Distribution of sputum cellular phenotype in a large asthma cohort: predicting factors for eosinophilic vs neutrophilic inflammation

BMC Pulmonary Medicine

Renaud Louis²  Laurence Seidel¹  Monique Henket²  Jocelyne Sele²  Maité Manise²  Florence N Schleich² 

[1] Medical Informatics and Biostatistics, University of Liege, Liege, Belgium;Department of Respiratory Medicine, CHU Sart-Tilman B35, Liege 4000, Belgium

关键词: Neutrophil;    Eosinophil;    Induced sputum;    Asthma;   

Others  :  1131287
DOI  :  10.1186/1471-2466-13-11

 received in 2012-09-13, accepted in 2013-02-22,  发布年份 2013

【 摘 要 】

Background

Phenotyping asthma according to airway inflammation allows identification of responders to targeted therapy. Induced sputum is technically demanding. We aimed to identify predictors of sputum inflammatory phenotypes according to easily available clinical characteristics.

Methods

This retrospective study was conducted in 508 asthmatics with successful sputum induction recruited from the University Asthma Clinic of Liege. Receiver-operating characteristic (ROC) curve and multiple logistic regression analysis were used to assess the relationship between sputum eosinophil or neutrophil count and a set of covariates. Equations predicting sputum eosinophils and neutrophils were then validated in an independent group of asthmatics.

Results

Eosinophilic (≥3%) and neutrophilic (≥76%) airway inflammation were observed in 46% and 18% of patients respectively. Predictors of sputum eosinophilia ≥3% were high blood eosinophils, FE_NO and IgE level and low FEV₁/FVC. The derived equation was validated with a Cohen’s kappa coefficient of 0.59 (p < 0.0001). ROC curves showed a cut-off value of 220/mm³ (AUC = 0.79, p < 0.0001) or 3% (AUC = 0.81, p < 0.0001) for blood eosinophils to identify sputum eosinophilia ≥3%. Independent predictors of sputum neutrophilia were advanced age and high FRC but not blood neutrophil count.

Conclusion

Eosinophilic and paucigranulocytic asthma are the dominant inflammatory phenotypes. Blood eosinophils provide a practical alternative to predict sputum eosinophilia but sputum neutrophil count is poorly related to blood neutrophils.

【 授权许可】

   
2013 Schleich et al; licensee BioMed Central Ltd.

【 图 表 】

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