[en] During recent years there has been a growing interest in using non-invasive biomarkers to understand and monitor the airway inflammation in subjects with respiratory tract disorders and mainly asthma and chronic obstructive pulmonary disease (COPD). Sputum induction is generally a well-tolerated and safe procedure and a European Respiratory Society Task Force has published a comprehensive review on sputum methodology. Induced sputum cell count and, to a lesser extent, mediator measurements have been particularly well validated. In asthma, the sputum and the cell culture supernatant can be used for the measurement of a variety of soluble mediators, including eosinophil-derived proteins, nitric oxide (NO) derivatives, cytokines and remodelling-associated proteins. Sputum eosinophilia (> 3%) is a classic feature of asthma although half of the patients seems to be non eosinophilic. Measuring the percentage of sputum eosinophils has proved to be useful in the clinical arena in helping to predict short term response to inhaled corticosteroids (ICS) and tailor the dose of ICS in the severe patients but there is scope for the application of other induced sputum markers potentially useful in clinical practice. The widespread application of induced sputum in asthma across the spectrum of disease severity has given insight into the relationship between airway function and airway inflammation, proposed new disease phenotypes and defined which of these phenotypes respond to current therapy, and perhaps most importantly provided an additional tool to guide the clinical management of asthmatic patients. To date sputum induction is the only non-invasive measure of airway inflammation that has a clearly proven role in asthma management.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Bakakos, P.
SCHLEICH, FLorence ; Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
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Bibliography
Nicholas, B.; Djukanovic, R. Induced sputum: a window to lung pathology. Biochem. Soc. Trans., 2009, 37, 868-72.
Pizzichini, E.; Pizzichini, M.M.; Efthimiadis, A.; Evans, S.; Morris, M.M.; Squillace, D.; Gleich, G.J.; Dolovich, J. Hargreave, F.E. Indices of airway inflammation in induced sputum: reproducibility and validity of cell and fluidphase measurements. Am. J. Respir. Crit. Care Med., 1996, 154, 308-17. (Pubitemid 26269096)
Spanevello, A.; Confalonieri, M.; Sulotto, F.; Romano, F.; Balzano, G.; Migliori, G.B.; Bianchi, A.; Michetti, G. Induced sputum cellularity. Reference values and distribution in normal volunteers. Am. J. Respir. Crit. Care. Med., 2000, 162, 1172-4.
Thomas, R.A.; Green, R.H.; Brightling, C.E.; Birring, S.S.; Parker, D.; Wardlaw, A.J.; Pavord, I.D. The influence of age on induced sputum differential cell counts in normal subjects. Chest, 2004, 126, 1811-4. (Pubitemid 39643984)
Efthimiadis, A.; Spanevello, A.; Hamid, Q.; Kelly, M.M.; Linden, M.; Louis, R.; Pizzichini, M.M.; Pizzichini, E.; Ronchi, C.; Van Overvel, F.; Djukanovic, R. Methods of sputum processing for cell counts, immunocytochemistry and in situ hybridisation. Eur. Respir. J. Suppl., 2002, 37, 19s-23s. (Pubitemid 35024263)
