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Sputum neutrophil differential cell count in health and relationship to disease severity in asthma

Sputum neutrophil differential cell count in health and relationship to disease severity in asthma
Sputum neutrophil differential cell count in health and relationship to disease severity in asthma
Rationale: Sputum inflammometry has been used to phenotype asthma, with eosinophilic, neutrophilic, mixed granulocytic and paucicellular sub-groups described. Both ≥40% and ≥61% have been used as criteria to define sputum neutrophilia.Methods: As part of the Wessex Severe Asthma Cohort study, induced sputum was obtained from healthy non-asthmatic controls (HC, n=67), non-steroid treated asthmatics (MA , n=44), steroid treated (step 2/3) asthmatics (ModA, n=44) and those with severe (step 4/5 treated)asthma (SA, n=246) and differential cell counts obtained. Sputum neutrophil counts were not normally distributed and group comparisons were undertaken using non-parametric statistical analysis.Results: Median [1QR] sputum neutrophil % was significantly greater (p<0.001) in the SA (51.0 [38.7] than either HC (19.3 [31.50], p<0.0001), MA (25.40 [31.37], p<0.0001) or ModA (31.05 [41.70], p=0.005). ModA neutrophil % was significantly higher than HC (p<0.02) but not MA. The respective proportion of subjects (%) with neutrophil % of ≥40% and ≥61% was: SA (65.4 and 39.4), ModA (43.2 and 22.7), MA (31.8 and 15.9), HC (25.4 and 12.9). In SA neutrophil% in sputum was independent of smoking history, atopic status or oral steroid use and very weakly correlated with age and FEV1% predicted (inverse) (each R2 = 0,031, p=0.005). Sputum eosinophilia (≥2%) was evident in 34.8% and 29.9% of those with≥40% and ≥61%sputum neutrophilia respectively.Conclusion: Neutrophilic asthma is a prominent phenotype in severe asthma with approximately one third also having co-existent airway eosinophilic inflammation independent of the definition.Funding: WSAC was funded by the Medical Research Council UK.
0903-1936
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Elliott, Scott
f3234b8e-63df-45b3-a832-26b9a1acaf7f
Ward, Jon
a8107b98-069d-4263-bd70-d29d79f07edc
Gove, Kerry
6493b359-21cd-4068-88f4-a6e684f73316
Brown, Tom
fdd42359-a39d-4f22-b48d-015d9b94ec76
Rupani, Hitasha
cbc7068a-4279-4c8e-b83f-353210711062
Hinks, Timothy
42cced71-4ca0-47b9-bb85-619f9fd6ee0d
Djukanovic, Ratko
d9a45ee7-6a80-4d84-a0ed-10962660a98d
Kurukulaaratchy, Ramesh
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Chauhan, Anoop
4f606144-8948-4f82-8cb1-e57e7a05a8ed
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Elliott, Scott
f3234b8e-63df-45b3-a832-26b9a1acaf7f
Ward, Jon
a8107b98-069d-4263-bd70-d29d79f07edc
Gove, Kerry
6493b359-21cd-4068-88f4-a6e684f73316
Brown, Tom
fdd42359-a39d-4f22-b48d-015d9b94ec76
Rupani, Hitasha
cbc7068a-4279-4c8e-b83f-353210711062
Hinks, Timothy
42cced71-4ca0-47b9-bb85-619f9fd6ee0d
Djukanovic, Ratko
d9a45ee7-6a80-4d84-a0ed-10962660a98d
Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Chauhan, Anoop
4f606144-8948-4f82-8cb1-e57e7a05a8ed
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21

Barber, Clair, Elliott, Scott, Ward, Jon, Gove, Kerry, Brown, Tom, Rupani, Hitasha, Hinks, Timothy, Djukanovic, Ratko, Kurukulaaratchy, Ramesh, Chauhan, Anoop and Howarth, Peter (2014) Sputum neutrophil differential cell count in health and relationship to disease severity in asthma. European Respiratory Journal, 44 (Suppl 58).

Record type: Meeting abstract

Abstract

Rationale: Sputum inflammometry has been used to phenotype asthma, with eosinophilic, neutrophilic, mixed granulocytic and paucicellular sub-groups described. Both ≥40% and ≥61% have been used as criteria to define sputum neutrophilia.Methods: As part of the Wessex Severe Asthma Cohort study, induced sputum was obtained from healthy non-asthmatic controls (HC, n=67), non-steroid treated asthmatics (MA , n=44), steroid treated (step 2/3) asthmatics (ModA, n=44) and those with severe (step 4/5 treated)asthma (SA, n=246) and differential cell counts obtained. Sputum neutrophil counts were not normally distributed and group comparisons were undertaken using non-parametric statistical analysis.Results: Median [1QR] sputum neutrophil % was significantly greater (p<0.001) in the SA (51.0 [38.7] than either HC (19.3 [31.50], p<0.0001), MA (25.40 [31.37], p<0.0001) or ModA (31.05 [41.70], p=0.005). ModA neutrophil % was significantly higher than HC (p<0.02) but not MA. The respective proportion of subjects (%) with neutrophil % of ≥40% and ≥61% was: SA (65.4 and 39.4), ModA (43.2 and 22.7), MA (31.8 and 15.9), HC (25.4 and 12.9). In SA neutrophil% in sputum was independent of smoking history, atopic status or oral steroid use and very weakly correlated with age and FEV1% predicted (inverse) (each R2 = 0,031, p=0.005). Sputum eosinophilia (≥2%) was evident in 34.8% and 29.9% of those with≥40% and ≥61%sputum neutrophilia respectively.Conclusion: Neutrophilic asthma is a prominent phenotype in severe asthma with approximately one third also having co-existent airway eosinophilic inflammation independent of the definition.Funding: WSAC was funded by the Medical Research Council UK.

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More information

Published date: September 2014
Venue - Dates: Munich European Respiratory Society Congress, 2014-09-06 - 2014-09-10

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Local EPrints ID: 422523
URI: https://eprints.soton.ac.uk/id/eprint/422523
ISSN: 0903-1936
PURE UUID: 9b75b335-cb16-4648-a9ea-22a5456b9cf5
ORCID for Clair Barber: ORCID iD orcid.org/0000-0001-5335-5129
ORCID for Ratko Djukanovic: ORCID iD orcid.org/0000-0001-6039-5612

Catalogue record

Date deposited: 25 Jul 2018 16:30
Last modified: 14 Mar 2019 01:55

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