Sputum Eosinophil and Macrophage Changes After Aspirin Challenge in Patients With Nonsteroidal Anti-Inflammatory Drug–Exacerbated Respiratory Disease

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-09-10 DOI:10.1002/clt2.70079

Gabriela Trąd-Wójcik, Piotr Szatkowski, Adam Ćmiel, Radosław Kacorzyk, Adam Stępień, Lucyna Mastalerz

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Abstract

Background

Induced sputum cell count is crucial for assessing airway inflammatory phenotypes. This study investigated how aspirin-induced bronchospasm affects sputum cell counts in patients with nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), comparing systemic versus local aspirin administration.

Methods

Seventy-eight patients with N-ERD and 39 with aspirin-tolerant asthma (ATA) participated. In the N-ERD group, induced sputum was collected before aspirin challenge and during aspirin-induced bronchospasm. We assessed changes in the percentages of eosinophils, neutrophils, lymphocytes, and macrophages, and airway inflammatory phenotypes classified by sputum cells into: (A) eosinophilic, neutrophilic, paucigranulocytic, and mixed; and (B) eosinophilic and noneosinophilic.

Results

Baseline sputum neutrophil percentage was lower in the N-ERD than in the ATA (32.9% ± 20.8% vs. 41.6% ± 22.5%; p = 0.02). Inflammatory phenotypes at baseline differed between groups in both classifications (A: p = 0.041; B: p = 0.044). In the N-ERD group, sputum eosinophil percentage decreased after both oral (8.9% ± 11.6% vs. 6.1% ± 8.9%, p = 0.009) and inhaled (10.4% ± 16.1% vs. 4.8% ± 6.3%, p = 0.045) challenges, without altering inflammatory phenotypes. The ATA group showed no changes. Sputum macrophage percentage dropped after oral challenge in both groups (N-ERD: 40.5% ± 18.5% vs. 35.6% ± 21.5%; p = 0.004; ATA: 36.5% ± 23.6% vs. 26.7% ± 20.4%; p = 0.0003). In the N-ERD group, baseline sputum lymphocyte and eosinophil percentages were inversely correlated with the provocative dose of aspirin that resulted in a 20% decrease in baseline forced expiratory volume in 1 s following oral aspirin challenge (R = −0.31, p = 0.02 and R = −0.33, p = 0.02, respectively).

Conclusion

In N-ERD, sputum eosinophil percentage decreased after aspirin challenge regardless of administration route. In both N-ERD and ATA, sputum macrophage percentage decreased after oral aspirin challenge.

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非甾体抗炎药加重呼吸系统疾病患者服用阿司匹林后痰中嗜酸性粒细胞和巨噬细胞的变化

诱导痰细胞计数是评估气道炎症表型的关键。本研究探讨了非甾体抗炎药加重呼吸系统疾病（N-ERD）患者阿司匹林诱导的支气管痉挛对痰细胞计数的影响，比较了全身和局部阿司匹林给药。方法对78例N-ERD患者和39例阿斯匹林耐受性哮喘（ATA）患者进行研究。在N-ERD组，在阿司匹林刺激前和阿司匹林引起的支气管痉挛期间收集诱导痰。我们评估了嗜酸性粒细胞、中性粒细胞、淋巴细胞和巨噬细胞百分比的变化，以及按痰细胞分类的气道炎症表型：(A)嗜酸性粒细胞、嗜中性粒细胞、少粒细胞和混合型；(B)嗜酸性和非嗜酸性。结果N-ERD组痰中性粒细胞基线百分比低于ATA组（32.9%±20.8% vs 41.6%±22.5%;p = 0.02）。两组的炎症表型在基线时存在差异（A: p = 0.041; B: p = 0.044）。在N-ERD组，口服（8.9%±11.6% vs. 6.1%±8.9%,p = 0.009）和吸入（10.4%±16.1% vs. 4.8%±6.3%,p = 0.045）刺激后痰嗜酸性粒细胞百分比下降，未改变炎症表型。ATA组没有变化。两组口腔攻毒后痰中巨噬细胞百分比均下降（N-ERD: 40.5%±18.5% vs. 35.6%±21.5%,p = 0.004; ATA: 36.5%±23.6% vs. 26.7%±20.4%,p = 0.0003）。在N-ERD组中，基线痰淋巴细胞和嗜酸性粒细胞百分比与阿司匹林刺激剂量呈负相关，阿司匹林刺激剂量导致口服阿司匹林刺激后1 s内基线用力呼气量减少20% （R = - 0.31, p = 0.02和R = - 0.33, p = 0.02）。结论在N-ERD中，不论给药途径如何，阿司匹林刺激后痰嗜酸性粒细胞百分比均下降。在N-ERD和ATA中，口服阿司匹林后痰中巨噬细胞百分比下降。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.