Clinical characteristics and inflammatory cells in sputum from asthmatics with acute exacerbation

Seo, Moon Jeong; Kim, Do Jin; Jeong, Ho Suck; Park, Jin; Uh, Soo Taek; Kim, Yong Hoon; Park, Choon Sik

Abstract

BACKGROUND
irway inflammation is considered to be important to the pathophysiology of asthma. Recently, several studies suggested that the frequency of acute severe asthma and death caused by acute exacerbation was increasing and that neutrophils were predominant in some sputum from severe or fatal asthmatic patients.
OBJECTIVE
To examine clinical and physiological factors that determine the different cellular profiles in airway inflammation, we analyzed the individual characteristics of patients with acute asthma.
METHODS
We performed cellular analysis on spontaneous or induced sputum from 27 subjects with acute asthma exacerbation (PEFR<70%). They were divided into two groups: eosinophil dominant (eosinophil%>10%) (group 1) and neutrophil dominant (neutrophil 70%) (group 2). We compared the laboratory, clinical and physiological data.
RESULTS
Twenty-two cases consisted of pure acute asthmatic patients without organic changes. Their sputum contained increased eosinophils, neutrophils, or both compared with the sputum from normal subjects. The cases of group 1 were more frequent (63.6%) than group 2 (36.4%) (p=0.001). The subjects included in group 1 were younger (mean 38.5 vs 58.6 years) (p<0.05) and had fewer smoking amounts (4.5 vs 10.8 pack years) (p=0.005) than group 2. The other factors were not different significantly.
CONCLUSION
Old age and heavy smoking are important factors associated with neutrophil dominant airway inflammation in acute asthma. Further studies are needed to clarify the relationship between cellular composition, asthma severity and treatment response in asthma patients with neutrophil dominant sputum.