Objectives

To assess the oxidant and inflammatory effects of fresh diesel exhaust on at-risk groups (patients with moderate to severe asthma, older patients with airflow obstruction/COPD) using less invasive sampling approach.

Methodology and study materials Asthmatics and COPD patients (without coronary disease) are characterised in terms of lung function, airway hyperresponsiveness and exercise capacity. They are subsequently exposed to fresh diesel exhaust with PM10 100 ug/m3 as described in WP5. Induced sputum performed according to Pizzichini has been proven useful in earlier evaluation of DE effects in healthy subjects. The stepwise inhalation of increasing concentrations of hypertonic saline has in the hands of the investigators resulted in 92 % success rate to obtain sputum plugs with <20 % epithelium addition. Sputum is assayed for cell profile and soluble components based on WP5.

Deliverables This study will provide information of the usefulness of induced sputum to reflect the airway inflammation by DE primarily in asthmatics as compared with the groups experience with bronchoscopy obtained data in the mentioned at-risk group. Secondarily, a screening is obtained to evaluate how COPD patients respond in comparison with healthy control subjects as well as asthmatics.

Milestones and expected results The work package will deliver the first evaluations of DE responses in the airway of asthmatics at 15 months and COPD patients at 24 months into the project. If proven useful and relevant the induced sputum method may be used in forthcoming large scale epidemiological studies to reflect local airway responses to ambient air pollution.