Cell counts in spontaneous sputum during exacerbations of asthma and COPD

J. D. Myers, A. Spanevello, G. Bolden, P. W. Ind

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Abstract

Asthma (As) and COPD are distinct diseases but overlap is a common clinical problem. Previous studies of bronchial histology have distinguished patients with stable asthma (As) from those with COPD but differences are less clear during exacerbations. Histological changes are mirrored by findings in induced sputum and BAL samples. We have assessed differential cell counts in spontaneous sputum (SS) expectorated during exacerbations of As and COPD. 25 patients (14 male) attending Hammersmith Hospital with moderate/severe acute exacerbations of airway disease (26 events) produced an adequate sample of SS within 48 h of presentation. They were classified by history, peak flow (PF) records and bronchodilator response into one of 3 groups: 10 asthmatics (A), mean age (range) 43 (18-79) yr; 9 with COPD, mean age (range) 66 (45-87) yr, and 7 with mixed clinical features (AC), mean age (range) 71 (64-78) yr. All patients in groups COPD and AC were ex- or current smokers (mean pack-years 45 and 32 respectively) as were 3 in A (group mean 1 pack-year). Only 2, both in AC, had bacteriologically confirmed infections. SS was fixed in formalin, embedded in paraffin wax and stained using chromotrope 2R. One investigator, blinded to clinical diagnosis, counted 200 cells per sample to provide differential counts (mean % ±SD). macrophages neutrophils eosinophils lymphocytes A 16.8 (±11.1) 50.1 (±32.4) 32.8 (±37.6) 1.3 (±1.4) AC 21.1 (±9.7) 76.3 (±11.0) 4.6 (±4.0) 1.4 (±1.4) COPD 15.6 (±9.8) 73.8 (±24.7) 7.2 (±16.6) 0.9 (±1.3) Severity of exacerbations was assessed (mean PF 1/min [% predicted]: A 158 [42%], AC 162 [40%], COPD 177 [39%]). COPD patients had significantly more neutrophils (p

Original languageEnglish
JournalThorax
Volume51
Issue numberSUPPL. 3
Publication statusPublished - Dec 1996

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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