Safety and reproducibility of sputum induction in asthmatic subjects in a multicenter study

The safety of sputum induction and the reproducibility of measurements in i nduced sputum in multicenter studies is unknown. We examined the safety of sputum induction in a two-visit, six-center study in 79 subjects with moder ate to severe asthma (mean +/- SD FEV1 71 +/- 12% predicted, 67% taking inh aled corticosteroids). In addition, we compared the reproducibility of mark ers of inflammation in induced sputum with the reproducibility of the FEV1 and the methacholine PC20. The FEV1 decreased greater than or equal to 20% from the post-bronchodilator baseline in 14% of all subjects and in 25% of subjects whose initial prebronchodilator baseline was 40 to 60% of predicte d. All subjects responded promptly to additional albuterol treatment, and n o subject developed refractory bronchoconstriction requiring treatment othe r than reversal of bronchospasm in the study laboratory. The reproducibilit y of measurements of the eosinophil percentage, eosinophil cationic protein , tryptase, and methacholine PC20 were similar (concordance correlation coe fficients of 0.74, 0.81, 0.79, and 0.74, respectively), without any signifi cant among-center effect. We conclude that sputum induction can be performe d safely in subjects with moderate to severe asthma in multicenter clinical trials when carried out under carefully monitored conditions. Importantly, we demonstrate that measurement of markers of inflammation in induced sput um is as reproducible as methacholine PC20 and should prove useful in the a ssessment of airway inflammation in multicenter clinical trials.