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Assessment of Airway Inflammation in Asthma Using Non-Invasive Methods

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Asthma: Epidemiology, Anti-Inflammatory Therapy and Future Trends

Part of the book series: Respiratory Pharmacology and Pharmacotherapy ((RPP))

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Abstract

Clinical measurement has become an essential complement to traditional physical diagnosis. An ideal clinical measurement should be quantitative, have a high level of reliability and accuracy, be safe, acceptable to the patient, easy to perform and non-invasive. The latter demands that the technique should not break the skin or the lining epithelium and should be devoid of effects on the tissues of the body by the dissipation of energy or the introduction of infection [1]. It is therefore logical that for a given measurement, a non-invasive test will be preferred if it provides the same information with the same accuracy and precision.

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References

  1. Taylor DEM, Whamond J (1977) Non-invasive clinical measurement. University Park Press, London, ix–xv

    Google Scholar 

  2. Dorland’s Illustrated Medical Dictionary (1988) WB Saunders Company, Philadelphia, p 835

    Google Scholar 

  3. Osier W (1892) The principles and practice of medicine. Appleton and Co, New York, p 497

    Google Scholar 

  4. Weissman G (1988) Inflammation• Historical perspectives. In: JI Gallin et al. (eds): Inflammation—Basic principles and clinical correlates. Raven Press, New York, 5

    Google Scholar 

  5. Ernst P, FitzGerald JM, Spier S (1996) Canadian asthma consensus conference: summary of recommendations. Can Respir J 3: 89–100

    Google Scholar 

  6. Sheffer AL, Bousquet J, Busse WW et al (1992) International consensus report on the diagnosis and management of asthma. Publication 92–3091, US Department of Health and Human Services, National Institute of Health, Bethesda, Maryland,. Eur Respir J 5: 601–41

    Google Scholar 

  7. O’Byrne PM, Hargreave FE (1994) Non-invasive monitoring of airway inflammation Am J Respir Crit Care Med 150: S100–2

    PubMed  Google Scholar 

  8. Kharitonov SA, Yates D, Robbins RA, Logan-Sinclair R, Shinebourne EA, Barnes PJ (1994) Increased nitric oxide in exhaled air of asthmatic patients. Lancet 343: 133–5

    Article  PubMed  CAS  Google Scholar 

  9. Iikura Y, Yamada T, Akasawa A, Ebisawa M, Katasunuma T (1993) Monitoring of inflammation in relation to pathophysiology. Allergy 48: 138–42

    Article  PubMed  CAS  Google Scholar 

  10. Paganin F, Seneterre E, Chanez P et al (1996) Computed tomography of the lungs in asthma: influence of disease severity and etiology. Am J Respir Crit Care Med 153: 110–4

    PubMed  CAS  Google Scholar 

  11. Fletcher FH, Fletcher SW, Wagner EH (1996) In: Clinical Epidemiology-the essentials Williams and Wilkins 19–42

    Google Scholar 

  12. Gibson PG, Wong BJO, Hepperle MJE, Kline PA, Girgis-Gabardo A, Guyatt G et al (1992) A research method to induce and examine a mild exacerbation of asthma by withdrawal of inhaled corticosteroid. Clin Exp Allergy 22: 525–32

    Article  PubMed  CAS  Google Scholar 

  13. Kendrick AH, Higgs CMB, Whitfield MJ, Laszlo G (1993) Accuracy of perception of severity of asthma: patients treated in general practice. BMJ 307: 422–4

    Article  PubMed  CAS  Google Scholar 

  14. Pavord ID, Pizzichini MMM, Clelland L, Efthimiadis A, Hargreave FE (1996) Sputum inflammatory cell characteristics of prednisone dependent asthma. Am J Respir Crit Care Med 153: A293

    Google Scholar 

  15. Pizzichini MMM, Pizzichini E, Clelland L, Efthimiadis A, Mahony J, Dolovich J, Hargreave FE (1997) Sputum in severe exacerbations of asthma: kinetics of inflammatory indices after prednisone treatment. Am J Respir Crit Care Med 155: 1501–8

    PubMed  CAS  Google Scholar 

  16. Kirby JG, Hargreave FE, Gleich GJ, O’Byrne PM (1987) Bronchoalveolar cell profiles of asthmatic and non-asthmatic subjects. Am Rev Respir Dis 136: 379–83

