Thorax 1998;53:1047-1052 ( December )

Inflammatory response after inhalation of bacterial endotoxin assessed by the induced sputum technique

Jörgen Thorn, Ragnar Rylander

Department of Environmental Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden

Correspondence to: Professor R Rylander.

Received 16 March 1998; Returned to authors 8 May 1998; Revised version received 12 August 1998; Accepted for publication 20 August 1998

BACKGROUNDOrganic dusts may cause inflammation in the airways. This study was performed to assess the usefulness of the induced sputum technique for evaluating the presence of airways inflammation using inhaled endotoxin (lipopolysaccharide) as the inducer of inflammation.
METHODSTo characterise the inflammatory response after inhalation of endotoxin, 21 healthy subjects inhaled 40 µg lipopolysaccharide and were examined before and 24 hours after exposure. Examinations consisted of a questionnaire for symptoms, spirometric testing, blood sampling, and collection of induced sputum using hypertonic saline. Eleven of the subjects inhaled hypertonic saline without endotoxin exposure as controls. Cell counts, eosinophilic cationic protein (ECP), and myeloperoxidase (MPO) were determined in blood and sputum.
RESULTSA significantly higher proportion of subjects reported respiratory and general symptoms after endotoxin inhalation. MPO and the number of neutrophils in the blood were higher and spirometric values were decreased after the lipopolysaccharide challenge. In the sputum MPO, ECP, and the numbers of neutrophils and lymphocytes were higher after the lipopolysaccharide challenge. No significant differences were found after the inhalation of hypertonic saline compared with before, except for a significantly lower number of lymphocytes in the sputum.
CONCLUSIONSThe results support previous studies that inhaled endotoxin causes an inflammation at the exposure site itself, as well as general effects. Sampling of sputum seems to be a useful tool for assessing the presence of airways inflammation, and the inhalation of hypertonic saline used to induce sputum did not significantly interfere with the results found after inhalation of lipopolysaccharide.

Keywords: endotoxin; airways inflammation; inflammatory markers

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© 1998 by Thorax
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