PERSISTENCE OF SPUTUM EOSINOPHILIA IN CHILDREN WITH CONTROLLED ASTHMAWHEN COMPARED WITH HEALTHY-CHILDREN

We aimed to describe induced sputum cell counts in healthy nonasthmati c children, and to compare these to children with controlled and uncon trolled asthma, Following clinical assessment and spirometry, ultrason ically nebulized hypertonic saline mas used to induce sputum from chil dren with asthma (n=50) and without asthma (n=72). Sputum was disperse d and cell counts performed to yield total and differential cell count s. Specific stains were used for eosinophil and mast cell counts. All of the children with asthma were receiving inhaled and/or oral cortico steroids. Current asthma control was assessed in terms of symptoms and lung function. Children were classified as controlled on inhaled cort icosteroids (no current symptoms, normal lung function n=15), current symptomatic asthma (n=16) and asthma exacerbation (n=11), It was found that eosinophils comprised a median 0.3% (interquartile range (IQR): 0, 1.05) of cells in sputum from healthy children, Sputum eosinophils (4.3% (IQR: 1.5, 14.1) p=0.0005) and epithelial cells (14% (IQR: 6, 19 .4) p=0.0005) were significantly higher in children with asthma than i n nonasthmatic children. Children whose asthma was controlled, as sell as those with symptoms, had more sputum eosinophils and epithelial ce lls than the nonasthmatics, Mast cells were found in the sputum of onl y four of the 42 children with asthma. This study demonstrates that eo sinophilic airway inflammation and epithelial damage can occur in chil dren with asthma, Airway inflammation persists even in those children who are receiving inhaled corticosteroids, hare normal lung function a nd good symptomatic control of their disease.