Clinical and Translational Allergy · Published 2025-09-01 · DOI 10.1002/clt2.70079
ABSTRACT Background Induced sputum cell count is crucial for assessing airway inflammatory phenotypes. This study investigated how aspirin‐induced bronchospasm affects sputum cell counts in patients with nonsteroidal anti‐inflammatory drug‐exacerbated respiratory disease (N‐ERD), comparing systemic versus local aspirin administration. Methods Seventy‐eight patients with N‐ERD and 39 with aspirin‐tolerant asthma (ATA) participated. In the N‐ERD group, induced sputum was collected before aspirin challenge and during aspirin‐induced bronchospasm. We assessed changes in the percentages of eosinophils, neutrophils, lymphocytes, and macrophages, and airway inflammatory phenotypes classified by sputum cells into: (A) eosinophilic, neutrophilic, paucigranulocytic, and mixed; and (B) eosinophilic and noneosinophilic. Results Baseline sputum neutrophil percentage was lower in the N‐ERD than in the ATA (32.9% ± 20.8% vs. 41.6% ± 22.5%; p = 0.02). Inflammatory phenotypes at baseline differed between groups in both classifications (A: p = 0.041; B: p = 0.044). In the N‐ERD group, sputum eosinophil percentage decreased after both oral (8.9% ± 11.6% vs. 6.1% ± 8.9%, p = 0.009) and inhaled (10.4% ± 16.1% vs. 4.8% ± 6.3%, p = 0.045) challenges, without altering inflammatory phenotypes. The ATA group showed no changes. Sputum macrophage percentage dropped after oral challenge in both groups (N‐ERD: 40.5% ± 18.5% vs. 35.6% ± 21.5%; p = 0.004; ATA: 36.5% ± 23.6% vs. 26.7% ± 20.4%; p = 0.0003). In the N‐ERD group, baseline sputum lymphocyte and eosinophil percentages were inversely correlated with the provocative dose of aspirin that resulted in a 20% decrease in baseline forced expiratory volume in 1 s following oral aspirin challenge (R = −0.31, p = 0.02 and R = −0.33, p = 0.02, respectively). Conclusion In N‐ERD, sputum eosinophil percentage decreased after aspirin challenge regardless of administration route. In both N‐ERD and ATA, sputum macrophage percentage decreased after oral aspirin challenge.
Abstract from DOAJ. Public domain (CC0 1.0).
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