医学
哮喘
痰
嗜酸性粒细胞
嗜酸性
免疫学
嗜酸性阳离子蛋白
内科学
病理
肺结核
作者
Jodie L. Simpson,Rodney J. Scott,Michael J. Boyle,Peter G. Gibson
出处
期刊:Respirology
[Wiley]
日期:2006-01-01
卷期号:11 (1): 54-61
被引量:790
标识
DOI:10.1111/j.1440-1843.2006.00784.x
摘要
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.
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