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Eosinophilic inflammation in sputum of poorly controlled asthmatics

Clinique des Maladies Respiratoires, Institut National de la Santé et de la recherche médicale U454, Centre Hospitalier Universitaire-Montpellier, Hopital Arnaud de Villeneuve, Montpellier, France

CORRESPONDENCE: P. Chanez, Hopital Arnaud de Villeneuve, 34295, Montpellier Cedex 5, France. Fax: 33 467521848. E-mail: chanez@montp.inserm.fr

Keywords: asthma control, asthma severity, eosinophils, induced sputum

Received: April 10, 2002
Accepted July 29, 2002

This study was supported in part by Direction de la Recherche Clinique (AOI 1995 no. 7515).

Despite full effective treatment, asthmatic patients often present with poorly controlled asthma. Airway eosinophilia is associated with asthma, but its relationship with asthma control is still undetermined.

To investigate the relationship between airway eosinophilia and asthma control, cellular and biochemical markers of airway inflammation were measured in 19 subjects with poorly controlled asthma, 16 subjects with asthma under control and eight normal volunteers. The severity of asthma was mild-to-moderate persistent in 23 patients (14 poorly controlled) and severe prednisone-dependent in 12 subjects (five poorly controlled). Induced sputum was analysed for total and differential cell counts, leukotriene E4 (LTE₄), eosinophil cationic protein (ECP), regulated on activation, normal T-cell expressed and secreted (RANTES), and interleukin (IL)-8.

Sputum eosinophils, LTE₄, ECP and RANTES levels (but not IL-8) were significantly higher in patients with poorly controlled asthma as compared to patients with controlled asthma. By contrast, sputum cells and sputum inflammatory markers were not different among groups of patients with different severity of asthma.

These results suggest that sputum eosinophilia is associated with poorly controlled asthma rather than with the severity of asthma.

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