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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 asthma research 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

Sputum analysis

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.

Blood analysis

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.

Upcoming research

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 community.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Diagnosing eosinophilic asthma using a multivariate prediction model based on blood granulocyte responsiveness. Allergy. Accessed January 21, 2017.
  2. Green RH, Brightling CE, McKenna S, Hargadon B, Parker D, Bradding P et al. Asthma exacerbations and sputum eosinophil counts: a randomized controlled trial. Lancet 2002; 360: 1715–1721.
  3. Jayaram L, Pizzichini MM, Cook RJ, Boulet L-PP, Lemière C, Pizzichini E et al. Determining asthma treatment by monitoring sputum cell counts: effect on exacerbations. Eur Respir J 2006; 27: 483–494.
  4. Chlumsky, Striz, Terl, Vondracek. Strategy Aimed at Reduction of Sputum Eosinophils Decreases Exacerbation Rate in Patients with Asthma. Journal of International Medical Research 2006; 34: 129139.
  5. Petsky HL, Cates CJ, Lasserson TJ, Li AM, Turner C, Kynaston JA et al. A systematic review and meta-analysis: tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils). Thorax 2012; 67:199–208.
  6. Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ et al. International ERS/ATS guidelines on definition, evaluation, and treatment of severe asthma. Eur Respir J 2014; 43: 343–373.
  7. PubMed - NCBI. National Center for Biotechnology Information. B%5BAuthor%5D&cauthor=true&cauthor_uid=28029172. Accessed January 21, 2017.