Chest
Clinical InvestigationsASTHMAHeterogeneity of Airway Inflammation in Persistent Asthma: Evidence of Neutrophilic Inflammation and Increased Sputum Interleukin-8
Section snippets
Subjects
Nonsmoking adults with persistent symptomatic asthma and healthy control subjects were recruited from the Respiratory Outpatient Clinic of the John Hunter Hospital and by advertisement (control subjects). Subjects were identified from a list of consecutive attendances to the respiratory clinic and were assessed for participation in this study. We screened 78 subjects with a diagnosis of asthma receiving high-dose inhaled corticosteroids, and identified 56 subjects who met the inclusion
Results
The 56 subjects with persistent asthma (Table 1) reported a long history of asthma and were receiving high-dose inhaled corticosteroids. Eleven subjects (20%) had mild persistent asthma, 26 subjects (46%) had moderate persistent asthma, and 19 subjects (34%) had severe persistent asthma. The subjects with severe persistent asthma were older with more severe airway obstruction and more severe airway hyperresponsiveness (p < 0.05). The eight control subjects (one male subject) were aged 35 years
Discussion
This study has confirmed that there is heterogeneity of airway inflammation in persistent asthma and identified evidence of neutrophilic inflammation and IL-8 secretion in noneosinophilic asthma. Using induced sputum, we could identify two distinct patterns of airway inflammation. The first pattern was a typical eosinophilic inflammation, where the percentage of eosinophils was increased and there was eosinophil degranulation with elevated ECP. Most subjects, however, had persistent symptoms
ACKNOWLEDGMENT
We thank H. Burgess, K. Fakes, N. Timmins, and A. Wilson for their technical assistance, and G. Sheather for preparation of the article.
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