Nasal eosinophilia: an indicator of eosinophilic inflammation in asthma

Clin Exp Allergy. 2010 Jun;40(6):867-74. doi: 10.1111/j.1365-2222.2009.03439.x. Epub 2010 Jan 20.

Abstract

Background: It is noteworthy that there is a clear clinical, epidemiological and pathophysiological association between upper and lower airway inflammation in rhinitis and asthma.

Objective: The aim of this study was to compare the eosinophil counts in induced sputum and nasal lavage fluids in asthma, checking their association and the accuracy of nasal eosinophilia as a predictor of sputum eosinophilia by a cross-sectional study.

Methods: The clinical evaluation, asthma control questionnaire (ACQ), pre- and post-bronchodilator spirometry, nasal and sputum sample was performed. The nasal eosinophilia was analysed by a receiver operating curve and logistic regression model.

Results: In 140 adults, the post-bronchodilator forced expiratory volume in 1 s (FEV(1)) did not differ between patients with or without sputum eosinophilia (0.18). After adjusted for upper airway symptoms, age, ACQ score and post-bronchodilator FEV(1), sputum eosinophilia was associated with 52 times increase in odds of nasal eosinophilia, whereas each 1% increase in bronchodilator response was associated with 7% increase in odds of nasal eosinophilia.

Conclusion: This study brings further evidence that upper airway diseases are an important component of the asthma syndrome. Furthermore, monitoring of nasal eosinophilia by quantitative cytology may be useful as a surrogate of sputum cytology in as a component of composite measurement for determining airway inflammation.

MeSH terms

  • Administration, Intranasal
  • Adult
  • Asthma* / diagnosis
  • Asthma* / immunology
  • Asthma* / physiopathology
  • Cross-Sectional Studies
  • Eosinophilia / diagnosis*
  • Eosinophilia / immunology
  • Eosinophils / cytology
  • Eosinophils / immunology
  • Female
  • Humans
  • Inflammation* / immunology
  • Inflammation* / physiopathology
  • Leukocyte Count
  • Male
  • Middle Aged
  • Nasal Lavage Fluid
  • Nose / immunology*
  • Sputum / immunology