Blood and sputum eosinophil levels in asthma and their relationship to sinus computed tomographic findings

OBJECTIVE: To investigate the relationship among blood and sputum eosinophil levels, sinus mucosal thickening, and osteitis in patients with asthma. PATIENTS AND METHODS: We conducted an observational study of 201 patients with asthma who underwent sinus computed tomographic (CT) imaging and induced sputum analysis at Mayo Clinic's site in Rochester, MN, from November 1, 2000, through December 31, 2005. Sinus CT scans were reviewed by an investigator blinded to patients' identity and chart information (J.B.H.) to assess for mucosal thickening. Each scan was assigned a CT score based on the Lund-Mackay staging scale. Approximately 20% of the scans were reviewed at random by a radiologist (N.G.C.) to ensure quality control. Bone changes consistent with osteitis were ascertained from radiology reports. Lung function was measured, and sputum was analyzed by conventional methods. RESULTS: Sinus CT scans revealed abnormalities in 136 (68%) of the 201 study patients. Severe mucosal thickening (CT score, ≥12) was found in 60 patients (30%) and osteitis in 18 patients (9%). There was a positive correlation between CT scores and eosinophil levels in both peripheral blood (?=0.45; 95% confidence interval, 0.33-0.56; P<.001) and induced sputum (?=0.46; 95% confidence interval, 0.34-0.57; P<.001). Further, elevated blood and sputum eosinophil levels were associated with the presence of osteitis on CT scan and previous sinus surgery. CONCLUSION: Blood and sputum eosinophil levels in patients with asthma are directly correlated with sinus mucosal thickening and are associated with osteitis, lending further support to the hypothesis that asthma and chronic rhinosinusitis are mediated by similar inflammatory processes.