Sputum eosinophils, and eosinophil cationic protein concentration, as well as increased nitric oxide and hydrogen peroxide levels in exhaled breath. Sputum eosinophils correlate with objective markers of disease severity in steroid-naive children with asthma, and in severe asthma. Inflammatory marker levels are lower in children using glucocorticosteroids. Induced Sputum and exhaled gases are important markers of inflammation in childhood asthma. The clinical utility of these markers warrants further study.
-
use of Induced Sputum cell counts to investigate airway inflammation in asthma
Thorax, 1992Co-Authors: Peter G. Gibson, Frederick E Hargreave, R Kolendowicz, Adele Girgisgabardo, Judah A Denburg, J DolovichAbstract:BACKGROUND: Airway inflammation is considered to be important in asthma but is relatively inaccessible to study. Less invasive methods of obtaining Sputum from patients unable to produce it spontaneously should provide a useful investigational tool in asthma. METHODS: A method to induce Sputum with inhaled hypertonic saline was modified for use in 17 asthmatic patients and 17 normal subjects who could not produce Sputum spontaneously. The success rate and safety of the method, the reproducibility of cell counts, and differences in cell counts between the asthmatic and normal groups were examined. Hypertonic saline solution 3-5% was inhaled for up to 30 minutes after inhalation of salbutamol. Subjects were asked to expectorate Sputum every five minutes. The quality of the sample was scored on the volume of plugs and the extent of salivary contamination. Plugs from the lower respiratory tract were selected for a total cell count and for differential cell counts of eosinophils and metachromatic cells (mast cells and basophils) in direct smears. RESULTS: Adequate samples from the lower respiratory tract were obtained in 76% of first attempts. The mean fall in the forced expiratory volume in one second (FEV1) during inhalation of saline was 5.3% and the maximum fall 20%. Eosinophil and metachromatic cell counts were reproducible (reliability coefficient 0.8 and 0.7 respectively). When compared with Sputum from normal subjects Sputum from asthmatic patients contained a significantly higher proportion of eosinophils (mean 18.5% (SE 3.8%) v 1.9% (0.6%)) and metachromatic cells (0.50% (0.18%) v 0.039% (0.014%)). In the asthmatic group the differential eosinophil count correlated with the baseline FEV1. CONCLUSION: Induced Sputum is capable of detecting differences in cell counts between normal and asthmatic subjects and merits further development as a potential means of assessing airway inflammation in asthma.
Jadwiga A. Wedzicha - One of the best experts on this subject based on the ideXlab platform.
-
detection of rhinovirus in Induced Sputum at exacerbation of chronic obstructive pulmonary disease
European Respiratory Journal, 2000Co-Authors: Terence Seemungal, R Harperowen, A Bhowmik, Donald J. Jeffries, Jadwiga A. WedzichaAbstract:Common colds are associated with exacerbations of chronic obstructive pulmonary disease (COPD). However, the role of the common cold virus (human rhinovirus) in the production of symptoms and lower airway inflammation at COPD exacerbation is unknown. Thirty three patients with moderate-to-severe COPD were seen at baseline, when the number of chest infections in the previous year was noted, and acutely at COPD exacerbation. Within 48 h after the onset of the exacerbation and at baseline, nasal aspirates and Induced Sputum were taken for rhinovirus reverse transcriptase polymerase chain reaction (RT-PCR) analysis and determination of cytokine levels. Symptoms, recorded on diary cards, were noted and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) measured. At exacerbation, mean FEV1 and FVC fell significantly from baseline (p<0.001). Ten of 43 exacerbations were associated with rhinovirus infection, detected in Induced Sputum. In four of these, nasopharyngeal samples contained no detectable rhinovirus. All baseline samples were negative for rhinovirus. The simultaneous presence of increased nasal discharge/nasal congestion (in 26 of the 43 exacerbations) and increased Sputum (29 exacerbations) was strongly associated with the presence of rhinovirus (odds ratio 6.15; p=0.036). Total symptom scores were greater for rhinovirus as compared to nonrhinovirus exacerbations (p=0.039). Median baseline Sputum interleukin-6 levels rose from 90.2 to 140.3 pg x mL(-1) at exacerbation (p=0.005); the change was greater in the presence of rhinovirus infection (p=0.008). Rhinovirus infection can be detected at chronic obstructive pulmonary disease exacerbation. This is associated with elevation of lower airway interleukin-6 levels, which may mediate lower airway symptom expression during chronic obstructive pulmonary disease exacerbations.
-
comparison of spontaneous and Induced Sputum for investigation of airway inflammation in chronic obstructive pulmonary disease
Thorax, 1998Co-Authors: A Bhowmik, Terence Seemungal, R J Sapsford, J L Devalia, Jadwiga A. WedzichaAbstract:BACKGROUND—Although Sputum induction is used as a technique to investigate lower airway inflammation in asthmatic subjects, advantages over spontaneous Sputum in patients with chronic obstructive pulmonary disease (COPD) have not been investigated. METHODS—Samples of spontaneous Sputum and Sputum Induced with 3% hypertonic saline for 14 minutes were collected from 27 patients with chronic obstructive pulmonary disease (COPD) who usually produced spontaneous Sputum. Spirometric indices and oxygen saturation (SaO2) were measured at seven minute intervals. The spontaneous, seven and 14 minute Sputum samples were analysed for total and differential cell counts, cell viability, and interleukin 8levels. RESULTS—Analysis of the Sputum revealed that median cell viability was higher in the seven minute (62.8%; p = 0.004) and 14 minute (65%; p = 0.001) Induced Sputum samples than in spontaneous Sputum (41.2%). There was no significant difference in total and differential cell counts or in interleukin 8 levels between spontaneous and Induced Sputum. During the Sputum induction procedure the mean (SD) fall in forced expiratory volume in one second (FEV1) was 0.098 (0.111) l (p < 0.001) and in forced vital capacity (FVC) was 0.247 (0.233) l (p < 0.001). There was a small but significant fall in SaO2 during Sputum induction (p = 0.03). CONCLUSIONS—Induced Sputum contains a higher proportion of viable cells than spontaneous Sputum. There are no significant differences between the Sputum samples obtained at seven minutes and at 14minutes of hypertonic saline nebulisation. Sputum induction is safe and well tolerated in patients with COPD.