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Updated: May 24, 2026
13:28
Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Sputum inflammatory phenotypes are not stable in children with asthma
Louise Fleming1, Lemonia Tsartsali, Nicola Wilson
1Department of Respiratory Paediatrics, Royal Brompton Hospital, Southwood Lane, London, UK. l.fleming@imperial.ac.uk
Thorax
|March 2, 2012
Summary
Asthma inflammatory phenotypes in children are not stable over time. Sputum cytology frequently shows varying eosinophilic and non-eosinophilic patterns, regardless of asthma severity or treatment.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Immunology
Background:
- Adult asthma is characterized by stable eosinophilic and non-eosinophilic inflammatory phenotypes.
- Phenotype-guided treatments have shown success in adult asthma management.
- The stability of these phenotypes in pediatric asthma remains largely uncharacterized.
Purpose of the Study:
- To classify sputum inflammatory phenotypes in children with asthma.
- To assess the stability of these sputum inflammatory phenotypes over time in pediatric asthma patients.
Main Methods:
- Sputum induction and cytology performed on children with severe and mild to moderate asthma.
- Phenotypes classified as eosinophilic, neutrophilic, mixed granulocytic, or paucigranulocytic.
- Longitudinal sputum sampling conducted over 1 year (severe asthma) and 3-6 months (mild to moderate asthma).
Main Results:
- Elevated inflammatory cells detected in sputum of 78% of children across all asthma severities.
- 63% of children exhibited two or more distinct sputum inflammatory phenotypes over the study period.
- Phenotype variability was not associated with changes in inhaled corticosteroid dosage, asthma control, or exhaled nitric oxide levels.
Conclusions:
- Sputum inflammatory phenotypes are frequently elevated but unstable in children with asthma.
- The dynamic nature of pediatric asthma inflammatory phenotypes may impact treatment strategies.
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