Clinical application of induced and spontaneous sputum in asthma and chronic obstructive pulmonary disease

In recent years induced sputum analysis has become a non-invasive method for the assessment of airway inflammation in obstructive airway diseases. Sputum induction is safe and well tolerated by the patients. The method has been standardized, and this has markedly improved the quality and reproducibility of sputum samples. Identification of sputum eosinophilia has the greatest clinical relevance as it predicts a favorable response to corticosteroids. Treatment strategy aiming normalisation of sputum eosinophil cell count may reduce the rate of exacerbations in asthma. Profiling inflammatory mediators in sputum supernatant provides new insights into the pathogenesis of asthma and chronic obstructive pulmonary disease. Cell type analysis in spontaneous sputum may also provide much information about inflammatory processes in the airways. Based on the results of clinical studies sputum analysis should be more often used in clinical settings in the future. Orv. Hetil., 2012, 153, 1847–1854.

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A study on asthma and chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.016 ◽

2021 ◽

Vol 6 (2) ◽

pp. 71-74

Author(s):

Venkatesh B.C ◽

Raju C.H

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Smoking History ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Airway Diseases ◽

History Of ◽

Sputum Eosinophils ◽

Obstructive Airway Diseases ◽

Asthma Group

There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. This is prospective, observational and descriptive study conducted at MNR Medical College and Hospital, Sangareddy, India from June 2020 to December 2020 among chronic airway diseases who were classified into three groups (COPD, Asthma, and Asthma and COPD overlap (ACO)). Patients with COPD and ACO were diagnosed according to GOLD guidelines 2020 and patients with asthma were diagnosed according to Global Initiative for Asthma (GINA) guidelines 2020. : Regarding the age difference between groups, it was found that patients who were diagnosed as having COPD and ACO were with mean age of 57.23±8.54 and 56.26±7.73 years, respectively. The men age of patients of Asthma was 57.51±8.43. In our study, 28 (30%) patients as having COPD, 39 (45.5%) patients were diagnosed as having ACO, 23 (24.4%) patients were diagnosed as having asthma. In our study comparison of groups regarding history of atopy. We found that 71.7% of ACO group, 78.2% of asthma group and 25% of COPD group had a positive history of atopy. Comparison of study groups regarding sputum eosinophils revealed that 30.7 % of ACO group, 73.9% of asthma group and 32.1% of COPD group had positive sputum eosinophils. ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

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Oxidative stress and macrophages: driving forces behind exacerbations of asthma and chronic obstructive pulmonary disease?

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.00456.2018 ◽

2019 ◽

Vol 316 (2) ◽

pp. L369-L384 ◽

Cited By ~ 10

Author(s):

Linsey E. S. de Groot ◽

T. Anienke van der Veen ◽

Fernando O. Martinez ◽

Jörg Hamann ◽

René Lutter ◽

...

Keyword(s):

Oxidative Stress ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Driving Forces ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Current State ◽

Airway Diseases ◽

Obstructive Airway Diseases

Oxidative stress is a common feature of obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD). Lung macrophages are key innate immune cells that can generate oxidants and are known to display aberrant polarization patterns and defective phagocytic responses in these diseases. Whether these characteristics are linked in one way or another and whether they contribute to the onset and severity of exacerbations in asthma and COPD remain poorly understood. Insight into oxidative stress, macrophages, and their interactions may be important in fully understanding acute worsening of lung disease. This review therefore highlights the current state of the art regarding the role of oxidative stress and macrophages in exacerbations of asthma and COPD. It shows that oxidative stress can attenuate macrophage function, which may result in impaired responses toward exacerbating triggers and may contribute to exaggerated inflammation in the airways.

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A study on overview of asthma-chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.025 ◽

2021 ◽

Vol 6 (2) ◽

pp. 117-120

Author(s):

P Ajoy Kumar ◽

Are Suryakari Sreekanth

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Smoking History ◽

Chronic Obstructive ◽

Age Difference ◽

Obstructive Pulmonary Disease ◽

Asthmatic Patients ◽

Airway Diseases ◽

Obstructive Airway Diseases ◽

Chronic Airway

Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another.There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. A prospective study included 70 patients with chronic airway diseases who were classified into three groups (COPD, asthma and ACO). They were selected from Department of Pulmonary Medicine, Kurnool Medical College outpatient clinic during the period from January 2019 to December 2019, where patients with COPD and ACO were diagnosed according to GOLD guidelines and patients with asthma were diagnosed according to GINA guidelines. Patients enrolled in the study were subjected to full history taking, clinical examination, full laboratory examination, plain chest radiography, spirometry before bronchodilator and after bronchodilator administration (reversibility test) and sputum analysis for counting eosinophils cells. This study was conducted on 70 patients with chronic airway diseases (COPD, asthma and asthma COPD overlap) were selected. It included 47(67.1%) males and 23(32.8%) females. In our study, 30 (42.8%) patients as having COPD, 19(27.1%) patients were diagnosed as having asthma and 21(30%) patients were diagnosed as having ACO. Regarding the age difference between groups, it was found that patients who were diagnosed as having ACO were older than asthmatic patients with mean age of 49.43±5.83 and 47.23±6.73years, respectively. The men age of patients with COPD was 57.32±6.74 which was older than both ACO and asthmatic patients. ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

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The success and safety profile of sputum induction in patients with chronic obstructive pulmonary disease: An Indian experience

Indian Journal of Tuberculosis ◽

10.1016/j.ijtb.2016.11.016 ◽

2017 ◽

Vol 64 (3) ◽

pp. 201-205 ◽

Cited By ~ 1

Author(s):

