They find sputum color can predict respiratory disease severity

The color of sputum in patients with bronchiectasis (dilation of the bronchi leading to recurrent bronchial infections) can indicate the degree of inflammation in the patient’s lungs and predict their future outcome. Research presented at the European Respiratory Society International Congress in Milan, Italy, clearly shows this.

Research, Nearly 20,000 patients from 31 countries participatedshowed for the first time Sputum color provides clinically relevant information about prognosis It can therefore assist in making treatment decisions.

Bronchiectasis is a chronic disease that has no cure. One or more small branching airways, called bronchi, can widen, causing excess mucus to build up and making the lungs more susceptible to infection.

This can lead to progressively worsening lung damage over time. Causes may include lung infections such as pneumonia or whooping cough, cystic fibrosis, underlying problems with the immune system that make the bronchi more susceptible to infection, or aspergillosis (an allergy to a certain fungus that causes the bronchi to become fragile), an inflammation that occurs if fungal spores are inhaled .

Bronchiectasis is one of the three most common chronic inflammatory airway diseases (the other two are asthma and chronic obstructive pulmonary disease). In Europe, North America, the United Kingdom and the United States, the prevalence of the disease ranges from 67 to 566 per 100,000 inhabitants.

Dr. Megan Crichton, a postdoctoral researcher at the University of Dundee in Scotland, who presented the study, explained: “One of the main features of bronchiectasis is chronic cough, and “Almost three-quarters of patients with bronchiectasis produce phlegm on a daily basis.”

“When patients develop a respiratory infection, the sputum becomes darker in color, and this color change is caused by a protein called myeloperoxidase, or MPO, released by inflammatory cells.; Therefore, sputum color can be used as a biomarker of inflammation,” he added.

“We know that levels of inflammation in the lungs are important for long-term health in patients with bronchiectasis,” he continued, “so we wanted to know if the color of the sputum has any impact when the patient is assessed when they are healthy and do not have a respiratory infection. .Relationships with long-term outcomes, such as lung function and the frequency and severity of exacerbations.”

Dr. Critchton and her colleagues recorded sputum color in 13,484 of 19,324 patients with frequent sputum production who were included in the Pan-European Bronchiectasis Registry: Embarc. They followed the patients for up to five years to see how many times they worsened, how severe they were and how many died.

The sputum is mucus-like, transparent, foamy, and gray; mucus-purulent, starting to appear milky yellow; purulent, the color darkens to dirty yellow or green, the texture becomes thicker, and Severe suppuration, which is the most severe, appears dark green, turns brown, and sometimes includes blood streaks.

Among patients with sputum production, 40% (5,541) had mucoid sputum, 40% (5,380) had mucopurulent sputum, 18% (2,486) had purulent sputum, and 1% (177) had severe purulent sputum.

“We found that the more purulent sputum, the higher the risk of illness, hospitalization and death. For every one percentage point increase in sputum purity, the risk of death increases by 12 percent,” Dr. Crichton said in a statement.

“As this is a large multinational study with five years of follow-up data, it provides evidence that sputum color reflects prognosis. Sputum samples can be collected easily from most patients, and color has been shown to be a useful indicator, This makes sputum an easily accessible and easily interpretable clinical biomarker of disease progression,” he said.

“We believe that the application of this biomarker in clinical practice will improve the treatment and monitoring of patients with bronchiectasis,” he added.

Additionally, sputum sampling is non-invasive for patients. “Knowing that observing the color of sputum as a means of self-monitoring can empower patients and give them some control over their condition, which we know is important for improving patients’ quality of life,” the doctor said.

Researchers are studying the introduction of sputum color charts into clinical practice and how best to help patients use them to monitor the severity of their disease. They will report these new findings so that patients, doctors and researchers can learn about them.

“The results of this study provide doctors and patients with a simple, non-invasive way to monitor their symptoms. If implemented in clinical practice, it could have a real impact on the management of this disease and enable Physicians are able to intervene early. If it is clear from the change in the color of the sputum that the patient’s symptoms are getting worse,” says Ca, President of the European Respiratory Society, Dean of the Faculty of Medicine at the University of Coimbra and Head of the Department of Respiratory Medicine. said Professor Los Robalo Cordeiro. Department of Pulmonary Medicine, University Hospital of Coimbra, Portugal, who was not involved in the study.