Blood and Sputum Analysis, Learning About New Things on the Horizon
I am always super excited to learn about things coming down the pipe in asthmaresearch or diagnostics. My quest for this knowledge first began as a way to be less confused in the doctor's office and keep up in conversations and diagrams with my doctor.
Neutrophils in blood and sputum
I was recently sent a link to a study that was published. It looked at the eosinophils and neutrophils in peripheral blood to sputum analysis.1 As research continues to look at biomarkers and the development of different diagnostics, there is quite a debate which is better in some circumstances. The latter, I feel is a really important distinguishing factor.
Just like not every asthmatic is the same, neither are all diagnostics. Sputum induction clinical value in asthma management has been validated in three randomized controlled trials that tailored treatment based on sputum eosinophils.2-4
I am treated in a center that has helped develop, research and believes in sputum cell count diagnostics. I have also been treated by other specialists, that have not shared the same philosophies. It is not so much a case of right or wrong, in my opinion, it is determining the best one to use in a particular circumstance. I am sure some researchers could debate my understanding or feelings about this.
Sputum induction is considered to be invasive, time-consuming and needs to be done in a specialized center. The procedures fail rate is 10-30%, I had no idea that the procedures fail rate was as high as 30%.5,6 I am very familiar with sputum induction, I have done countless of them. I even remember my first one, which was awkward but I had a super patient RT. There are several other studies and journal articles that look at the many benefits of sputum induction; a quick PubMed search should bring these up for you.
What is exciting is that blood eosinophil count counts are offering a promising alternative for sampling the airways.7 Blood eosinophil counts do not correlate exactly with sputum eosinophilia. Researchers are working on ways to identify a quick and accurate way to predict eosinophilia. Blood work is seen as a driving force in potential inflammatory phenotyping advancements.
I am quite in tune with my sputum and as a subscriber to the "Eosinophilia Club," there isn't really a club but that would be cool! I have ongoing eosinophilia and have been using sputum cell counts in conjunction with my physician, spirometry to keep it in check. For one of the clinical trials that I participated in, there was a side study that examined monitoring with both methods. I also know that a major center in my neck of the woods does not even one sputum induction facilities. Not from a lack of trying or advocacy from Physicians but for a number of high-level health care administration and budgetary reasons, is what I am led to believe.
I am looking forward to seeing what else research will bring in the future. From the patient perspective, I want the tests to be efficient and easy but I also want them to tell me the post about what is going on. I would love to hear what other patients have been doing or experiencing. Don't forget to visit the Asthma.net community.
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