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The aim of our study was to evaluate cellular content in induced sputum in chronic obstructive pulmonary disease (COPD) in relation to the degree of airway obstruction, macrophage count, and phenotype. We compared the proportion of macrophages and cells expressing the following markers: CD11b, CD14, CD54, and CD71 in induced sputum obtained from patients with mild-to-moderate and severe COPD (n=29)], asymptomatic smokers (n=18), and nonsmokers (n=18). The differential cell count and macrophage phenotypes were examined in induced sputum by immunocytochemistry. We observed a greater proportion of neutrophils and eosinophils and an elevated macrophage count in patients with COPD and in smokers in comparison with nonsmokers. Macrophages in patients with severe airway obstruction were characterized by a significantly elevated expression of CD11b and CD14 markers. There were higher proportions of macrophages with expression of CD11b, CD14, CD54, and CD71 in induced sputum of smokers in comparison with nonsmokers. We concluded that macrophages are the cells involved in the inflammatory process caused by smoking in COPD. The macrophage phenotype with elevated CD11b and CD14 expressions was associated with severe airflow limitation.
Some patients with allergic rhinitis and no clinical evidence of asthma exhibit bronchial hyperresponsiveness. In the present study, induced sputum and acetylcholine and capsaicin challenges were assessed in four groups of adult subjects: allergic rhinitis (AR), allergic rhinitis with lower airway symptoms (ARLA), mild stable asthma (BA), and healthy volunteers (C) to correlate lower airway inflammatory markers with bronchial and cough reactivity. Patients with AR (n = 13) and ARLA (n = 11) did not take any anti-inflammatory drugs. Those with BA (n = 9) used inhaled corticosteroids and C (n = 10) were respiratory symptoms free. The patients underwent capsaicin cough challenge and sputum induction with hypertonic saline during the first visit, and acetylcholine bronchial challenge on a separate day. We found that the percentage of eosinophils in induced sputum was significantly higher in patients with AR, ARLA, and BA than in C 14.5 ±1.8(SE) vs. 13.5 ±2.9 vs. 13.9 ±4.0 vs. 3.6 ±0.8 %, respectively (P=0.012). In contrast, acetylcholine PD20 in patients with AR, ARLA, and BA was significantly lower than in C 5.6 ±0.9 vs. 4.1 ±0.4 vs. 2.8 ±0.4 vs. 12.9 ±2.7 mg, respectively (P=0.0001). Neither the eosinophil percentage nor PD20, nor cough sensitivity appreciably differed across the patients groups. Sputum eosinophils correlated significantly with the acetylcholine PD20 (r=0.37, P=0.016). We conclude that eosinophilic inflammation of lower airways and increased bronchial reactivity were present in adult patients with allergic rhinitis.
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