Sputum appearance, cell viability, total and differential cell counts, and the fluid phase measurements of the 32 patients who produced sputum before treatment (Table 2) were examined. In 19 (59%) patients, the proportion and absolute number of neutrophils were above the upper limit for healthy patients. None of the patients had an increase in the proportion or absolute number of eosinophils (0 [0.01]x106/mL). Sputum ECP levels were above the normal range only in seven patients. Fibrinogen levels were increased in each sputum sample, and this was accompanied by high levels of IL-8, albumin and substance P (the last two markers were measured only in 19 samples). These sputum findings were not explained by a previous history of smoking or an association of postnasal drip (six patients). Fluid phase markers did not differ significantly between patients with and without sputum neutrophilia. ventolin inhalers
The correlations between the inflammatory markers in sputum (Figure 2) were also studied. Fluid phase ECP was strongly correlated with neutrophils (rho=0.61, P=0.001) but not with eosinophils (rho=0.38, P=0.06). IL-8 was correlated with neutrophils (rho=0.72, P<0.001), fibrinogen (rho=0.65, P<0.001), albumin (rho=0.67, P=0.001) and ECP (rho=0.60, P=0.001). Substance P was correlated with albumin (rho=0.60, P=0.006) but not with fibrinogen (rho=0.48, P=0.07).
Table 2. Clinical features and sputum inflammatory indices in subjects with and without sputum neutrophilia
|Subjects (n)||ClinicalVAS(mm)||featuEx-S(n)||resPND(n)||VJ=||E (%)||N (%)||M (%)||Sput L (%)||um in BEC(%)||dices ECP F (pg/L) (pg/mL)||Albumin(pg/L)*||IL-8(pg/L)||Subst P (pg/mL)*|
|Neutrophilia||52||6||3||3.8 (3.9)||0 (0.3)||0)(4.0
|No neutrophilia||56||5||3||2.1 (4.1)||0 (0.2)||2).05.
|All subjects||55||11||6||2.6 (4.5)||0 (0.3)||39||58||0.5||0||192||3200||880||4840||836|
|Sputum values (upper limit) for healthy subjects’1‘||5.5||1.2||33.7||80.6||2.5||1.2||655||1275||588||–||–|
Data are expressed as median and interquartile range, p values were calculated for differences between groups. *Measured only in 19 subjects; fFrom reference 5 BEC Bronchial epithelial cells; E Eosinophils; ECP Eosinophil cationic protein; Ex-S Ex-smokers; F Fibrinogen; IL Interleukin; L Lymphocytes; M Macrophages; N Neutrophils; NS Not significant; PND Postnasal drip; Subst P Substance P; TCC Total cell count; V4S Visual analogue scale
Figure 2) Correlations between sputum inflammatory indexes. A strong correlation was observed between eosinophil cationic protein (ECP) and neutrophils but not eosinophils. Sputum interleukin (lL)-8 was strongly correlated with neutrophils, fibrinogen and ECP. Substance P correlated only with albumin