Kumar Roshan M, Pajanivel R, Koteeswaran G, Menon Surendra K, Charles Pravin Mv
Department of Pulmonary Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
Lung India. 2017 May-Jun;34(3):256-261. doi: 10.4103/lungindia.lungindia_73_16.
Asthma is a chronic inflammatory disorder of the airway with involvement of various cellular populations and release of many inflammatory mediators. Eosinophils and serum immunoglobulin E (IgE) are considered a good marker of airway inflammation in asthma. The correlation of clinical assessment with various markers of airway inflammation in asthma is not well established in the Indian population.
This study aims to study the correlation of serum IgE, sputum eosinophil count, and peripheral eosinophil count with clinical severity of Asthma.
This is a cross-sectional study involving 76 stable asthmatic patients of 18-60 years of age attending the pulmonary medicine OPD. Spirometry measured at baseline. Participants were categorized according to the GINA criteria based on clinical symptoms and pulmonary function test. Blood samples were collected for peripheral eosinophil count, serum IgE levels, and sputum samples for eosinophil count. All three parameters were compared with severity of asthma. The correlation of sputum eosinophil count, peripheral eosinophil count, and serum IgE with severity of asthma was analyzed by Pearson's Chi-square test, Fisher's exact test, and the correlation coefficient was reported together with standard error of the estimate.
The mean age of patients in our study was 37.42 years and 56.6% were male. There was a significant inverse correlation between serum IgE levels and predicted forced expiratory volume 1 s (FEV1). Sputum eosinophilia was significantly seen in severe persistent asthma patients (19.7%). There was a significant inverse correlation between sputum eosinophil count and predicted FEV1and forced vital capacity. We also found there was a significant association between peripheral eosinophil count, sputum eosinophil count, and elevated serum IgE (g100 IU/mL) with severe persistent asthma.
The assessment of sputum eosinophil count is simple, inexpensive, noninvasive, and direct measurement of airway inflammation. It could be the preferred method in monitoring airway inflammation and guided management in day-to-day practice.
哮喘是一种气道慢性炎症性疾病，涉及多种细胞群体并释放多种炎症介质。嗜酸性粒细胞和血清免疫球蛋白E（IgE）被认为是哮喘气道炎症的良好标志物。在印度人群中，哮喘临床评估与各种气道炎症标志物之间的相关性尚未明确确立。
本研究旨在探讨血清IgE、痰液嗜酸性粒细胞计数和外周血嗜酸性粒细胞计数与哮喘临床严重程度之间的相关性。
这是一项横断面研究，纳入了76名年龄在18至60岁之间、病情稳定的哮喘患者，他们均在呼吸内科门诊就诊。在基线时进行肺功能测定。根据全球哮喘防治创议（GINA）标准，基于临床症状和肺功能测试对参与者进行分类。采集血样用于外周血嗜酸性粒细胞计数、血清IgE水平检测，并采集痰液样本用于嗜酸性粒细胞计数。将这三个参数与哮喘严重程度进行比较。采用Pearson卡方检验、Fisher精确检验分析痰液嗜酸性粒细胞计数、外周血嗜酸性粒细胞计数和血清IgE与哮喘严重程度的相关性，并报告相关系数及估计标准误差。
本研究中患者的平均年龄为37.42岁，男性占56.6%。血清IgE水平与预计第1秒用力呼气容积（FEV1）之间存在显著负相关。在重度持续性哮喘患者中，痰液嗜酸性粒细胞增多明显（19.7%）。痰液嗜酸性粒细胞计数与预计FEV1和用力肺活量之间存在显著负相关。我们还发现外周血嗜酸性粒细胞计数、痰液嗜酸性粒细胞计数和血清IgE升高（≥100 IU/mL）与重度持续性哮喘之间存在显著关联。
痰液嗜酸性粒细胞计数评估简单、廉价、无创，是气道炎症的直接测量方法。它可能是日常实践中监测气道炎症和指导管理的首选方法。