    Article  PubMed  CAS  Google Scholar 

  17. Wardlaw AJ, Dunnette S, Gleich GJ, Collins JV, Kay AB (1988) Eosinophils and mast cells in bronchoalveolar lavage in subjects with mild asthma. Am Rev Respir Dis 137: 62–9

    Article  PubMed  CAS  Google Scholar 

  18. Cartier A, Thompson NC, Frith PA, Roberts R, Hargreave FE (1982) Allergen-induced increase in bronchial responsiveness to histamine: relationsihp to the late asthmatic response and change in airway calibre. JAllerg Clin Jmmunol 70: 170–7

    Article  CAS  Google Scholar 

  19. Twentyman OP, Holgate ST (1988) The temporal development of increased bronchial responsiveness following allergen challenge and its relationship to the late asthmatic reaction. Am Rev Respir Dis 137: 135

    Google Scholar 

  20. Josephs LK, Gregg I, Mullee MA, Holgate ST (1989) Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma. Am Rev Respir Dis 140: 350–7

    Article  PubMed  CAS  Google Scholar 

  21. Barnes PJ, Kharitonov SA (1996) Exhaled nitric oxide: a new lung function test. Thorax 51: 233–7

    Article  PubMed  CAS  Google Scholar 

  22. Kharitonov SA, O’Connor BJ, Evans DJ, Barnes PJ (1995) Allergen induced late asthmatic reactions are associated with elevation of exhaled nitric oxide. Am J Respir Crit Care Med 151: 1894–9

    PubMed  CAS  Google Scholar 

  23. Jatakanon A, Lim S, Kharitonov SA, Chung KF, Barnes PJ (1998) Correlation between exhaled nitric oxide, sputum eosinophils and metacholine responsiveness in patients with mild asthma. Thorax 53: 91–95

    Article  PubMed  CAS  Google Scholar 

  24. Kharitonov SA, Wells AU, O’Connor BJ, Hansell DM, Cole PJ, Barnes PJ (1995) Elevated levels of exhaled nitric oxide in bronchiectasis. Am J Respir Crit Care Med 151: 1889–93

    CAS  Google Scholar 

  25. Kharitonov SA, Yates D, Barnes PJ (1995) Increased nitric oxide in exhaled air or normal human subjects with upper respiratory tract infections. Eur Respir J 8: 295–297

    Article  PubMed  CAS  Google Scholar 

  26. Taylor IK, Hill AA, Hayes B et al (1996) Imaging allergen-invoked airway inflammation in atopic asthma with [18F]-flurodeoxyglucose and positron emission tomography. Lancet 347: 937–940

    Article  PubMed  CAS  Google Scholar 

  27. Kips JC, Fahy JV, Hargreave FE, Ind PW, in’t Veen JCCM (1998) Position paper on methods for sputum induction and analysis of induced sputum as a method for assessing airway inflammation in asthma. Eur Respir J 11(Suppl. 26): 9S–12S

    Google Scholar 

  28. Fahy JV, Wong H, Liu J, Boushey HA (1995) Comparison of samples collected by sputum induction and bronchoscopy from asthmatic and healthy subjects. Am J Respir Crit Care Med 152: 53–8

    PubMed  CAS  Google Scholar 

  29. Pin I, Gibson PG, Kolendowicz et al (1992) Use of induced sputum cell counts to investigate airway inflammation in asthma. Thorax 47: 25–9

    Article  PubMed  CAS  Google Scholar 

  30. Iredale MJ, Wanklyn SAR, Philips IP, Krauz T, Ind PW (1994) Non-invasive assessment of bronchial inflammation in asthma: no correlation between eosinophilia of induced sputum and bronchial responsiveness to inhaled hypertonic saline. Clin Exp Allergy 24: 940–5

    Article  PubMed  CAS  Google Scholar 

  31. Popov TA, Pizzichini E, Kolendowicz R et al (1995) Some technical factors influencing the induction of sputum for cell analysis. Eur Respir J 8: 559–65

    PubMed  CAS  Google Scholar 

  32. Pizzichini E, Pizzichini MMM, Efthimiadis A, Hargreave FE, Dolovich J (1996) Measurement of inflammatory indices in induced sputum: effects of selection of sputum to minimize salivary contamination. Eur Respir J 9: 1174–80

