Sputum Cellularity and Immune Biomarkers During Acute Exacerbations of Asthma
Notice bibliographique
Résumé
Abstract Rationale: Acute asthma exacerbations are frequently triggered by viral infections and the airway epithelium is the principal target. Various pro-inflammatory molecules are released including the alarmins (interleukin (IL)-33, thymic stromal lymphopoietin and IL-25). The sputum is frequently used to phenotype asthma but is subject to contamination from the upper airways. The aim of the present study was to assess the markers of innate immune responses during an acute exacerbation of asthma by the analysis of sputum and to relate the levels of pro-inflammatory molecules to the quality of the sputum as reflected in the percentage of squamous cells.Methods: We studied asthmatic subjects (n= 45) presenting to the Montreal Chest Institute with a physician diagnosed asthma exacerbation. Clinical data, spirometry, Asthma Control Questionnaires (ACQ), complete blood counts and expectorated sputum were acquired on admission to the study (day 1) and on days 10 and 28. Sputum was processed for differential cell counts and sputum supernatants from a subset of subjects (n=25) were analysed by Bioplex for 25 inflammatory markers. Cysteinyl leukotrienes (CysLTs) in the sputum supernatants were analyzed by enzyme immunoassay. Results: On day 1, subjects had an ACQ score of 3.56 ± 0.84 and an FEV1 was 69.1 ± 21.4 (% predicted). Blood eosinophil counts >150/µl were present in 26/45. Expectorated sputum had squamous cell counts that ranged from 0 to 90%, with a median value of 16.81%. Mediator levels (interleukin (IL)-4, IL-5, IL-8, and TNF-α) were significantly lower in samples for which squamous cells exceeded 16 (%). Similarly, CysLTs were significantly higher in sputum squamous cell counts < 16% (median 697 pg/ml) than when sputum squamous cells were > 16% (median 364 pg/ml; p=0.006). Alarmins were an exception to this finding and levels of IL-33 were 5.29 ± 1.12pg/ml for samples below 16% squamous cells and 8.13 ±2.74 pg/ml for samples above 16%. Similarly, TSLP levels were not statistically significantly different for sputum with < 16% squamous cells to > 16% squamous cells (1.39pg ± 0.43/ml vs 2.15 ± 2.23 pg/ml) and for IL-25 (4.16 ± 2.87 pg/ml and 6.19 ± 1.17 pg/ml, respectively). Alarmin levels were not significantly different between subjects with peripheral blood eosinophils above and below 150/µl.Conclusions: Selected cytokines/chemokines and CysLTs in expectorated sputum are likely under-estimated in sputum samples in which squamous cells are elevated. Alarmin levels are not affected by the squamous cell counts, suggesting a significant contribution to these mediators from the oropharynx.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».