Use of biological markers of airway inflammation to detect the efficacy of nurse-delivered asthma education.
OBJECTIVE
The purpose of this study was to determine whether analysis of the constituents of induced sputum could be used to document the efficacy of a nurse-delivered patient education intervention and whether changes in the biological markers of inflammation in sputum would correlate with improvements in pulmonary function and symptoms.


METHODS
The study design was prospective, open trial with repeated measures.


METHODS
The study took place at a West Coast academic medical center laboratory.


METHODS
Subjects included 12 nonsmoking persons with asthma, ages 23 to 51 years, on prescribed daily anti-inflammatory inhaled therapy who had not required oral prednisone in the previous 4 weeks of enrollment.


METHODS
The effect of one 30-minute asthma education session on spirometry, peak flow, symptoms, and biological markers of inflammation in sputum was tested for 8 weeks to determine whether biological markers reflect the efficacy of educational interventions.


RESULTS
Mean symptom scores decreased and lung function increased slightly over 8 weeks. Markers of eosinophil degranulation decreased by 50% and albumin by 25% from baseline to 8 weeks. Eosinophil percentages dropped 20% over time but did not change consistently at all time points. Clinical markers of asthma control correlated in the low-to-moderate range with biological markers of airway inflammation.


CONCLUSIONS
The results of this study show the effects of a patient education intervention can be detected in both clinical and biological outcomes. Individual education may influence self-care of asthma including adherence to inhaled corticosteroid therapy and thereby suppress airway inflammation.
Janson
S
S
Department of Community Health Systems, University of California-San Francisco, San Francisco, CA 94143, USA.
Hardie
G
G
Fahy
J
J
Boushey
H
H
D000328:Adult; D001249:Asthma / Q000378:metabolism / Q000451:nursing* / Q000517:prevention & control*; D015415:Biomarkers / Q000032:analysis*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D012137:Respiratory System / Q000473:pathology*; D013183:Sputum / Q000737:chemistry
D015415:Biomarkers