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

Abstract

Background-Examination of sputum provides a direct non-invasive method to investigate airway inflammation. The aim of this study was to investigate changes in sputum cell counts between acute exacerbations of asthma, and the relation of this to current asthma severity.
Methods -In this study, 72 children between 5-17 years old, all diagnosed with mild to moderate athopic asthma, underwent sputum induction using inhaled nebulised hypertonic saline, in concentration of 2; 3 and 4.5%, 10 minutes each. All the children repeated the procedure within one month, being there own controls. Functional monitoring was made by PEF and FEV1 before and after the inhalation of hypertonic saline aerosol. Differential cell counts of induced sputum were determined on May-Grunwald-Giemsa and Field stained cytospins.
Results-The mean decreasing in PEF and FEV₁ reported to the base value during sputum induction was 4.5% (PEF) and 4.8%(FEV₁) during the first visit, and 3.1% (PEF) and 3.4%(FEV₁) after one month . A satisfactory sample (>500 non-squamous cells) was obtained in 48 children (66.6%) at an average age of 9.2 years.
Despite a median of 27.8% (at the first visit) and 50.6% (at the second consultation) squamous cells, significant differences were found between the two visits for the eosinophil differential count (p=0.001) and neutrophil differential count(p= 0.003).There was only a weak correlation in FEV₁ and PEF between those with eosinophils in sputum and those with none(p=0.03)
Conclusions-Sputum induction did not have any undesired effect with the patients. It is only possible in a certain proportion of the children. Sputum cytological analysis in asthmatic children proves to be accessible, cheap and safe.

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Citations should be made in the following way:
I. P. Sosa, M. Nanulescu (Cluj-Napoca, Romania). Induced sputum in children with mild-to-moderate atopic asthma. Eur Respir J 2002; 20: Suppl. 38, 931

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