Increased sputum endotoxin levels are associated with an impaired lung function response to oral steroids in asthmatic patients Charles McSharry, PhD,

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Increased sputum endotoxin levels are associated with an impaired lung function response to oral steroids in asthmatic patients Charles McSharry, PhD, Mark Spears, PhD, Rekha Chaudhuri, MD, Euan J. Cameron, PhD, Holger Husi, PhD, Neil C. Thomson, MD Journal of Allergy and Clinical Immunology Volume 134, Issue 5, Pages 1068-1075 (November 2014) DOI: 10.1016/j.jaci.2014.08.022 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Endotoxin concentrations in sputum from asthmatic patients and healthy subjects (A) and never smokers, exsmokers, and current smokers with asthma (B) are shown. There were no significant differences in sputum endotoxin concentrations between asthmatic patients and healthy subjects (median, 152 EU/mL [IQR, 55-332 EU/mL] vs 164 EU/mL [IQR, 106-373 EU/mL], P = .833). Bars = 95% CI of the mean. There were no differences in sputum endotoxin levels between smokers, never smokers, and exsmokers (median, 177 EU/mL [IQR, 41-772 EU/mL] vs 184 EU/mL [IQR, 91-310 EU/mL] vs 123 EU/mL [IQR, 39-207 EU/mL], P = .703. Bars = 95% CI of the mean. Journal of Allergy and Clinical Immunology 2014 134, 1068-1075DOI: (10.1016/j.jaci.2014.08.022) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Association of percentage change in FEV1 after oral corticosteroids with sputum endotoxin concentrations in asthmatic patients. The linear regression line (solid line) with the true 95% CI (dashed lines) of nonsmokers (open circles) and smokers (red squares) is shown. In the combined asthma group the percentage change in FEV1 after oral dexamethasone decreased with increasing sputum endotoxin concentration (Spearman rho: r = −0.329 [95% CI, −0.570 to −0.036], P = .029). Journal of Allergy and Clinical Immunology 2014 134, 1068-1075DOI: (10.1016/j.jaci.2014.08.022) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Association of sputum endotoxin concentrations with sputum IL-1Ra concentrations in asthmatic patients. The linear regression line (solid line) with the true 95% CI (dashed lines) of nonsmokers (open circles) and smokers (red squares) is shown. In the combined asthma patient group sputum endotoxin concentrations correlated with the sputum IL-1Ra concentrations (Spearman rho: r = 0.510 [95% CI, 0.273-0.689], P < .001). Journal of Allergy and Clinical Immunology 2014 134, 1068-1075DOI: (10.1016/j.jaci.2014.08.022) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Association of serum endotoxin concentrations with sputum IL-6 (A), IL-8 (B), and CCL2 (C) concentrations in asthmatic patients. The linear regression lines (solid lines) with the true 95% CIs of nonsmokers (open circles) and smokers (red squares) are shown. In asthmatic patients serum endotoxin concentrations correlated with sputum concentrations of the cytokines IL-6 (r = 0.481 [95% CI, 0.147-0.717], P = .007), IL-8 (r = 0.495 [95% CI, 0.164-0.726], P = .005), and CCL2 (r = 0.542 [95% CI, 0.226-0.755], P = .002). Journal of Allergy and Clinical Immunology 2014 134, 1068-1075DOI: (10.1016/j.jaci.2014.08.022) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions