Airway inflammation and mannitol challenge test in COPD
| Autor: | F.H. Krouwels, Peter J. Sterk, Reindert P. van Steenwijk, René Lutter, Niki Fens, Erica Dijkers, Selma B. de Nijs, Barbara S. Smids-Dierdorp |
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| Přispěvatelé: | Other departments, Pulmonology, AII - Amsterdam institute for Infection and Immunity, Faculteit der Geneeskunde |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Bronchoconstriction Anti-Inflammatory Agents Severity of Illness Index Pulmonary Disease Chronic Obstructive Predictive Value of Tests Forced Expiratory Volume Administration Inhalation Humans Medicine Eosinophilia Mannitol Pulmonary Eosinophilia Aged Netherlands Peroxidase lcsh:RC705-779 COPD business.industry Research Interleukin-8 Sputum Pneumonia lcsh:Diseases of the respiratory system Middle Aged Eosinophil respiratory system medicine.disease Hypertonic saline respiratory tract diseases Cross-Sectional Studies Treatment Outcome medicine.anatomical_structure ROC Curve Immunology Female Bronchial Hyperreactivity Inflammation Mediators medicine.symptom business medicine.drug |
| Zdroj: | Respiratory research, 12(1). BioMed Central Respiratory Research, Vol 12, Iss 1, p 11 (2011) Respiratory Research, 12(1):11. BioMed Central Respiratory Research |
| ISSN: | 1465-9921 |
| Popis: | Background Eosinophilic airway inflammation has successfully been used to tailor anti-inflammatory therapy in chronic obstructive pulmonary disease (COPD). Airway hyperresponsiveness (AHR) by indirect challenges is associated with airway inflammation. We hypothesized that AHR to inhaled mannitol captures eosinophilia in induced sputum in COPD. Methods Twenty-eight patients (age 58 ± 7.8 yr, packyears 40 ± 15.5, post-bronchodilator FEV1 77 ± 14.0%predicted, no inhaled steroids ≥4 wks) with mild-moderate COPD (GOLD I-II) completed two randomized visits with hypertonic saline-induced sputum and mannitol challenge (including sputum collection). AHR to mannitol was expressed as response-dose-ratio (RDR) and related to cell counts, ECP, MPO and IL-8 levels in sputum. Results There was a positive correlation between RDR to mannitol and eosinophil numbers (r = 0.47, p = 0.03) and level of IL-8 (r = 0.46, p = 0.04) in hypertonic saline-induced sputum. Furthermore, significant correlations were found between RDR and eosinophil numbers (r = 0.71, p = 0.001), level of ECP (r = 0.72, p = 0.001), IL-8 (r = 0.57, p = 0.015) and MPO (r = 0.64, p = 0.007) in sputum collected after mannitol challenge. ROC-curves showed 60% sensitivity and 100% specificity of RDR for >2.5% eosinophils in mannitol-induced sputum. Conclusions In mild-moderate COPD mannitol hyperresponsiveness is associated with biomarkers of airway inflammation. The high specificity of mannitol challenge suggests that the test is particularly suitable to exclude eosinophilic airways inflammation, which may facilitate individualized treatment in COPD. Trial registration Netherlands Trial Register (NTR): NTR1283 |
| Databáze: | OpenAIRE |
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