Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/921988

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Title
Mannitol challenge for assessment of airway responsiveness, airway inflammation and inflammatory phenotype in asthma
Author/Creator
Wood, L. G.;  Powell, H.;  Gibson, P. G.
Institution
The University of Newcastle. Faculty of Health, School of Biomedical Sciences and Pharmacy
Description
Background: Assessment of airway inflammation in asthma is becoming increasingly important, as the inflammatory phenotype underpins the treatment response. Objective: This study aimed to evaluate mannitol as a tool for assessing airway responsiveness and airway inflammation in asthma, compared with hypertonic saline. Methods: Fifty-five subjects with stable asthma completed a hypertonic (4.5%) saline challenge and a mannitol challenge at two separate visits, performed 48–72 h apart, in random order. Results: Induced sputum was obtained from 49 (89%) subjects during the saline challenge and 42 (76%) subjects during the mannitol challenge (P>0.05). There was a significant correlation between the greatest percentage fall in forced expiratory volume in 1 s (FEV₁)(r=0.6, P<0.0001), the dose–response slope (r=0.73), cumulative dose (r=0.55) and PD15 (r=0.46) for mannitol and hypertonic saline. The greatest percentage fall in FEV₁to mannitol was less in non-eosinophilic asthma. There was a lower total cell count in mannitol vs. hypertonic-saline-induced sputum. However, sputum eosinophils and neutrophils were not significantly different. Using mannitol, a higher proportion of subjects were classified as having eosinophilic asthma. There were no differences in IL-8, neutrophil elastase or matrix-metalloproteinase 9 concentrations in sputum samples induced with mannitol or hypertonic saline. Conclusion: We conclude that mannitol can be used to induce good-quality sputum, useful for analysis of inflammatory mediators and for predicting the inflammatory phenotype in asthma.
Relation
Clinical & Experimental Allergy Vol. 40, Issue 2, p. 232-241
Publisher Link
http://dx.doi.org/10.1111/j.1365-2222.2009.03371.x
Date
2010
Publisher
Wiley-Blackwell Publishing
Keyword(s)
airway inflammation;  airway responsiveness;  asthma;  hypertonic saline;  inflammatory phenotypes;  mannitol
Resource Type
journal article
Identifier
http://hdl.handle.net/1959.13/921988
Identifier
ISSN:1365-2222
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Subject
"Clinical & Experimental Allergy"
 
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