Djukanovic, R.; Sterk, P.J.; Fahy, J.V.; Hargreave, F.E. Standardised methodology of sputum induction and processing. Eur. Respir. J. Suppl., 2002, 37, 1s-2s. (Pubitemid 35024260)
Vignola, A.M.; Rennar, S.I.; Hargreave, F.E.; Fah, J.V.; Bonsignore, M.R.; Djukanovic, R.; Sterk, P.J. Standardised methodology of sputum induction and processing. Future directions. Eur. Respir. J. Suppl., 2002, 37, 51s-5s
Fahy, J.V.; Liu, J.; Wong, H.; Boushey, H.A. Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. Am. Rev. Respir Dis., 1993, 147, 1126-31. (Pubitemid 23149867)
Richter, K.; Holz, O.; Jorres, R.A.; Mucke, M.; Magnussen, H. Sequentially induced sputum in patients with asthma or chronic obstructive pulmonary disease. Eur. Respir. J., 1999, 14, 697-701. (Pubitemid 29479739)
Holz, O.; Jorres, R.A.; Koschyk, S.; Speckin, P.; Welker, L.; Magnussen, H. Changes in sputum composition during sputum induction in healthy and asthmatic subjects. Clin. Exp. Allergy, 1998, 28, 284-92. (Pubitemid 28125912)
Cianchetti, S.; Bacci, E.; Ruocco, L.; Bartoli, M.L.; Carnevali, S.; Dente, F. L.; Di Franco, A.; Giannini, D.; Scuotri, L.; Vagaggini, B.; Paggiaro, P.L. Salbutamol pretreatment does not change eosinophil percentage and eosinophilic cationic protein concentration in hypertonic saline-induced sputum in asthmatic subjects. Clin. Exp. Allergy, 1999, 29, 712-8. (Pubitemid 29222992)
ten Brinke, A.; de Lange, C.; Zwinderman, A.H.; Rabe, K.F.; Sterk, P.J.; Bel, E.H. Sputum induction in severe asthma by a standardized protocol: predictors of excessive bronchoconstriction. Am. J. Respir. Crit. Care. Med., 2001, 164, 749-53. (Pubitemid 32881908)
Cianchetti, S.; Bacci, E.; Ruocco, L.; Bartoli, M.L.; Ricci, M.; Pavia, T.; Dente, F.L.; Di Franco, A.; Vagaggini, B.; Paggiaro, P.L. Granulocyte markers in hypertonic and isotonic saline-induced sputum of asthmatic subjects. Eur. Respir. J., 2004, 24, 1018-24. (Pubitemid 39642295)
Cataldo, D.; Foidart, J.M.; Lau, L.; Bartsch, P,; Djukanovic, R.; Louis, R. Induced sputum: comparison between isotonic and hypertonic saline solution inhalation in patients with asthma. Chest, 2001, 120, 1815-21. (Pubitemid 34053439)
Delvaux, M.; Henket, M.; Lau, L.; Kange, P.; Bartsch, P.; Djukanovic, R,; Louis, R. Nebulised salbutamol administered during sputum induction improves bronchoprotection in patients with asthma. Thorax, 2004, 59, 111-5. (Pubitemid 38223480)
Efthimiadis, A.; Jayaram, L.; Weston, S.; Carruthers, S.; Hargreave, F.E. Induced sputum: time from expectoration to processing. Eur. Respir. J., 2002, 19, 706-8. (Pubitemid 34285168)
Kelly, M.M.; Hargreave, F.E.; Cox, G. A method to preserve sputum for delayed examination. Eur. Respir. J., 2003, 22, 996-1000. (Pubitemid 37540655)
Pizzichini, E.; Pizzichini, M.M.; Efthimiadis, A.; Hargreave, F.E.; Dolovich, J. Measurement of inflammatory indices in induced sputum: effects of selection of sputum to minimize salivary contamination. Eur. Respir. J., 1996, 9, 1174-80. (Pubitemid 26231731)
Cleland, W. W. Dithiothreitol, a new protective reagent for SH groups. Biochemistry, 1964, 3, 480-2.
