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Cell counts in severe asthma: concordance of sputum and BAL in Wessex Severe Asthma Cohort

Cell counts in severe asthma: concordance of sputum and BAL in Wessex Severe Asthma Cohort
Cell counts in severe asthma: concordance of sputum and BAL in Wessex Severe Asthma Cohort
Background: Asthma is widely considered an eosinophilic disease however severe asthma is frequently non-eosinophilic. Treatment options can depend on airway cell counts but proximal and distal airways may not be concordant in terms of cell differential. The Wessex Severe Asthma Cohort (WSAC) recruited 342 participants with severe asthma for detailed phenotyping with some participants undergoing sputum induction and/or bronchoscopy with bronchoalveolar lavage (BAL). We aimed to use data from the WSAC to assess the agreement between sputum and BAL cell differentials.
Methods: WSAC participants with severe asthma were included if they underwent both BAL and successful sputum induction. Correlation coefficients and classification tables were used to calculate the agreement between the proximal (sputum) and distal (BAL) compartments.
Results: 38 participants were included in the analysis. Correlation coefficients were 0.429 for neutrophil count (p=0.007) and 0.569 for eosinophil count (p<0.001). Sputum and BAL eosinophilia (3% and 1%) were concordant in 68% with Sputum eosinophilia alone in 21% and BAL alone in 11%. Neutrophilia (60% and 3%) were concordant in 45%, with sputum neutrophilia alone in 50% and BAL alone in 5%.
Conclusions: Sputum and BAL cell counts showed moderate correlation, but significant classification discrepancies were found when using recognised thresholds. Sampling of multiple compartments may be required for optimal assessment of individuals with severe asthma.
0903-1936
Jones, Thomas
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Brown, Thomas P.
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Elliott, Scott P.
f3234b8e-63df-45b3-a832-26b9a1acaf7f
Rupani, Hitasha
cbc7068a-4279-4c8e-b83f-353210711062
Chauhan, Anoop
4f606144-8948-4f82-8cb1-e57e7a05a8ed
Gove, Kerry
6493b359-21cd-4068-88f4-a6e684f73316
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Lau, Laurie
2af8045d-6162-4939-aba7-28dd2f60f6a8
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21
Jones, Thomas
2ed43a38-d65d-4786-9208-a1e1298ce413
Brown, Thomas P.
fdd42359-a39d-4f22-b48d-015d9b94ec76
Elliott, Scott P.
f3234b8e-63df-45b3-a832-26b9a1acaf7f
Rupani, Hitasha
cbc7068a-4279-4c8e-b83f-353210711062
Chauhan, Anoop
4f606144-8948-4f82-8cb1-e57e7a05a8ed
Gove, Kerry
6493b359-21cd-4068-88f4-a6e684f73316
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Lau, Laurie
2af8045d-6162-4939-aba7-28dd2f60f6a8
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21

Jones, Thomas, Brown, Thomas P., Elliott, Scott P., Rupani, Hitasha, Chauhan, Anoop, Gove, Kerry, Barber, Clair, Lau, Laurie and Howarth, Peter (2017) Cell counts in severe asthma: concordance of sputum and BAL in Wessex Severe Asthma Cohort. European Respiratory Journal, 50 (Suppl 61).

Record type: Meeting abstract

Abstract

Background: Asthma is widely considered an eosinophilic disease however severe asthma is frequently non-eosinophilic. Treatment options can depend on airway cell counts but proximal and distal airways may not be concordant in terms of cell differential. The Wessex Severe Asthma Cohort (WSAC) recruited 342 participants with severe asthma for detailed phenotyping with some participants undergoing sputum induction and/or bronchoscopy with bronchoalveolar lavage (BAL). We aimed to use data from the WSAC to assess the agreement between sputum and BAL cell differentials.
Methods: WSAC participants with severe asthma were included if they underwent both BAL and successful sputum induction. Correlation coefficients and classification tables were used to calculate the agreement between the proximal (sputum) and distal (BAL) compartments.
Results: 38 participants were included in the analysis. Correlation coefficients were 0.429 for neutrophil count (p=0.007) and 0.569 for eosinophil count (p<0.001). Sputum and BAL eosinophilia (3% and 1%) were concordant in 68% with Sputum eosinophilia alone in 21% and BAL alone in 11%. Neutrophilia (60% and 3%) were concordant in 45%, with sputum neutrophilia alone in 50% and BAL alone in 5%.
Conclusions: Sputum and BAL cell counts showed moderate correlation, but significant classification discrepancies were found when using recognised thresholds. Sampling of multiple compartments may be required for optimal assessment of individuals with severe asthma.

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More information

Published date: September 2017
Venue - Dates: European Respiratory Society International Congress, Milan, Italy, 2017-09-09 - 2017-09-13

Identifiers

Local EPrints ID: 422516
URI: https://eprints.soton.ac.uk/id/eprint/422516
ISSN: 0903-1936
PURE UUID: d4b2becb-6c10-4ea9-be8d-008ae41bb1f0
ORCID for Clair Barber: ORCID iD orcid.org/0000-0001-5335-5129

Catalogue record

Date deposited: 25 Jul 2018 16:30
Last modified: 14 Mar 2019 01:27

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Contributors

Author: Thomas Jones
Author: Thomas P. Brown
Author: Scott P. Elliott
Author: Hitasha Rupani
Author: Anoop Chauhan
Author: Kerry Gove
Author: Clair Barber ORCID iD
Author: Laurie Lau
Author: Peter Howarth

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