2023-09-12 06:20:48
The scientists focused on patients with bronchiectasis. Bronchiectasis is a chronic disease, one of the three most common chronic inflammatory pathologies of the respiratory tract (along with asthma and COPD). In this condition, one or more of the tiny branches of the airways (bronchi) dilate, causing excess mucus to accumulate, which can make the lungs more vulnerable to infection.
Over time, this causes gradual damage to the lungs. As a rule, it occurs due to pulmonary infections, cystic fibrosis, pathologies of the immune system, and even foreign bodies entering the respiratory tract that cannot be removed.
It is impossible to completely get rid of bronchiectasis. The quality of life of patients depends on the prevalence of lung damage, the degree of pulmonary function impairment, the severity and frequency of exacerbations.
Symptoms include a cough with copious sputum production, the total volume of which can reach 200 milliliters per day, the appearance of a focus of “wet” rales in the lungs, traces of blood in the sputum and its taste during coughing. Patients also experience severe shortness of breath and chest pain.
The study, which included approximately 20,000 patients from 31 countries, is the first to show that sputum color provides clinically relevant information regarding prognosis and can help guide effective treatment strategies.
“One of the main signs of bronchiectasis is a productive cough. Almost three-quarters of patients with bronchiectasis produce sputum daily. In chest infections, the color of the sputum darkens, and this color change is caused by a protein called myeloperoxidase (MPO), which is released from inflamed cells; thus, sputum color can be used as a biomarker of inflammation. We know that the level of lung inflammation is important for long-term health in bronchiectasis, so we wanted to find out whether the color of sputum, assessed when the patient is healthy and not infected, has any relationship with long-term outcomes such as lung function, frequency and severity. exacerbations,” said study author Megan Crichton, who presented it at the International Congress of the European Respiratory Society (ERS) in Milan.
The scientists recorded the color of sputum in 13,484 of 19,324 patients who regularly coughed up sputum and whose data were entered into the pan-European bronchiectasis registry EMBARC. They were monitored for five years: the number of exacerbations, their severity and the number of deaths were analyzed.
The researchers classified sputum into four levels: mucous – transparent, foamy and gray in color; mucopurulent begins to acquire a creamy yellow color; purulent – the color darkens to dirty yellow or green, and the consistency becomes dense, and, finally, strongly purulent – the heaviest, dark green, turning brown, sometimes streaked with blood.
Classification of mucus into 4 levels: mucous, mucopurulent, purulent and highly purulent. © European Respiratory Journal
In 40% of patients (5541) the sputum was mucous, in 40% (5380) it was mucopurulent, in 18% (2486) it was purulent, in 1% (177) it was strongly purulent. Scientists found an increased risk of exacerbations, hospitalizations and death with more purulent sputum. For every one point increase in sputum purulence, the risk of death increased by 12%.
“The results of this study suggest that sputum color reflects prognosis. Sputum samples can be easily collected from most patients, and sputum color has proven to be a useful indicator. This makes sputum a readily available and easily interpretable clinical biomarker of disease progression.
We believe that the introduction of this biomarker into clinical practice will improve the treatment and monitoring of patients with bronchiectasis,” the authors noted.
Now scientists are exploring how to implement the sputum color map into clinical practice and how best to help patients use it to monitor the severity of their disease. In their opinion, this will help make a real contribution to the prescription of treatment and allow doctors to detect the disease at a very early stage.
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