Louis, R.; Shute, J.; Goldring, K.; Perks, B.; Lau, L.C.; Radermecker, M.; Djukanovic, R. The effect of processing on inflammatory markers in induced sputum. Eur. Respir. J., 1999, 13, 660-7. (Pubitemid 29180182)
Spanevello, A.; Beghe, B.; Bianchi, A.; Migliori, G.B.; Ambrosetti, M.; Neri, M.; Ind, P.W. Comparison of two methods of processing induced sputum: selected versus entire sputum. Am. J. Respir. Crit. Care. Med., 1998, 157, 665-8. (Pubitemid 28090565)
Fleury-Feith, J.; Escudier, E.; Pocholle, M.J.; Carre, C.; Bernaudin, J.F. The effects of cytocentrifugation on differential cell counts in samples obtained by bronchoalveolar lavage. Acta Cytol., 1987, 31, 606-10. (Pubitemid 17157755)
Mordelet-Dambrine, M.; Arnoux, A.; Stanislas-Leguern, G.; Sandron, D.; Chretien, J.; Huchon, G. Processing of lung lavage fluid causes variability in bronchoalveolar cell count. Am. Rev. Respir. Dis., 1984, 130, 305-6. (Pubitemid 14055822)
in ', V, de Gouw, H.W.; Smits, H.H.; Sont, J.K.; Hiemstra, P.S.; Sterk, P.J.; Bel, E.H. Repeatability of cellular and soluble markers of inflammation in induced sputum from patients with asthma. Eur. Respir. J., 1996, 9, 2441-7. (Pubitemid 26407890)
Pizzichini, M.M.; Pizzichini, E.; Clelland, L.; Efthimiadis, A.; Mahony, J.; Dolovich, J.; Hargreave, F.E. Sputum in severe exacerbations of asthma: kinetics of inflammatory indices after prednisone treatment. Am. J. Respir. Crit. Care. Med., 1997, 155, 1501-8. (Pubitemid 27216650)
Keatings, V.M.; Collins, P.D.; Scott, D.M.; Barnes, P.J. Differences in interleukin-8 and tumor necrosis factor-alpha in induced sputum from patients with chronic obstructive pulmonary disease or asthma. Am. J. Respir. Crit. Care. Med., 1996, 153, 530-4.
Fahy, J.V.; Steiger, D.J.; Liu, J.; Basbaum, C.B.; Finkbeiner, W.E.; Boushey, H.A. Markers of mucus secretion and DNA levels in induced sputum from asthmatic and from healthy subjects. Am. Rev. Respir. Dis., 1993, 147, 1132-7. (Pubitemid 23149868)
Keatings, V.M.; Barnes, P.J. Granulocyte activation markers in induced sputum: comparison between chronic obstructive pulmonary disease, asthma, and normal subjects. Am. J. Respir. Crit. Care. Med., 1997, 155, 449-53. (Pubitemid 27085784)
Keatings, V.M.; O'Connor, B.J.; Wright, L.G.; Huston, D.P.; Corrigan, C.J.; Barnes, P.J. Late response to allergen is associated with increased concentrations of tumor necrosis factor-alpha and IL-5 in induced sputum. J. Allergy. Clin. Immunol., 1997, 99, 693-8. (Pubitemid 27213198)
Louis, R.; Shute, J.; Biagi, S.; Stanciu, L.; Marrelli, F.; Tenor, H.; Hidi, R.; Djukanovic, R. Cell infiltration, ICAM-1 expression, and eosinophil chemotactic activity in asthmatic sputum. Am. J. Respir. Crit. Care Med., 1997, 155, 466-72. (Pubitemid 27085787)
Kanazawa, H.; Shoji, S.; Yamada, M.; Fujii, T.; Kawaguchi, T.; Kudoh, S.; Hirata, K.; Yoshikawa, J. Increased levels of nitric oxide derivatives in induced sputum in patients with asthma. J. Allergy. Clin. Immunol., 1997, 99, 624-9. (Pubitemid 27213190)
Popov, T.; Gottschalk, R.; Kolendowicz, R.; Dolovich, J.; Powers, P.; Hargreave, F.E. The evaluation of a cell dispersion method of sputum examination. Clin. Exp. Allergy, 1994, 24, 778-83. (Pubitemid 24265178)
Erin, E.M.; Jenkins, G.R.; Kon, O.M.; Zacharasiewicz, A.S.; Nicholson, G. C.; Neighbour, H.; Tennant, R.C.; Tan, A.J.; Leaker, B.R.; Bush, A.; Jose, P.J.; Barnes, P.J.; Hansel, T.T. Optimized dialysis and protease inhibition of sputum dithiothreitol supernatants. Am. J. Respir. Crit. Care. Med., 2008, 177, 132-41.
Dente, F.L.; Carnevali, S.; Bartoli, M.L.; Cianchetti, S.; Bacci, E.; Di Franco, A.; Vagaggini, B.; Paggiaro, P. Profiles of proinflammatory cytokines in sputum from different groups of severe asthmatic patients. Ann. Allergy Asthma Immunol., 2006, 97, 312-20. (Pubitemid 44476566)
Hemelaers, L.; Henket, M.; Sele, J.; Bureau, F.; Louis, R. Cysteinylleukotrienes contribute to sputum eosinophil chemotactic activity in asthmatics. Allergy, 2006, 61, 136-9. (Pubitemid 43381204)
Quaedvlieg, V.; Henket, M.; Sele, J.; Louis, R. Cytokine production from sputum cells in eosinophilic versus non-eosinophilic asthmatics. Clin. Exp. Immunol, 2006, 143, 161-6.
