Sputum quantitative cytometry in patients with interstitial lung disease and chronic cough

Chronic cough frequently occurs in patients with diffuse interstitial lung diseases (ILDs), and can have negative effects on quality-of-life. While there are multiple possible contributors to cough in this setting, the contribution and consequences of airway inflammation have not been previously mea...

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Bibliographic Details
Published in:Respiratory medicine 2020-08, Vol.170, p.106067-106067, Article 106067
Main Authors: Ho, Terence, Scallan, Ciaran, Rezaee, Nahid, Hambly, Nathan, Cox, P. Gerard, Kolb, Martin, Nair, Parameswaran
Format: Article
Language:English
Subjects:
Airway inflammation
Antibiotics
Asthma
Bronchitis
Chronic cough
Chronic obstructive pulmonary disease
Connective tissue
Cough
Cytometry
Eosinophilia
Gastroesophageal reflux
Inflammation
Interstitial lung disease
Lung diseases
Medical screening
Quality of life
Respiratory function
Respiratory tract
Respiratory tract diseases
Rheumatoid arthritis
Sarcoidosis
Spirometry
Sputum
Sputum cell count
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Summary:Chronic cough frequently occurs in patients with diffuse interstitial lung diseases (ILDs), and can have negative effects on quality-of-life. While there are multiple possible contributors to cough in this setting, the contribution and consequences of airway inflammation have not been previously measured. We aimed to estimate the prevalence of airway cellular inflammation in patients with chronic cough and ILD, and examine the interaction between airway inflammation and changes in lung function. We examined all patients with physician-diagnosed ILD and chronic cough who had sputum quantitative cytometry ordered between 2004 and 2018. The prevalence of airway inflammation was estimated by applying previously established criteria for bronchitis. FEV1 and FVC were compared between individuals based on the presence of airway inflammation. The changes in FEV1 and FVC were compared between individuals who had their treatment tailored to their sputum result, and those who did not. Airway inflammation was present in 50% of patients (n = 173), and was associated with lower FEV1 (1.87 vs 2.05 L, p = 0.043) and FVC (2.39 vs 2.71, p = 0.024). Sputum-guided management of airway eosinophilia was associated with improvements in FEV1 (+120 vs −205mL, p 
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2020.106067