Document Detail

Neutrophil predominance in induced sputum from asthmatic patients. Therapeutic implications and role of clara cell 16-KD protein.
MedLine Citation:
PMID:  21893447     Owner:  NLM     Status:  Publisher    
Eosinophil is considered to be a main protagonist in asthma; however, often discordances between clinical manifestations and response to treatment are observed. We aimed to determine the occurrence of neutrophil predominance in asthma and to identify its characteristics on the basis of clinical-functional features, induced sputum cellular pattern and soluble molecules, to guide the appropriated anti-inflammatory therapy. A total of 41 patients were included in randomized groups: 21-40 year-old, with stable mild-to-severe asthma, steroid-naïve and non-smokers. An induced sputum sample was obtained under basal conditions, a second one after treatment with budesonide (400 ug b.i.d.) or montelukast (10 mg/d) for six weeks, and a final one after a 4-week washout period. By cytospin we evaluated eosinophil (EP) or neutrophil predominance (NP), and in supernatant we determined LTE4, and CC16. Peak expiratory flow variability (PEFV) was measured. A total of 23/41 patients corresponded to EP and 18/41 patients to NP. The PEFV was higher in EP than in NP. LTE4 was higher with NP than with EP. No difference was found for CC16. Montelukast reduced the predominant cell in both subsets, whereas budesonide only reduced eosinophils in EP. Budesonide and montelukast reduced PEFV in EP but not in NP. Considering the total treated-samples in each subset, CC16 level increased significantly in EP. In conclusion: a NP subset of asthmatic patients was identified. These patients show a lower bronchial lability; the leukotriene pathway is involved which responds to anti-leukotriene treatment. This phenotype shows a poor recovery of CC16 level after treatment.
Elisa M Uribe Echevarría; Cristina A Maldonado; Agustín M Uribe Echevarría; Agustín Aoki
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Publication Detail:
Journal Detail:
Title:  Medicina     Volume:  71     ISSN:  0025-7680     ISO Abbreviation:  -     Publication Date:  2011  
Date Detail:
Created Date:  2011-9-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0204271     Medline TA:  Medicina (B Aires)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  343-349     Citation Subset:  -    
Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba.
Vernacular Title:
Predominio de neutrófilos en esputo inducido de asmáticos. Implicancias terapéuticas y rol de la proteína 16-KD de la célula clara.
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