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Airway inflammation and mannitol challenge test in COPD.

Abstract：

BACKGROUND:Eosinophilic airway inflammation has successfully been used to tailor anti-inflammatory therapy in chronic obstructive pulmonary disease (COPD). Airway hyperresponsiveness (AHR) by indirect challenges is associated with airway inflammation. We hypothesized that AHR to inhaled mannitol captures eosinophilia in induced sputum in COPD. METHODS:Twenty-eight patients (age 58 ± 7.8 yr, packyears 40 ± 15.5, post-bronchodilator FEV1 77 ± 14.0%predicted, no inhaled steroids ≥4 wks) with mild-moderate COPD (GOLD I-II) completed two randomized visits with hypertonic saline-induced sputum and mannitol challenge (including sputum collection). AHR to mannitol was expressed as response-dose-ratio (RDR) and related to cell counts, ECP, MPO and IL-8 levels in sputum. RESULTS:There was a positive correlation between RDR to mannitol and eosinophil numbers (r = 0.47, p = 0.03) and level of IL-8 (r = 0.46, p = 0.04) in hypertonic saline-induced sputum. Furthermore, significant correlations were found between RDR and eosinophil numbers (r = 0.71, p = 0.001), level of ECP (r = 0.72, p = 0.001), IL-8 (r = 0.57, p = 0.015) and MPO (r = 0.64, p = 0.007) in sputum collected after mannitol challenge. ROC-curves showed 60% sensitivity and 100% specificity of RDR for >2.5% eosinophils in mannitol-induced sputum. CONCLUSIONS:In mild-moderate COPD mannitol hyperresponsiveness is associated with biomarkers of airway inflammation. The high specificity of mannitol challenge suggests that the test is particularly suitable to exclude eosinophilic airways inflammation, which may facilitate individualized treatment in COPD. TRIAL REGISTRATION:Netherlands Trial Register (NTR): NTR1283.

journal_name

Respir Res

journal_title

Respiratory research

authors

de Nijs SB,Fens N,Lutter R,Dijkers E,Krouwels FH,Smids-Dierdorp BS,van Steenwijk RP,Sterk PJ

doi

10.1186/1465-9921-12-11

subject

Has Abstract

pub_date

2011-01-18 00:00:00

pages

11

eissn

1465-9921

issn

1465-993X

pii

1465-9921-12-11

journal_volume

12

pub_type

杂志文章,随机对照试验

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