Interrelationship of Bronchial Phagocytes with Airway Hyperresponsiveness to Hyposmolar Stimulus in Patients with Asthma

The disturbance of osmolar homeostasis in the airways of patients with asthma can promote the development of bronchoconstriction and an uncontrolled course of the disease, which is associated with poorly studied changes in the cellular profile of bronchial inflammation. We aimed to assess the relationship between phagocytes of the inflammatory profile of the bronchi and airway response to the hyposmolar stimulus in patients with asthma. METHODS: In 69 patients with mild asthma, it collected the induced sputum, the next day a bronchoprovocation by 3-min. inhalation of ultrasonically nebulized distilled water (UNDW) was performed, after which there was a second sputum collection. It carried cytological examination of sputum using light-optical immersion microscopy, with a quantitation of at least 400 cells in 100 fields of view, in the central and peripheral parts of the smears. The number of neutrophils and macrophages counted in sputum smears was expressed as a percentage. The cytosis level was detected by determining the number of cells in 1 L. We assessed the clinical symptoms of asthma, the level of asthma control according to the Asthma Control Test, and measured the lung function (FEV 1 ) before and after the UNDW test (FEV 1 , МEF 25-75 ). RESULTS: According to UNDW test, the patients were divided into two groups: group 1 included 17 patients with positive, group 2 -52 patients with a negative airway reaction: FEV 1 -15.21.9 vs. -0.450.88% (p=0.0001), МEF 25-75 -26.42.2 vs. -2.42.0% (p=0.0001). Patients had no differences in asthma control (16.21.5 vs. 16.21.2 points ACT, p>0.05) and FEV 1 (95.73.6 vs. 96.12,4%; p>0.05). After the UNDW test, an increase in the cytosis of sputum was noted in group 1 (from 1.90.13 to 2.60.32, p=0.028) in the absence of changes in group 2 (2.30.20 and 2,30.18; p>0.05). According to the correlation analysis, in group 1, the baseline neutrophils in sputum significantly influenced the concentration of macrophages after the UNDW (r=-0.53, p=0.027). In group 2, the number of macrophages before the test correlated with the number of neutrophils after the test (r=-0.50, p=0.002). There was a correlation between the baseline concentration of macrophages in sputum and the airway reaction (МEF 25-75 ) to the UNDW test (r=-0.28, p=0.043). CONCLUSION: The level of neutrophils and macrophages in the bronchi manifests a change in the phagocyte population after the bronchoprovocation with UNDW. An increase in the proportion of macrophages may be related to the formation of a bronchoconstrictor response to a hyposmolar stimulus.