Neutrophilic asthma: a new horizon in the pathogenesis of bronchial asthma

ABSTRACT

Eosinophilic asthma has emerged as a distinct phenotype of asthma. However there is increasing recognition of neutrophilic form of asthma. To study the possible role of neutrophilic airway inflammation among patients with moderate persistent asthma. The study included 2 groups of subjects. Group I included 40 patients with moderate persistent asthma subjected for sputum induction. Sputum cell count, esoinophil catalonic protein[ECP] and rnyeloperoxidase enzyme were assessed. peak expiratory flow rate [PEFR] was also estimated. Group 11 included 15 healthy subjects served as control group. Neutrophilic asthmatics represents 45% of the studied asthmatic patients, while Eosinophilic asthmatics constitute 55%. Ncutrophilic asthmatic patients had higher sputum neutrophils and myelopcroxidase in comparison to eosinophilic group [p<0.001], also eosinophilic asthmatic patients had higher sputum eosinophils and ECP in comparison to neutrophilic group [p<0.001]. Sputum neutrophilis and myeloperoxidase correlated negatively to PEFR in neutrophilic asthmatics. Sputum eosinophilis and ECP correlated negatively to PEFR in esoinophilic group. Asthma is known to involve a heterogeneous airway inflammatory response where many cells play a part. Neutrophilic asthma is a sizeable subgroup of asthma which might lead to further understanding the pathogenesis of such disease and though, a new modalities in treatment is required