Airway Inflammation and Cellular Stress in Noneosinophilic Atopic Asthma: Subjects
The primary aim was to test the hypothesis that NEA shows a distinct pattern of airway inflammation, primarily neutrophilic, compared to EA. Considering that NEA has been related to increased asthma severity, a relative increase in stress-related protein levels would also be expected, The secondary aim of the study was to test the hypothesis that airway inflammation in NEA patients resembles that seen in COPD patients. Our results did not show any difference between NEA and EA patients. Moreover, the inflammatory profile of NEA patients was different from that seen in COPD patients.
Induced sputum samples were obtained from 37 asthmatic patients and 25 patients with COPD who had been recruited from the Pulmonary Outpatient Clinic of the University Hospital of Heraklion in Crete, Greece. A diagnosis of asthma was made according to the National Heart, Lung, and Blood Institute criteria. A diagnosis of COPD was made according to the current guidelines., All asthmatic patients were life-long atopic nonsmokers. All COPD patients were ex-smokers with irreversible airflow limitation (ie, increases in FEV1 of <12% of the predicted baseline FEV1 after the inhalation of 400 |j,g of salbutamol and/or increases in FEV1 of < 200 mL). None of the COPD patients reported a history of allergic diseases or showed atopy. Atopy was defined by at least one positive skin-prick reaction test result or a positive radioallergosorbent test result. read only
All COPD and asthmatic patients were receiving therapy with inhaled steroids (at least 400 mg/d fluticasone) and inhaled bronchodilators (short-acting P2-agonists and/or long-acting P2-agonists). No subject was receiving other medication or had another pulmonary or systemic disease.
At the time of the study, all patients were clinically stable. No subject had experienced a respiratory infection or an exacerbation for at least 6 weeks prior to entering the study. The Hospital Ethics Committee approved the protocol, and all subjects gave their written consent.