    Article  PubMed  CAS  Google Scholar 

  33. Pizzichini MMM, Popov T, Efthimiadis A et al (1996) Spontaneous and induced sputum to measure indices of airway inflammation. Am J Respir Crit Care Med 154: 866–9

    PubMed  CAS  Google Scholar 

  34. Efthimiadis A, Pizzichini E, Pizzichini MMM, Hargreave FE (1997) Sputum examination for indices of airway inflammation: laboratory procedures. Astra Draco AB, Lund, Sweden

    Google Scholar 

  35. Pizzichini E, Pizzichini MMM, Efthimiadis A et al (1996) Indices of inflammation in induced sputum: reproducibility and validity of cell and fluid phase measurements. Am J Respir Crit Care Med 154: 308–17

    PubMed  CAS  Google Scholar 

  36. Keatings VM, Barnes PJ (1997) Granulocyte activation markers in induced sputum: comparison between chronic obstructive pulmonary disease, asthma and normal subjects. Am J Respir Crit Care Med 155: 449–53

    PubMed  CAS  Google Scholar 

  37. Keatings VM, Collins PD, Scott DM, Barnes PJ (1996) differences in interleukin-8 and tumor necrosis factor-ct in induced sputum from patients with chronic obstructive pulmonary disease or asthma. Am J Respir Crit Care Med 153: 530–4

    PubMed  CAS  Google Scholar 

  38. Kurashima K, Mukaida N, Fujimura M et al (1996) Increase of chemokine levels in sputum precedes exacerbation of acute asthma attacks. J Leukocyte Biol 59: 313–6

    PubMed  CAS  Google Scholar 

  39. Tomaki M, Ichinose M, Miura M et al (1995) Elevated substance P content in induced sputum from patients with asthma and patients with chronic bronchitis. Am J Respir Crit Care Med 151: 613–7

    PubMed  CAS  Google Scholar 

  40. Louis R, Shute J, Biagi S et al (1997) Cell infiltration, ICAM-1 expression and eosinophil chemotactic activity in asthmatic sputum Am J Respir Crit Care Med 155: 466–72

    PubMed  CAS  Google Scholar 

  41. Schoonbrood DFM, Lutter R, Habets FJM et al (1994) Analysis of plasma-protein leakage and local secretion in sputum from patients with asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 150: 1519–27

    PubMed  CAS  Google Scholar 

  42. Evans DJ, Barnes PJ, Spaethe SM et al (1996) Effect of a leukotriene B4 receptor antagonist LY293111 on allergen induced responses in asthma. Thorax 51: 1178–84

    Article  PubMed  CAS  Google Scholar 

  43. Fahy JV, Steiger DJ, Liu J, Basbaum CB, Finkbeiner WE, Boushey H (1993) Markers of mucus secretion and DNA levels in induced sputum from asthmatic and from healthy subjects. Am Rev Respir Dis 147: 1132–7

    PubMed  CAS  Google Scholar 

  44. Gibson PG, Girgis-Gabardo A, Hargreave FE et al (1989) Cellular characteristics of sputum from patients with asthma and chronic bronchitis. Thorax 44: 693–9

    Article  PubMed  CAS  Google Scholar 

  45. Gibson PG, Hargreave FE, Girgis-Gabardo A, Moms MM, Denburg JA, Dolovich J (1995) Chronic cough with eosinophilic bronchitis and examination for variable airflow obstruction and response to corticosteroid. Clin Exp Allergy 25: 127–32

    Article  PubMed  CAS  Google Scholar 

  46. Turner MO, Hussack P, Sears MR, Dolovich J, Hargreave FE (1995) Exacerbations of asthma without sputum eosinophilia. Thorax 50: 1057–61

    Article  PubMed  CAS  Google Scholar 

  47. Fahy JV, Kim KW, Liu J, Boushey HA (1995) Prominent neutrophilic inflammation in sputum from subjects with asthma exacerbation. JAllerg Clin Immunol 95: 843–52

    Article  CAS  Google Scholar 

  48. Maestrelli P, Saetta M, Di Stefanno A et al (1995) Comparison of leukocyte counts in sputum, bronchial biopsies and bronchoalveolar lavage. Am J Respir Crit Care Med 152: 1926–31

