Shin Bomi, Kwon Hyouk-Soo, Park So Young, Kim Tae-Bum, Moon Hee-Bom, Cho You Sook
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Asia Pac Allergy. 2017 Jan;7(1):19-28. doi: 10.5415/apallergy.2017.7.1.19. Epub 2017 Jan 26.
The sputum inflammatory cell profile is an important indicator for classifying asthma phenotypes.
To investigate if sputum inflammatory cell profile remains stable and there are different characteristics between groups that show different profile over time in stable asthmatic patients.
A total of 149 asthmatic patients, who were clinically stable at the time of sputum examination and had undergone sputum analysis twice, were subjected to a detailed review. Eosinophilic inflammation was diagnosed when the proportion of the sputum eosinophils was >3%. We divided the patients into 4 groups according to the transition patterns of their sputum profiles: group 1, persistent eosinophilia; group 2, eosinophilic to noneosinophilic; group 3, noneosinophilic to eosinophilic; and group 4, persistent noneosinophilia. The results of the pulmonary function tests and other clinical parameters were compared between these 4 groups.
Thirty-four of the initially eosinophilic asthmatic patients (39.5%; 34 of 86 patients) demonstrated noneosinophilic airway inflammation at their second sputum examination, and 24 of the initially noneosinophilic patients (38.1%; 24 of 63 patients) demonstrated eosinophilic airway inflammation at follow-up. Various clinical parameters, except the blood eosinophil count, demonstrated no significant differences between the eosinophilic and noneosinophilic asthmatic patients or among the 4 groups.
A substantial proportion of asthmatic patients who demonstrate a certain sputum inflammatory cell profile at the initial examination demonstrated profile transition in clinically stable settings over time. The clinical significance of using induced sputum analysis to phenotype stable asthmatic patients requires further evaluation.
痰液炎症细胞谱是哮喘表型分类的重要指标。
研究稳定期哮喘患者痰液炎症细胞谱是否保持稳定，以及不同时间呈现不同谱型的组间是否存在不同特征。
对149例哮喘患者进行详细回顾，这些患者在痰液检查时临床稳定且进行了两次痰液分析。当痰液嗜酸性粒细胞比例>3%时诊断为嗜酸性粒细胞炎症。根据痰液谱型的转变模式将患者分为4组：第1组，持续性嗜酸性粒细胞增多；第2组，嗜酸性粒细胞性转变为非嗜酸性粒细胞性；第3组，非嗜酸性粒细胞性转变为嗜酸性粒细胞性；第4组，持续性非嗜酸性粒细胞增多。比较这4组的肺功能测试结果和其他临床参数。
最初为嗜酸性粒细胞性哮喘的患者中有34例（39.5%；86例中的34例）在第二次痰液检查时表现为非嗜酸性粒细胞性气道炎症，最初为非嗜酸性粒细胞性的患者中有24例（38.1%；63例中的24例）在随访时表现为嗜酸性粒细胞性气道炎症。除血嗜酸性粒细胞计数外，各种临床参数在嗜酸性粒细胞性和非嗜酸性粒细胞性哮喘患者之间或4组之间均无显著差异。
相当一部分在初次检查时表现出特定痰液炎症细胞谱的哮喘患者在临床稳定的情况下随时间出现谱型转变。使用诱导痰液分析对稳定期哮喘患者进行表型分析的临床意义需要进一步评估。
