The Role of Eosinophilic Count in Induced Sputum in the Determination of Asthma Severity, Control and in the Adjustment of Drugs Dosage

Asthma is a chronic inflammatory disease of the airways, and long-term therapy for it is therefore directed towards the suppression of airway inflammation. Assessment of asthma severity and the effectiveness of therapy should be guided by the degree of airway inflammation. This is currently guided by indirect markers, such as lung function and existing asthma symptoms. Unfortunately, their uncertain relationship with the degree of airway inflammation and their temporarily improvement under bronchodilator therapy without controlling airway inflammation are considered major drawbacks. More¬over, the use of bronchoscopy for sampling of,the lower airway tissue is inappropriate for clinical practice, and thus this is only reserved for research purposes. Recently, interest has been directed towards developing relatively less invasive markers for monitoring the airway inflammation more directly. These markers had proved their ability to reflect airway inflammation, moreover, their change are in agreement with the findings in airway biopsies. They are useful in monitoring treatment effectiveness and are sensitive enough to reflect worsening of airway inflammation. Among various newer methods being developed for monitoring airway inflammation, sputum induction seem to be very promising, being reproduc¬ible and less invasive, and thus could be applied for sequential measurements. Thus this study aimed at revealing the role of induced sputum (by means of the determination of sputum eosinophilic percentage) in determining asthma severity, guiding the physicians in controlling asthma, and in the adjustment of drugs dosage. This study included 27 asthmatic patients who approved to participate in this study and who fulfilled the inclusion criteria. This study showed the presence of correlation between sputum eosinophilia and asthma sever¬ity, moreover it revealed the ability of sputum eosinophilia to reveal asthma control and to help in drug adjustment.