Source: Annual Congress 2002 - The role of inflammatory markers in children with asthma
Disease area: Airway diseases

Abstract

BACKGROUND: Bronchial inflammation plays a central role in asthma and eosinophils are known to be the main effector cells. Immunoglobulin A ( IgA) plays an essential role in local defence mechanism and α-1-antitrypsin is the main inhibitor of elastase, reliased from neutrophils. OBJECTIVE: The aim of this study was to describe the characteristics of airway inflammation in children with an acute asthma exacerbation and to evaluate the possible disbalance in the local defence mechanism using sputum cell count and fluid-phase measurements. METHODS: Sputum was obtained from forty children aged 6 to 13 years presenting to the Emergency Department with acute asthma (18 expectorated spontaneously and 22 underwent sputum induction). Twenty healthy children serve as controls. Sputum portions were selected, dispersed and total and differential cell counts were performed. Immunoglobulin isotypes ( IgG, IgM, IgA) and α-1-antitrypsin were measured in sputum supernatant. RESULTS: Neutrophils were found to be the prominent cell type (55,5%) during asthma exacerbation, whereas significant eosinophilia (>= 5 %) was found in 13 children (32,5%). No significant correlation between serum and sputum eosinophil count was found (rs=-0,35). Both in healthy and children with asthma IgA was the predominant immunoglobulin in the lower respiratory tract, followed by IgG and IgM. In patients with asthma the levels of IgA, IgG, IgM and α-1-antitrypsin in sputum were significantly elevated when compared to controls (P < 0.05). CONCLUSION: We found two different types of airway inflammation in children with acute asthma: neutrophilic and combined eosinophilic- neutrophilic infiltration and they may require different treatment strategies.

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Citations should be made in the following way:
I. Tzotcheva, I. Kalev, T. Popov (Sofia, Bulgaria). The use of sputum differential cell counts and soluble phase measurements to assess airway inflammation in children with asthma exacerbation. Eur Respir J 2002; 20: Suppl. 38, 926

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