Prominent neutrophilic inflammation in sputum from subjects with asthma exacerbation☆,☆☆,★,★★
Section snippets
Subjects with asthma
Patients who had acute severe asthma diagnosed by emergency room physicians at San Francisco General Hospital and at Moffitt-Long Hospital at the University of California, San Francisco (UCSF) were invited to provide a sample of sputum and to complete a medical questionnaire. The medical questionnaire inquired about asthma history, asthma medications, concomitant illnesses (including allergies), history of cigarette smoking, events that triggered the current asthma attack, and the length of
RESULTS
We found that neutrophils rather than eosinophils were more frequently the predominant cell in sputum from patients with acute severe asthma (Table III, Fig. 1). Neutrophils made up more than 75% of the nonsquamous cells in 10 samples and constituted more than 90% of cells in five samples. Eosinophils made up more than 75% of the nonsquamous cells in only three samples but were identifiable in all asthmatic sputum samples at lower percentages. Eight of the 16 subjects with asthma (50%) who
DISCUSSION
In this study we analyzed the cellular and biochemical constituents of sputum from acutely ill subjects with asthma and compared the findings with those from analysis of sputum from patients with CF. Our main findings are that the predominant inflammatory cell in sputum from acutely ill subjects with asthma is more frequently the neutrophil than the eosinophil and that asthmatic sputum is also characterized by relatively high levels of DNA, albumin, and MLG. The pathophysiologic mechanisms
Acknowledgements
We thank Carol Basbaum, PhD, and Walter Finkbeiner, MD for providing us with the A10G5 monoclonal antibody, and Alan Gelb, MD; Susan K. Ulrich, MS, RN; and Virginia Hill, RN, for assistance in the collection of sputum samples and characterization of the subjects.
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From the aDepartment of Medicine and the bCardiovascular Research Institute, University of California, San Francisco.
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Supported by Program Project grant HL 24136 from the National Institutes of Health and by NRSA grant HL07185 (J.V.F.).
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Reprint requests: John V. Fahy, MD, Box 0130, University of California, San Francisco, 505 Parnassus Ave., San Francisco, CA 94143,
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