Manise, M.; Schleich, F.; Gusbin, N.; Godinas, L.; Henket, M.; Antoine, N.; Corhay, J.L.; Louis, R. Cytokine production from sputum cells and blood leukocytes in asthmatics according to disease severity. Allergy, 2010, 65, 889-96.
Kodric, M.; Shah, A.N.; Fabbri, L.M.; Confalonieri, M. An investigation of airway acidification in asthma using induced sputum: a study of feasibility and correlation. Am. J. Respir. Crit Care. Med., 2007, 175, 905-10. (Pubitemid 46684700)
Sugiura, H.; Komaki, Y.; Koarai, A.; Ichinose, M. Nitrative stress in refractory asthma. J. Allergy. Clin. Immunol., 2008, 121, 355-60.
Maisi, P.; Prikk, K.; Sepper, R.; Pirila, E.; Salo, T.; Hietanen, J.; Sorsa, T. Soluble membrane-type 1 matrix metalloproteinase (MT1-MMP) and gelatinase A (MMP-2) in induced sputum and bronchoalveolar lavage fluid of human bronchial asthma and bronchiectasis. APM1S, 2002, 110, 771-82. (Pubitemid 36152710)
Suzuki, R.; Kato, T.; Miyazaki, Y.; Iwata, M.; Noda, Y.; Takagi, K.; Nakashima, N.; Torii, K. Matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases in sputum from patients with bronchial asthma. J. Asthma, 2001, 38, 477-84. (Pubitemid 34326661)
Vignola, A.M.; Riccobono, L.; Mirabella, A.; Profita, M.; Chanez, P.; Bellia, V.; Mautino, G.; D'accardi, P.; Bousquet, J.; Bonsignore, G. Sputum metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio correlates with airflow obstruction in asthma and chronic bronchitis. Am. J. Respir. Crit. Care Med., 1998, 158, 1945-50. (Pubitemid 29008837)
Nomura, A.; Uchida, Y.; Sakamoto, T.; Ishii, Y.; Masuyama, K.; Morishima, Y.; Hirano, K.; Sekizawa, K. Increases in collagen type I synthesis in asthma: the role of eosinophils and transforming growth factor-beta. Clin. Exp. Allergy, 2002, 32, 860-5. (Pubitemid 34626083)
Asai, K.; Kanazawa, H.; Kamoi, H.; Shiraishi, S.; Hirata, K.; Yoshikawa, J. Increased levels of vascular endothelial growth factor in induced sputum in asthmatic patients. Clin. Exp. Allergy, 2003, 33, 595-9. (Pubitemid 36629683)
Yamaguchi, M.; Niimi, A.; Matsumoto, H.; Ueda, T.; Takemura, M.; Matsuoka, H.; Jinnai, M.; Otsuka, K.; Oguma, T.; Takeda, T.; Ito, I.; Chin, K.; Mishima, M. Sputum levels of transforming growth factor-beta1 in asthma: relation to clinical and computed tomography findings. J. Investig. Allergol. Clin. Immunol., 2008, 18, 202-6. (Pubitemid 351872287)
Profita, M.; Gagliardo, R.; Di Giorgi, R.; Pompeo, F.; Gjomarkaj, M.; Nicolini, G.; Bousquet, J.; Vignola, A.M. Biochemical interaction between effects of beclomethasone dipropionate and salbutamol or formoterol in sputum cells from mild to moderate asthmatics. Allergy, 2005, 60, 323-9. (Pubitemid 40293348)
Park, S.W.; Jangm, H.K.; An, M.H.; Min, J.W.; Jang, A.S.; Lee, J.H.; Park, C.S. Interleukin-13 and interleukin-5 in induced sputum of eosinophilic bronchitis: comparison with asthma. Chest, 2005, 128, 1921-7. (Pubitemid 41507522)
Chodosh, S. Examination of sputum cells. N. Engl J. Med., 1970, 282, 854-7.
