EOSINOPHILIC AND NEUTROPHILIC INFLAMMATION IN ASTHMA, CHRONIC-BRONCHITIS, AND CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Background: Eosinophils but not neutrophils may play a role in the air way inflammation of asthma. In chronic bronchitis (CB) and chronic obs tructive pulmonary disease (COPD), neutrophils are present in the airw ays. To differentiate among the pathology of asthma, CB, and COPD eosi nophils and neutrophils were studied in peripheral blood, bronchial bi opsy specimens, and bronchoalveolar lavage fluid (BALF). Methods: We s tudied nine nonsmoking healthy subjects, 20 nonsmoking patients with a sthma, 10 nonatopic smoking patients with CB (forced expiratory volume in 1 second: 98.4% +/- 11.3%) and 17 patients with COPD (forced expir atory volume in 1 second: 51.2% +/- 14.3%). Eosinophils were character ized by their enumeration in biopsy specimens (EG2 monoclonal antibody ), peripheral blood, and BALF and by measurement of eosinophil cationi c protein in RALF. Neutrophils were characterized by their enumeration in biopsy specimens (anti-elastase monoclonal antibody) and BALF and by measurement of neutrophil-specific myeloperoxidase in BALF. Results : In patients with asthma we found degranulated eosinophils in biopsy specimens and significantly increased eosinophil cationic protein leve ls in BALF. In patients with CB or COPD, eosinophil numbers in biopsy specimens were not significantly different from those of patients with asthma, but cells were not degranulated and eosinophil cationic prote in levels in BALF were similar to those of normal subjects. In patient s with CB or COPD neutrophils were not increased in the mucosa, but ne utrophil numbers and myeloperoxidase levels in RALF were significantly increased. Conclusion: The percentages of neutrophils in BALF were gr eater in patients with COPD than in those with CB, suggesting a role i n the chronic airflow limitation.