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Chronic obstructive pulmonary disease: airways and systemic features
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P152 SPUTUM IL-5 CONCENTRATION IS ASSOCIATED WITH A SPUTUM EOSINOPHILIA AND ATTENUATED BY CORTICOSTEROID THERAPY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

1M Bafadhel, 1S Saha, 1R Siva, 2M McCormick, 1W Monterio, 2P Rugman, 2P Dodson, 1ID Pavord, 2P Newbold, 1CE Brightling. 1Institute of Lung Health, Leicester, UK, 2AstraZeneca R&D, Charnwood, Loughborough, UK

Background: Airway inflammation in chronic obstructive pulmonary disease (COPD) is predominantly neutrophilic, but some subjects demonstrate eosinophilic airway inflammation. Whether these inflammatory phenotypes have differential cytokine and chemokine expression is unknown.

Aims: To assess the sputum concentrations of cytokines and chemokines and their response to oral corticosteroid therapy in COPD subjects with or without a sputum eosinophilia.

Methods: Cytokine and chemokine concentrations were measured using the mesoscale device platform. To assess validity recovery of exogenous spikes was examined. The concentrations of the validated mediators were measured in COPD sputum from subjects with or without a sputum eosinophilia. In a subgroup with a sputum eosinophilia the response to prednisolone 10 mg for 1 month was examined.

Results: The recovery in sputum of exogenous spiked mediators was >80% in 17/26 cytokines and chemokines. In supernatants from eosinophilic (n  =  39) versus non-eosinophilic (n  =  59) sputa the geometric mean (95% CI) concentration was increased for IL-5 (9.0, 4.5 to 18 pg/ml vs 3.6, 2.7 to 6.3 pg/ml; p = 0.03) and CCL26 (23.4, 10.8 to 19.8 pg/ml vs 9.0, 5.4 to 16.2 pg/ml; p = 0.04). IL-5 correlated with sputum eosinophil counts (R2  =  0.11, p = 0.001) and was attenuated following treatment with prednisolone (n  =  9; mean difference 2.3 pg/ml (95% CI 0.2 to 4.3; p = 0.03).

Conclusion: We have validated the use of the mesoscale device platform for cytokine and chemokine measurements in the sputum supernatants in COPD. Sputum IL-5 was associated with a sputum eosinophilia. Whether this cytokine is important in the pathogenesis of COPD in a subgroup of patients warrants …

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