Gibson, P.G.; Girgis-Gabardo, A.; Morris, M.M.; Mattoli, S.; Kay, J.M.; Dolovich, J.; Denburg, J.; Hargreave, F.E. Cellular characteristics of sputum from patients with asthma and chronic bronchitis. Thorax, 1989, 44, 693-9. (Pubitemid 19243264)
Maestrelli, P.; Saetta, M.; Di Stefano, A.; Calcagni, P.G.; Turato, G.; Ruggieri, M.P.; Roggeri, A.; Mapp, C.E.; Fabbri, L.M. Comparison of leukocyte counts in sputum, bronchial biopsies, and bronchoalveolar lavage. Am. J. Respir. Crit. Care Med., 1995, 152, 1926-31.
Louis, R.; Lau, L.C.; Bron, A.O.; Roldaan, A.C.; Radermecker, M.; Djukanovic, R. The relationship between airways inflammation and asthma severity. Am. J. Respir. Crit. Care. Med., 2000, 161, 9-16. (Pubitemid 30055896)
Louis, R.; Sele, J.; Henket, M.; Cataldo, D.; Bettiol, J.; Seiden, L.; Bartsch, P. Sputum eosinophil count in a large population of patients with mild to moderate steroid-naive asthma: distribution and relationship with methacholine bronchial hyperresponsiveness. Allergy, 2002, 57, 907-12.
Gibson, P.G.; Simpson, J.L.; Saltos, N. Heterogeneity of airway inflammation in persistent asthma : evidence of neutrophilic inflammation and increased sputum interleukin-8. Chest, 2001, 119, 1329-36. (Pubitemid 32686012)
Green, R.H.; Brightling, C.E.; Woltmann, G.; Parker, D.; Wardlaw, A.J.; Pavord, I.D. Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled corticosteroids. Thorax, 2002, 57, 875-9. (Pubitemid 35178612)
Iredale, M.J.; Wanklyn, S.A.; Phillips, I.P.; Krausz, T.; Ind, P.W. Noninvasive assessment of bronchial inflammation in asthma: no correlation between eosinophilia of induced sputum and bronchial responsiveness to inhaled hypertonic saline. Clin. Exp. Allergy, 1994, 24, 940-5. (Pubitemid 24320326)
Ronchi, M.C.; Piragino, C.; Rosi, E.; Stendardi, L.; Tanini, A.; Galli, G.; Duranti, R.; Scano, G. do sputum eosinophils and ECP relate to the severity of asthma? Eur. Respir. J., 1997, 10, 1809-13. (Pubitemid 27368374)
Quaedvlieg, V.; Sele, J.; Henket, M.; Louis, R. Association between asthma control and bronchial hyperresponsiveness and airways inflammation: a cross-sectional study in daily practice. Clin. Exp. Allergy, 2009, 39, 1822-9.
Obata, H.; Dittrick, M.; Chan, H.; Chan-Yeung, M. Sputum eosinophils and exhaled nitric oxide during late asthmatic reaction in patients with western red cedar asthma. Eur. Respir. J., 1999, 13, 489-95. (Pubitemid 29180153)
Todd, D.C.; Armstrong, S.; D'Silva, L.; Allen, C.J.; Hargreave, F.E.; Parameswaran, K. Effect of obesity on airway inflammation: a cross-sectional analysis of body mass index and sputum cell counts. Clin. Exp. Allergy, 2007, 37, 1049-54. (Pubitemid 46957461)
Lessard, A.; Turcotte, H. ; Cormier, Y. ; Boulet, L.P. Obesity and asthma: a specific phenotype? Chest, 2008, 134, 317-23.
Fahy, J.V.; Kim, K.W.; Liu, J.; Boushey, H.A. Prominent neutrophilic inflammation in sputum from subjects with asthma exacerbation. J. Allergy. Clin. Immunol., 1995, 95, 843-52.