    PubMed  CAS  Google Scholar 

  49. Pizzichini E, Pizzichini MMM, Kidney JC, Efthimiadis A, Popov T, Cox G, Dolovich J, O’Byrne PM, Hargreave FE (1998) Induced sputum, bronchoalveolar lavage and blood from mild asthmatics: inflammatory cells, lymphocyte subsets and soluble markers compared. Eur Respir J 11: 828–834

    Article  PubMed  CAS  Google Scholar 

  50. Parameswaran K, Pizzichini MMM, Li D, Pizzichini E, Jeffery PK, Hargreave FE (1998) Serial sputum cell counts in the management of chronic airflow limitation. Eur Respir J 11: 1405–1408

    Article  PubMed  CAS  Google Scholar 

  51. In’t Veen JCCM, de Gouw HWFM, Smits HH et al (1996) Repeatability of cellular and soluble markers of inflammation in induced sputum from patients with asthma. Eur Respir J 9: 2441–7

    Article  Google Scholar 

  52. Kidney JC, Wong AG, Efthimiadis A et al (1996) Elevated B-cells in sputum of asthmatics: close correlation with eosinophils. Am J Respir Crit Care Med 153: 540–4

    PubMed  CAS  Google Scholar 

  53. Pin I, Freitag AP, O’Byrne PM et al (1992) Changes in the cellular profile of induced sputum after allergen-induced asthmatic responses. Am Rev Respir Dis 145: 1265–9

    PubMed  CAS  Google Scholar 

  54. Maestrelli P, Calcagni PG, Saetta M et al (1994) Sputum eosinophilia after responses induced by isocyanates in sensitized subjects. Clin Exp Allergy 24: 29–34

    Article  PubMed  CAS  Google Scholar 

  55. Claman DM, Boushey DA, Liu J, Wong H, Fahy JV (1994) Analysis of induced sputum to examine the effects of prednisone on airway inflammation in asthmatic subjects. J Allerg Clin Immunol 94: 861–9

    Article  CAS  Google Scholar 

  56. Pizzichini MMM, Pizzichini E, Clelland E, Efthimiadis A, Pavord I, Dolovich J, Hargreave FE (1999) Prednisone dependent asthma• inflammatory indices in induced sputum. Eur Respir J 13: 15–21

    Article  PubMed  CAS  Google Scholar 

  57. Gauvreau GM, Doctor J, Watson RM, Jordana M, O’Byrne PM (1996) Effects of inhaled budesonide on allergen induced airway responses and inflammation. Am J Respir Crit Care Med 154: 1267–71

    PubMed  CAS  Google Scholar 

  58. Pizzichini E, Pizzichini MMM, Efthimiadis A, Dolovich J, Hargreave FE (1997) Measuring airway inflammation in asthma: eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood. JAllerg Clin Immunol 99: 539–44

    Article  CAS  Google Scholar 

  59. Anderson SD, Smith CM, Rodwell LT, du Toit JI, Riedler J, Robertson CF (1995) The use of non-isotonic aerosols for evaluating bronchial hyperresponsiveness. In: CL Spector (ed): Provocation testing in clinical practice. Marcel Dekker, New York, 249–78

    Google Scholar 

  60. Wong HH, Fahy JV (1997) Safety of one method of sputum induction. Am Rev Respir Crit Care Med 156: 299–303

    CAS  Google Scholar 

  61. Pizzichini E, Pizzichini MMM, Gibson P, Parameswaran K, Gleich GJ, Berman L, Dolovich J, Hargreave FE (1998) Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis. Am J Respir Crit Care Med 158: 1511–1517

    PubMed  CAS  Google Scholar 

  62. Djukanovic R, Wilson JW, Lai CKW, Holgate ST, Howarth PH (1991) The safety aspects of fiberoptic bronchoscopy, bronchoalveolar lavage, and endobronchial biopsy in asthma. Am Rev Respir Dis 143: 772–7

    PubMed  CAS  Google Scholar 

  63. Van Vyve T, Chanez P, Bousquet J, Lacoste J, Michel F, Godard P (1992) Safety of bronchoalveolar lavage and bronchial biopsies in patients with asthma of variable severity. Am Rev Respir Dis 146: 116–21

    PubMed  Google Scholar 

  64. Keatings VM, Evans DJ, O’Connor BJ (1997) Cellular profiles in asthmatic airways: a comparison of induced sputum, bronchial washings and bronchoalveolar lavage fluid. Thorax 52: 372–4