Lalita Fernandes ◽

Anthony Menezes Mesquita

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Safety Profile ◽

Chronic Obstructive ◽

Sputum Induction ◽

Obstructive Pulmonary Disease ◽

Indian Experience

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Update on Clinical Inflammometry for the Management of Airway Diseases

Canadian Respiratory Journal ◽

10.1155/2013/602936 ◽

2013 ◽

Vol 20 (2) ◽

pp. 117-120 ◽

Cited By ~ 19

Author(s):

Parameswaran Nair

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Airway Inflammation ◽

Pulmonary Disease ◽

Treatment Strategies ◽

Chronic Obstructive ◽

Central Feature ◽

Obstructive Pulmonary Disease ◽

Cell Counts ◽

Airway Diseases ◽

Anti Inflammatory

Airway inflammation is a central feature of many airway diseases such as asthma, chronic bronchitis, bronchiectasis and chronic cough; therefore, it is only logical that it is measured to optimize its treatment. However, most treatment recommendations, including the use of anti-inflammatory therapies such as corticosteroids, are based on assessments of only airflow and symptoms. Over the past 10 years, methods have been developed to assess airway inflammation relatively noninvasively. Quantitative cell counts in sputum and the fraction of exhaled nitric oxide are the most validated tests. Judicious use of currently available drugs, such as corticosteroids, bronchodilators and antibiotics, and other anti-inflammatory therapies guided by sputum eosinophil and neutrophil counts, have been demonstrated to decrease exacerbations of asthma and chronic obstructive pulmonary disease, ameliorate cough, improve quality of life in patients with these diseases and is cost effective compared with treatment strategies based on guidelines that do not incorporate these measurements. Thus, it is unfortunate that this is not used more widely in the management of airway diseases, particularly in patients with severe asthma and chronic obstructive pulmonary disease who experience frequent exacerbations.

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The Role of Electronic Noses in Phenotyping Patients with Chronic Obstructive Pulmonary Disease

Biosensors ◽

10.3390/bios10110171 ◽

2020 ◽

Vol 10 (11) ◽

pp. 171 ◽

Cited By ~ 1

Author(s):

Simone Scarlata ◽

Panaiotis Finamore ◽

Martina Meszaros ◽

Silvano Dragonieri ◽

Andras Bikov

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Exhaled Breath ◽

Related Factors ◽

Obstructive Pulmonary Disease ◽

Electronic Noses ◽

Non Invasive ◽

Exhaled Breath Analysis ◽

Invasive Method

Chronic obstructive pulmonary disease (COPD) is a common progressive disorder of the respiratory system which is currently the third leading cause of death worldwide. Exhaled breath analysis is a non-invasive method to study lung diseases, and electronic noses have been extensively used in breath research. Studies with electronic noses have proved that the pattern of exhaled volatile organic compounds is different in COPD. More recent investigations have reported that electronic noses could potentially distinguish different endotypes (i.e., neutrophilic vs. eosinophilic) and are able to detect microorganisms in the airways responsible for exacerbations. This article will review the published literature on electronic noses and COPD and help in identifying methodological, physiological, and disease-related factors which could affect the results.

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Safety of sputum induction in moderate-to-severe chronic obstructive pulmonary disease

Respiratory Medicine ◽

10.1053/rmed.2002.1342 ◽

2002 ◽

Vol 96 (7) ◽

pp. 482-486 ◽

Cited By ~ 17

Author(s):

E.RAND SUTHERLAND ◽

J.P. AK ◽

E.L. LANGMACK ◽

P.E. SILKOFF ◽

R.J. MARTIN

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Sputum Induction ◽

Obstructive Pulmonary Disease

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Inhaled corticosteroid suppression of cathelicidin drives dysbiosis and bacterial infection in chronic obstructive pulmonary disease

Science Translational Medicine ◽

10.1126/scitranslmed.aav3879 ◽

2019 ◽

Vol 11 (507) ◽

pp. eaav3879 ◽

Cited By ~ 14

Author(s):

Aran Singanayagam ◽

Nicholas Glanville ◽

Leah Cuthbertson ◽

Nathan W. Bartlett ◽

Lydia J. Finney ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Bacterial Infection ◽

Pulmonary Disease ◽

Cathepsin D ◽

Inhaled Corticosteroids ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Airway Diseases ◽

Infection Susceptibility ◽

Pulmonary Immunity

Bacterial infection commonly complicates inflammatory airway diseases such as chronic obstructive pulmonary disease (COPD). The mechanisms of increased infection susceptibility and how use of the commonly prescribed therapy inhaled corticosteroids (ICS) accentuates pneumonia risk in COPD are poorly understood. Here, using analysis of samples from patients with COPD, we show that ICS use is associated with lung microbiota disruption leading to proliferation of streptococcal genera, an effect that could be recapitulated in ICS-treated mice. To study mechanisms underlying this effect, we used cellular and mouse models of streptococcal expansion withStreptococcus pneumoniae, an important pathogen in COPD, to demonstrate that ICS impairs pulmonary clearance of bacteria through suppression of the antimicrobial peptide cathelicidin. ICS impairment of pulmonary immunity was dependent on suppression of cathelicidin because ICS had no effect on bacterial loads in mice lacking cathelicidin (Camp−/−) and exogenous cathelicidin prevented ICS-mediated expansion of streptococci within the microbiota and improved bacterial clearance. Suppression of pulmonary immunity by ICS was mediated by augmentation of the protease cathepsin D. Collectively, these data suggest a central role for cathepsin D/cathelicidin in the suppression of antibacterial host defense by ICS in COPD. Therapeutic restoration of cathelicidin to boost antibacterial immunity and beneficially modulate the lung microbiota might be an effective strategy in COPD.

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