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Precision Sampling to Characterize Airway Inflammation in Asthma

Hansel TT, Kon O.

RDD Europe 2015. Volume 1, 2015: 17-26.

Abstract:

Mucosal inflammation of the airways is a feature of respiratory infections, allergic rhinitis, asthma and chronic obstructive pulmonary disease (COPD). However, there are problems with conventional non-invasive methods to sample the airways since blood, breath and sputum samples have individual limitations when used to quantify levels of inflammatory mediators. Despite these caveats, the humble blood eosinophil count and sputum eosinophil numbers are proving useful to define eosinophilic phenotypes of asthma in conjunction with more invasive bronchoscopic sampling methods. In this article we consider the use of synthetic absorptive matrix (SAM) strips that are inserted onto airway mucosal surfaces to absorb nasal secretions. It is postulated that inflammatory mediators in the mucosal lining fluid (MLF) reflect underlying inflammation. Cytokines and chemokine levels in serial nasosorption samples from patients with allergic rhinitis given topical nasal allergen challenge with grass pollen extract have been studied. Subject to development of appropriate sampling devices and rigorous validation in a range of clinical situations, absorption of airway MLF may aid definition of molecular signatures of patients with asthma. This could facilitate the diagnosis, stratification, and monitoring of a variety of airway diseases.