    Article  PubMed  CAS  Google Scholar 

  65. Grootendorst DC, Sont JK, Willems LNA et al (1997) Comparison of inflammatory cell counts in asthma: induced sputum vs bronchoalveolar lavage and bronchial biopsies. Clin Exp Allergy 27: 769–79

    Article  PubMed  CAS  Google Scholar 

  66. Ward C, Gardiner PV, Booth H, Walters EH (1995) Intrasubject variability in airway inflammation sampled by bronchoalveolar lavage in stable asthmatics. Eur Respir J 8: 1866–71

    Article  PubMed  CAS  Google Scholar 

  67. Richmond I, Booth H, Ward C, Walters EH (1996) Intrasubject variability in airway inflammation in biopsies in mild to moderate stable asthma. Am J Respir Crit Care Med 153: 899–903

    PubMed  CAS  Google Scholar 

  68. Thomson Sir Wm (Lord Kelvin). (1891) Electrical units of measurement. In: Popular lectures and addresses. MacMillan and Co, London, 80–143

    Google Scholar 

  69. Gibson PG, Dolovich J, Denburg J, Ramsdale EH, Hargreave FE (1989) Chronic cough: eosinophilic bronchitis without asthma. Lancet 1346–8

    Google Scholar 

  70. Lemiere C, Efthimiadis A, Hargreave FE (1997) Occupational eosinophilic bronchitis without asthma: an unknown occupational airway disease. J Allergy Clin Immunol 100: 852–853

    Article  PubMed  CAS  Google Scholar 

  71. Wong AG, Pavord ID, Sears MR, Hargreave FE (1996) A case for serial examination of sputum inflammatory cells. Eur Respir J 9: 2174–5

    Article  PubMed  CAS  Google Scholar 

  72. Lemiere C, Pizzichini MMM, Balkissoon R, Efthimiadis A, Clelland L, O’Shaughnessy D, Dolovich J, Hargreave FE (1999) Diagnosing occupational asthma: use of induced sputum. Eur Respir J 13: 482–488

    Article  PubMed  CAS  Google Scholar 

  73. Pizzichini E, Pizzichini MMM, Johnston S, Hussack P, Efthimiadis A, Mahony J, Dolovich J, Hargreave FE (1998) Asthma and natural colds: inflammatory indices in induced sputum. A feasibility study. Am J Respir Crit Care Med 158: 1178–1184

    PubMed  CAS  Google Scholar 

  74. Parameswaran K, Pizzichini E, Pizzichini MMM, Hussack P, Efthimiadis A, Hargreave FE (1999) Clinical judgement of airway inflammation versus sputum cell counts in patients with asthma. Eur Respir J; in press

    Google Scholar 

  75. Pizzichini MMM, Pizzichini E, Parameswaran K, Clelland L, Efthimiadis A, Dolovich J, Hargreave FE (1999) Non-asthmatic chronic cough: no effect of treatment with an inhaled corticosteroid in patients without sputum eosinophilia. Can Respir J 6: 323–330

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Asthma Research Group, St. Joseph’s Hospital and McMaster University, Hamilton, Ontario, Canada, L8N 3Z5

    K. Parameswaran & F. E. Hargreave

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  1. K. Parameswaran
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  2. F. E. Hargreave
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Editors and Affiliations

  1. Department of Thoracic Medicine, Imperial College of Science, Technology and Medicine, National Heart and Lung Institute, London, SW3 6LY, England

    Mark A. Giembycz

  2. Clinical Studies Unit, The Royal Brompton National Heart and Lung Hospital, Sydney Street, London, SW3 6NP, England

    Brian J. O’Connor

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Parameswaran, K., Hargreave, F.E. (2000). Assessment of Airway Inflammation in Asthma Using Non-Invasive Methods. In: Giembycz, M.A., O’Connor, B.J. (eds) Asthma: Epidemiology, Anti-Inflammatory Therapy and Future Trends. Respiratory Pharmacology and Pharmacotherapy. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-8480-8_4

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  • DOI: https://doi.org/10.1007/978-3-0348-8480-8_4

  • Publisher Name: Birkhäuser, Basel

  • Print ISBN: 978-3-0348-9585-9

  • Online ISBN: 978-3-0348-8480-8

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