Induced Sputum for Assessment of Airway Inflammation in Patients with Copd, Asthma and Asthma-like Symptoms

.................................................................................................................. 9 INTRODUCTION ...................................................................................................... 10 REVIEW OF THE LITERATURE ........................................................................... 11 DEFINITIONS ............................................................................................................ 11 Chronic obstructive pulmonary disease (COPD) ................................................ 11 Asthma ................................................................................................................. 11 Asthma-like symptoms, chronic cough with eosinophilic bronchitis ................. 12 ASSESSMENT OF AIRWAY INFLAMMATION ................................................... 13 Direct measurement of airway inflammation ...................................................... 13 Indirect measurement of airway inflammation ................................................... 16 INDUCED SPUTUM ................................................................................................. 17 Sputum induction ................................................................................................. 17 Sputum processing ............................................................................................... 19 Spontaneous versus induced sputum ................................................................... 22 Comparison between direct measurements of airway inflammation .................. 23 Clinical applications of assessment of induced sputum ..................................... 23 Induced sputum in children ................................................................................. 23 Induced sputum in other diseases ........................................................................ 24 AIMS OF THE STUDY .............................................................................................. 25 SUBJECTS AND METHODS ................................................................................... 26 STUDY POPULATIONS AND DESIGNS.............................................................. 26 Study I .................................................................................................................. 26 Study II ................................................................................................................. 27 Study III ............................................................................................................... 27 Study IV ............................................................................................................... 28 Study V ................................................................................................................. 30 METHODS ................................................................................................................... 30 Lung function measurements ............................................................................... 30 Skin prick tests ..................................................................................................... 31 Sputum induction ................................................................................................. 32 Sputum processing ............................................................................................... 32 Fluid-phase measurements ................................................................................... 36 Statistical analyses ............................................................................................... 36 RESULTS ..................................................................................................................... 38 CLINICAL CHARACTERISTICS OF SUBJECTS................................................ 38