Wark, P.A.; Johnston, S.L.; Moric, I.; Simpson, J.L.; Hensley, M.J.; Gibson, P.G. Neutrophil degranulation and cell lysis is associated with clinical severity in virus-induced asthma. Eur. Respir. J., 2002, 19, 68-75. (Pubitemid 34105570)
Ronchi, M.C.; Piragino, C.; Rosi, E.; Amendola, M.; Duranti, R.; Scano, G. Role of sputum differential cell count in detecting airway inflammation in patients with chronic bronchial asthma or COPD. Thorax, 1996, 51, 1000-4. (Pubitemid 26360175)
Brightling, C.E.; Monteiro, W.; Ward, R.; Parker, D.; Morgan, M.D.; Wardlaw, A.J.; Pavord, I.D. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial. Lancet, 2000, 356, 1480-5.
Louis, R.E.; Cataldo, D.; Buckley, M.G.; Sele, J.; Henket, M.; Lau, L.C.; Bartsch, P.; Walls, A.F.; Djukanovic, R. Evidence of mast-cell activation in a subset of patients with eosinophilic chronic obstructive pulmonary disease. Eur. Respir. J., 2002, 20, 325-31.
Keatings, V.M.; Evans, D.J.; O'Connor, B.J.; Barnes, P.J. Cellular profiles in asthmatic airways: a comparison of induced sputum, bronchial washings, and bronchoalveolar lavage fluid. Thorax, 1997, 52, 372-4. (Pubitemid 27204901)
Grootendorst, D.C.; Sont, J.K.; Willems, L.N.; Kluin-Nelemans, J.C.; Van Krieken, J.H.; Veselic-Charvat, M.; Sterk, P.J. Comparison of inflammatory cell counts in asthma: induced sputum vs bronchoalveolar lavage and bronchial biopsies. Clin. Exp. Allergy, 1997, 27, 769-79. (Pubitemid 27306156)
Fahy, J. V.; Wong, H.; Liu, J.; Boushey, H.A. Comparison of samples collected by sputum induction and bronchoscopy from asthmatic and healthy subjects. Am. J. Respir. Crit. Care. Med., 1995, 152, 53-8.
Gibson, P.G.; Henry, R.L.; Thomas, P. Noninvasive assessment of airway inflammation in children: induced sputum, exhaled nitric oxide, and breath condensate. Eur. Respir. J., 2000, 16, 1008-15. (Pubitemid 32049395)
Hunter, C.J.; Brightling, C.E.; Woltmann, G.; Wardlaw, A.J.; Pavord, I.D. A comparison of the validity of different diagnostic tests in adults with asthma. Chest, 2002, 121, 1051-7. (Pubitemid 34280422)
Pizzichini, M.M.; Kidney, J.C.; Wong, B.J.; Morris, M.M.; Efthimiadis, A.; Dolovich, J.; Hargreave, F.E. Effect of salmeterol compared with beclomethasone on allergen-induced asthmatic and inflammatory responses. Eur Respir. J., 1996, 9, 449-55. (Pubitemid 26117787)
Claman, D.M.; Boushey, H.A.; Liu, J.; Wong, H.; Fahy, J.V. Analysis of induced sputum to examine the effects of prednisone on airway inflammation in asthmatic subjects. J. Allergy. Clin. Immunol., 1994, 94, 861-9. (Pubitemid 24354484)
Gibson, P.G.; Hargreave, F.E.; Girgis-Gabardo, A.; Morris, M.; Denburg, J.A.; Dolovich, J. Chronic cough with eosinophilic bronchitis: examination for variable airflow obstruction and response to corticosteroid. Clin. Exp. Allergy, 1995, 25, 127-32.
Bacci, E.; Cianchetti, S.; Bartoli, M.; Dente, F.L.; Di Franco, A.; Vagaggini, B.; Paggiaro, P. Low sputum eosinophils predict the lack of response to beclomethasone in symptomatic asthmatic patients. Chest, 2006, 129, 565-72.
