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a Department of
Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH,
UK, b Department of Internal
Medicine, University of Utah, Salt Lake City, UT, USA
Correspondence to: Professor R A Stockley r.a.stockley{at}bham.ac.uk
Received 17 July 2000; Returned to authors 19 January 2001; Revised version received 2 February 2001; Accepted for publication 2 February 2001
BACKGROUND
Airway
inflammation, with recruitment of neutrophils to the airway lumen,
results in purulent secretions and a variety of potential adverse
consequences for patients with chronic bronchitis and
bronchiectasis. We hypothesised that gradations of sputum colour would
correlate directly with the myeloperoxidase content of sputum and with
various other indicators of the activity and consequences of bronchial diseases.
METHODSTo test this
hypothesis, we quantified sputum colour by reference to a sensitive
nine point colour chart and correlated this assessment with indices of
a number of inflammatory mediators in sputum.
RESULTSThe results
indicate that standardised visual measurements of sputum colour
correlated strongly with myeloperoxidase, interleukin 8, leucocyte
elastase (both activity and total quantity), sputum volume, protein
leak, and secretory leucocyte proteinase inhibitor (p<0.001 for all).
In addition, there was a strong direct correlation between leucocyte
elastase and both myeloperoxidase (p<0.003) and sputum volume
(p<0.001), but a strong negative correlation with secretory leucocyte
proteinase inhibitor (p<0.001).
CONCLUSIONSThese
results indicate that sputum colour graded visually relates to the
activity of the underlying markers of bronchial inflammation. The
results of this simple visual analysis of sputum provides guidance
concerning underlying inflammation and its damaging potential. It also
provides a useful scientific tool for improving the monitoring of
chronic airways diseases and response to treatment.
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