Thorax 64:671-676 doi:10.1136/thx.2008.108290
  • Airway biology

Granulocyte–macrophage colony-stimulating factor expression in induced sputum and bronchial mucosa in asthma and COPD

Open Access
  1. C E Brightling1
  1. 1Institute of Lung Health, Leicester, UK
  2. 2MedImmune Ltd, Milstein Building, Granta Park, Cambridge, UK
  1. Professor C E Brightling, Institute for Lung Health, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK; ceb17{at}
  • Received 20 September 2008
  • Accepted 21 January 2009
  • Published Online First 12 February 2009


Background: Granulocyte–macrophage colony-stimulating factor (GM-CSF) has been implicated as an important mediator in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). However, the expression of GM-CSF and its receptor in airway samples in asthma and COPD across disease severity needs to be further defined.

Methods: Sputum GM-CSF was measured in 18 control subjects, 45 subjects with asthma and 47 subjects with COPD. Enumeration of GM-CSF+ cells in the bronchial submucosa and airway smooth muscle bundle was performed in 29 control subjects, 36 subjects with asthma and 10 subjects with COPD.

Results: The proportion of subjects with measurable GM-CSF in the sputum was raised in those with moderate (7/14) and severe (11/18) asthma, and in those with COPD GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage II (7/16), III (8/17) and IV (7/14) compared with controls (1/18) and those with mild asthma (0/13); p = 0.001. The sputum GM-CSF concentration was correlated with the sputum eosinophilia in subjects with moderate to severe asthma (rs = 0.41; p = 0.018). The median (interquartile range) GM-CSF+ and GM-CSFR+ cells/mm2 of submucosa was increased in severe asthma (1.4 (3.0) and 2.1 (8.4)) compared with those with mild to moderate asthma (0 (2.5) and 1.1 (5)) and healthy controls (0 (0.5) and 0 (1.6)), (p = 0.004 and p = 0.02, respectively).

Conclusions: The findings support a potential role for GM-CSF in asthma and COPD and suggest that overexpression of GM-CSF in sputum and the bronchial mucosa is a particular feature of severe asthma.


  • Competing interests: Declared. CB has received research funding from AstraZeneca, MedImmune and GlaxoSmithKline, and consultancy fees from MedImmune and GlaxoSmithKline. MS and ESC are employees of MedImmune.

  • Funding: Asthma UK, MedImmune, DOH Clinical Scientist award (CB) and Wellcome Senior Clinical Fellowship (CB).

  • Ethics approval: The study was approved by the Leicestershire ethics committee.