Abstract
Objective: To evaluate the viability of sputum cytology in asthmatic
children, recognizing inflammatory patterns and correlating them with
clinical, epidemiological and functional variables of the disease.
Methods: This was a cross-sectional and observational study of children
with asthma who underwent sputum induction through increasing
concentrations of nebulized hypertonic saline solution from 3% to 7%.
The samples were processed according to the technique developed by
Pizzichini et al. and the cytological pattern classified as
pauci-granulocytic, neutrophilic, eosinophilic and mixed. Samples with
cell viability> 50% were considered adequate. Asthma
control was assessed using the asthma control test (ACT). Results:
Seventy-nine children performed sputum induction. Thirty-three samples
were excluded because they were not viable for analysis, resulting in 46
samples. The children’s average age was 9.4 (± 3) years. There was a
predominance of eosinophilic (25/46, 54.3%), followed by mixed (13/46,
28.3%), pauci-granulocytic (7/46, 15.2%) and neutrophilic (1/46,
2.2%) pattern. Sixty-three percent of the children had severe asthma
and 84.7% were treated with inhaled corticosteroids. The ACT showed
that 25 (56.8%) patients had the disease under control. Forty-five
children (97.8%) underwent pulmonary function tests (spirometry) and in
13 cases (28.9%) an obstructive ventilatory defect was found.
Conclusions: The eosinophilic profile was predominant in the assessed
asthmatic children. Non-eosinophilic phenotypes were found, but less
frequently. There was no difference between the clinical variables and
the sputum profile in this study group. Sputum induction in children
with asthma is feasible and safe and can contribute to a specific and
personalized approach to the disease.