Meijer, R.J.; Postma, D.S.; Kauffman, H.F.; Arends, L.R.; Koeter, G.H.; Kerstjens, H.A. Accuracy of eosinophils and eosinophil cationic protein to predict steroid improvement in asthma. Clin. Exp. Allergy, 2002, 32, 1096-103. (Pubitemid 34779609)
Berry, M.; Morgan, A.; Shaw, D.E.; Parker, D.; Green, R.; Brightling, C.; Bradding, P.; Wardlaw, A.J.; Pavord, I.D. Pathological features and inhaled corticosteroid response of eosinophilic and non-eosinophilic asthma. Thorax, 2007, 62, 1043-9. (Pubitemid 350206195)
Kips, J.C.; O'Connor, B.J.; Inman, M.D.; Svensson, K.; Pauwels, R.A.; O'Byrne, P.M. A long-term study of the antiinflammatory effect of low-dose budesonide plus formoterol versus high-dose budesonide in asthma. Am. J. Respir. Crit. Care Med., 2000, 161, 996-1001. (Pubitemid 30171763)
Turner, M.O.; Johnston, P.R.; Pizzichini, E.; Pizzichini, M.M.; Hussack, P.A.; Hargreave, F.E. Anti-inflammatory effects of salmeterol compared with beclomethasone in eosinophilic mild exacerbations of asthma: a randomized, placebo controlled trial. Can. Respir J., 1998, 5, 261-8. (Pubitemid 28448488)
Louis, R.; Bettiol, J.; Cataldo, D.; Sele, J.; Henquet, M.; Radermecker, M. Effect of a 4-week treatment with theophylline on sputum eosinophilia and sputum eosinophil chemotactic activity in steroid-naive asthmatics. Clin. Exp. Allergy, 2000, 30, 1151-60. (Pubitemid 30619769)
Little, S.A.; Chalmers, G.W.; Macleod, K.J.; McSharry, C.; Thomson, N.C. Non-invasive markers of airway inflammation as predictors of oral steroid responsiveness in asthma. Thorax, 2000, 55, 232-4. (Pubitemid 30245974)
Dente, F.L.; Bacci, E.; Bartoli, M.L.; Cianchetti, S.; Costa, F.; Di Franco, A.; Malagrino, L.; Vagaggini, B.; Paggiaro, P. Effects of oral prednisone on sputum eosinophils and cytokines in patients with severe refractory asthma. Ann. Allergy. Asthma. Immunol., 2010, 104, 464-70.
Malerba, M.; Ragnoli, B.; Radaeli, A.; Tantucci, C. Usefulness of exhaled nitric oxide and sputum eosinophils in the long-term control of eosinophilic asthma. Chest, 2008, 134, 733-9.
ten Brinke, A.; Zwinderman, A.H.; Sterk, P.J.; Rabe, K.F.; Bel, E.H. "Refractory" eosinophilic airway inflammation in severe asthma: effect of parenteral corticosteroids. Am. J. Respir. Crit. Care Med., 2004, 170, 601-5. (Pubitemid 39202200)
Nair, P.; Pizzichini, M.M.; Kjarsgaard, M.; Inman, M.D.; Efthimiadis, A.; Pizzichini, E.; Hargreave, F.E.; O'Byrne, P.M. Mepolizumab for prednisonedependent asthma with sputum eosinophilia. N. Engl. J. Med., 2009, 360, 985-93.
Haldar, P.; Brightling, C.E.; Hargadon, B.; Gupta, S.; Monteiro, W.; Sousa, A.; Marshall, R.P.; Bradding, P.; Green, R.H.; Wardlaw, A.J.; Pavord, I.D. Mepolizumab and exacerbations of refractory eosinophilic asthma. N. Engl. J. Med., 2009, 360, 973-84.
Schleich, F.N.; Seidel, L.; Sele, J.; Manise, M.; Quaedvlieg, V.; Michils, A.; Louis, R. Exhaled nitric oxide thresholds associated with a sputum eosinophil count >=3% in a cohort of unselected patients with asthma. Thorax, 2010, 65, 1039-44.
Tseliou, E.; Bessa, V.; Hillas, G.; Delimpoura, V.; Papadaki, G.; Roussos, C.; Papiris, S.; Bakakos, P.; Loukides, S. Exhaled nitric oxide and exhaled breath condensate pH in severe refractory asthma. Chest, 2010, 138, 107-13.
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