Induced sputum eosinophilia in ulcerative colitis patients: The lung as a mirror image of intestine?
| Autor: | Zvi Fireman, Moshe Shtark, Yael Kopelman, Shmuel Kivity, Gabi Groisman, Elizabeth Fireman, Farid Masarwy |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Pancolitis medicine.medical_specialty Pathology Lung injury Gastroenterology Pulmonary function testing FEV1/FVC ratio Predictive Value of Tests T-Lymphocyte Subsets Internal medicine Biopsy medicine Eosinophilia Humans Induced sputum Lung medicine.diagnostic_test business.industry Sputum Middle Aged medicine.disease Ulcerative colitis Respiratory Function Tests Intestines Eosinophils Case-Control Studies Colitis Ulcerative Female medicine.symptom business |
| Zdroj: | Respiratory Medicine. (7):1025-1032 |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2009.01.016 |
| Popis: | Summary Background Ulcerative colitis (UC) is a systemic disease of unknown etiology with extra-intestinal manifestation. Induced sputum (IS) non-invasively assesses extrapulmonary involvement in Crohn's disease. We sought to determine whether there is a cellular marker of lung injury in UC patients detectable by IS. Methods Nineteen UC patients (mean age 46.4 ± 11.3 years, disease duration 8.6 ± 7.5 years [range 1–25 years] 68.4% males) were studied, 6 with active disease and 13 in remission. Eleven received 5-ASA, 5 received steroids and/or azathioprine and 3 patients were untreated. UC patients were compared with 27 healthy non-smoker controls. IS was recovered after 20 min inhalation of 3% saline with an ultrasonic nebulizer by the selecting plugs method, and 300 cells were differentially cell counted in cytospin Giemsa-stained slides. CD4/CD8 subsets were identified by FACS. Pulmonary function tests were performed by the Jaeger Masterlab spirometer. Results UC patients' IS contained higher %eosinophils than controls (p = 0.05) and lower FEV1/FVC ratios (p = 0.001). Steroid- and/or azathioprine-treated patients had significantly lower FEV1/FVC ratios than only 5-ASA-treated patients (p = 0.019). Eosinophil infiltration in airways was high in 5-ASA-treated patients compared to those receiving steroids and/or azathioprine (p = 0.046) and those with less extensive disease (p = 0.05). Using a cutoff of 3% eosinophils, IS had a sensitivity of 67% and specificity of 73% to differentiate patients with a cutoff of 70 eosinophils/mm2 in biopsy. Conclusions The percentage of sputum eosinophils is significantly different between UC patients with proctitis and pancolitis. These immune abnormalities may be a common pattern that is present throughout the mucosae. |
| Databáze: | OpenAIRE |
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