The eosinophilic and neutrophilic counts in sputum of asthmatic Iraqi patients and its correlation with asthma control

Background: Asthma control is very critical guide for therapy according to the current asthma guidelines. The asthma control test (ACT) was successfully used to assess the control level. However, variation in clinical features which composite the items of the test does not always associate with the extent of the structural changes in pulmonary airways. Thus, there is a necessity for the surrogate marker to assess the control level. Eosinophilic and neutrophilic cells have an important role in the pathological process of asthma. Aims: The aim of this study is to assess the sputum eosinophil and neutrophils as a discriminative marker between different levels of asthma control. Patients and Methods: This cross-sectional study included 88 asthmatic patients. Only 50 patients produced sputum. Demographic data, ACT parameters took from patients. Spirometer test has been done. Sputum study includes processing of sputum, counting of sputum total white cell were done. Results: According to sputum cells count and differentiation, 64% eosinophils, 10% neutrophils, 6% mixed and 20% was paucigranulocytic (non). Eosinophilic phenotype patients were poorly control with a statistically significant difference. While neutrophilic phenotype was nonstatistically significant difference. Conclusions: The most common type of asthma phenotyping is eosinophil which in turn correlated with poor asthma control while other types like neutrophil are not correlated.