Smoking and atopy as determinants of sputum eosinophilia and bronchial hyper-responsiveness in adults with normal lung function

• Published in: Respiratory medicine 2003-08, Vol.97 (8), p.947-954
• Main Authors: Petäys, T, von Hertzen, L, Metso, T, Rytilä, P, Jousilahti, P, Helenius, I, Vartiainen, E, Haahtela, T
• Format: Article
• Language: English
• Subjects: Adult; Airway management; Allergic diseases; Allergies; Asthma; Atopy; Biological and medical sciences; Bronchi - drug effects; Bronchial hyper-responsiveness; Bronchial Provocation Tests; Bronchoconstriction; Bronchoconstrictor Agents; Confidence intervals; Cytokines; Eosinophilia - etiology; Eosinophilia - pathology; Eosinophilia - physiopathology; Eosinophils; Epidemiology; Female; Forced Expiratory Volume - physiology; Humans; Hypotheses; Immunopathology; Lifestyles; Male; Medical sciences; Methacholine Chloride; Middle Aged; Pathogenesis; Questionnaires; Regression analysis; Respiratory and ent allergic diseases; Respiratory Hypersensitivity - pathology; Respiratory Hypersensitivity - physiopathology; Risk Factors; Skin; Smoking - adverse effects; Smoking - pathology; Smoking - physiopathology; Sputum - cytology; Sputum eosinophilia
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/S0954-6111(03)00122-7

Data concerning the determinants of sputum eosinophilia and bronchial hyper-responsiveness (BHR) in large cohorts of individuals with normal lung function are limited. Here, we assessed the occurrence of sputum eosinophilia and BHR and identified the risk factors for these variables in two populations living in North Karelia, Finland, and in Pitkäranta, the Republic of Karelia, Russia. These areas are geographically adjacent, but differ, however, fundamentally in major cultural, socioeconomical and lifestyle aspects. The study population comprised 790 Finns and 387 Russian, aged 25–54 years, who were randomly enrolled from the population registers. A methacholine challenge test to measure BHR was successfully performed in 581 (74%) Finns and 307 (79%) Russians with virtually normal lung function (FEV1>70% of predicted). Of these, induced sputum samples were obtained from 41% of the Finns and from 67% of the Russians. The proportion of current smokers was 27% among the former and 42% among the latter. Sputum eosinophilia was assessed using a semi-quantitative method, and total concentrations of sputum eosinophilic cationic protein (ECP) and myeloperoxidase (MPO) were measured using an immunoassay. Risk factors for BHR and sputum eosinophilia were identified with a regression analysis. The prevalence of sputum eosinophilia was 22% among the Finns and 19% among the Russians, and the respective figures for BHR were 14% and 13%. The median ECP concentration in sputum was significantly higher among the Russians as compared with the Finns ( P