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Am. J. Respir. Crit. Care Med., Volume 161, Number 1, January 2000, 9-16

The Relationship between Airways Inflammation and Asthma Severity

RENAUD LOUIS, LAURIE C. K. LAU, ADRIAAN O. BRON, ALBERT C. ROLDAAN, MAURICE RADERMECKER, and RATKO DJUKANOVIC

University of Southampton, Southampton, United Kingdom; Dutch Asthma Center, Davos, Switzerland; and University of Liege, Leige, Belgium

In order to investigate the relationship between airways inflammation and disease severity, and improve the understanding of persistent asthma, 74 asthmatics, with disease severity ranging from intermittent, to mild to moderate and severe persistent (classified according to the Global Initiative for Asthma [GINA] guidelines), and 22 nonatopic control subjects were studied using the method of induced sputum. Sputum was analyzed for total and differential cell counts concentrations of albumin, and levels of eosinophil cationic protein (ECP), myeloperoxidase (MPO), and tryptase, inflammatory mediators reflecting eosinophil, neutrophil, and mast cell activation. Asthma severity (assessed by FEV1, peak expiratory flow [PEF] variability, and daily symptom scores) and methacholine airways responsiveness were related to sputum eosinophilia and ECP. In addition, sputum neutrophilia and MPO levels correlated, albeit weakly, with PEF variability and symptom scores, respectively. Tryptase concentrations were raised in mild to moderate asthmatics. Albumin concentrations were significantly raised across the spectrum of asthma severity and correlated with those of tryptase and ECP. Despite treatment with either high doses of inhaled corticosteroids or oral corticosteroids, prominent eosinophilic inflammation with raised ECP was noted. This study points to persistent, disease severity-related airways inflammation in asthma, involving eosinophils, mast cells, and neutrophils, which is evident despite treatment with corticosteroids. Louis R, Lau LCK, Bron AO, Roldaan AC, Radermecker M, Djukanovic'R. The relationship between airways inflammation and asthma severity.




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K. OSHIKAWA, K. KUROIWA, K. TAGO, H. IWAHANA, K. YANAGISAWA, S. OHNO, S.-I. TOMINAGA, and Y. SUGIYAMA
Elevated Soluble ST2 Protein Levels in Sera of Patients with Asthma with an Acute Exacerbation
Am. J. Respir. Crit. Care Med., July 15, 2001; 164(2): 277 - 281.
[Abstract] [Full Text] [PDF]

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 ChestHome page
P. G. Gibson, J. L. Simpson, and N. Saltos
Heterogeneity of Airway Inflammation in Persistent Asthma : Evidence of Neutrophilic Inflammation and Increased Sputum Interleukin-8
Chest, May 1, 2001; 119(5): 1329 - 1336.
[Abstract] [Full Text] [PDF]

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 ChestHome page
R. D. Grembiale, S. Naty, C. Iorio, N. Crispino, G. Pelaia, and C. M. E. Tranfa
Bronchial Asthma Induced by an Antithyroid Drug
Chest, May 1, 2001; 119(5): 1598 - 1599.
[Abstract] [Full Text] [PDF]

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 PediatricsHome page
H. Bisgaard
Leukotriene Modifiers in Pediatric Asthma Management
Pediatrics, February 1, 2001; 107(2): 381 - 390.
[Abstract] [Full Text]


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