Asmanet ENFUMOSA : D. Dusser The genetic component of asthma, bronchial hyperresponsiveness and atopy in the French EGEA study

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màj 23/07/98

ENFUMOSA
(courriel: Chanez (at) montp.inserm.fr )
The European Network For Understanding
Mechanisms of Severe Asthma
BIOMED 2 Program - European Commission

4th quaterly meeting, with the support of INSERM and
Merck Sharp & Dhome Laboratory
February 13-14th 1998 in Montpellier- France
(see programm, abstracts and experts comments )

Elastase activity in sputum is related to the
severity of airway obstruction in asthma but not in COPD
A. Telfour*. K. Dimakou*. J.M. Tournier**. D.J. Dusser*. *
Service de Pneumologie, UFR Cochin Port-Royal, Paris.
and **INSERM U314, Reims, France.

Vendredi 13 Février 1998		Présentateurs		Modérateurs	Experts
15h00-16h00	Epithelium	A. Campbell (Montpellier) D. Dusser (Paris) Discussion	15' 15' 30'	M. Murris (Toulouse) N. Roche (Paris)	A.M. Vignola (Palerme) W. Coers (Groningen, NL)

We studied the relationship between neutrophil elastase activity (NE act) in sputum, inflamrnatory cells in sputum and airway obstruction in 71 COPD and 34 asthmatic patients during exacerbation without bacterial infection. Total cells and differentials of nonsquamous cells, NE act and the NE inLibitor, the secretory leucoprotease inhibitor (SLPI) were determined in sputum. Results are expressed as means ( iSEM).

	Pulmonary Function				Sputum
	FEV1 (% pred)	FVC (% pred)	Total cell x 106/ml	PMN (%)	Eos. (%)	NE act uM	SLPI ug/ml
Asthma	55*	72*	5,0	52,7*	8,6*	0,25*	14,2
n=34	(3,3)	(3,0)	(1,6)	(7,1)	(2,9)	(0,09)	(2,2)
COPD	38,8	59,6	5,6	75,2	2,0	0,55	14,1
n=71	(2,2)	(2,0)	(0,9)	(3,5)	(0,7)	(0,08)	(1,7)

*p<0.05 for comparison between COPD and astEmatic patients. PMN were the predornin~nt inflammatory cells in sputum in COPD and asthma. Sputum PMN correlatod negatively with FEV1 in asthma (Rho=~.6, p<0.001) but notin COPD. In asthmatic patients, NE act in sputum was increased in 1/3 of patients and correlated negatively with FEV1 (Rho=-0.2, p=0.001) and positively with sputum PMN (Rho=O.S, p<0.05). In COPD patients, NE act was grester than in asthmatic patients and was relatod to the magnitude of sputum PlvfN (Rho=0.2, p=0.05) but not with FEV1. We conclude that (1) NE act in sputum is greater in COPD than in asthma whereas SLPI concentration in sputum is similar in these discases, (2) NE act is related to sputum PMN in asthma and COPD and (3) NE act in sputum is related to the severity of airway obstruction in asthma but not in COPD.