{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:34:15Z","timestamp":1791254055395,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2005,1,27]],"date-time":"2005-01-27T00:00:00Z","timestamp":1106784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2005,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Difficult childhood asthma is defined by persistent symptoms despite maximal conventional therapy. We aimed to establish a safe method of sputum induction for these children and to study cytology and the relationship to exhaled nitric oxide (eNO). Sputum induction was performed in 38\/40 children (aged 6\u201316 years) with difficult asthma, using 3.5% saline for four 5\u2010min periods after bronchodilator pretreatment. Two children were excluded from sputum induction because postbronchodilator forced expired volume in 1 sec (FEV<jats:sub>1<\/jats:sub>) was &lt;65% predicted. Seven of 38 children had symptoms (dyspnea and wheezing) during induction; of these, 3 experienced a fall in FEV<jats:sub>1<\/jats:sub> of &gt;20% from postbronchodilator FEV<jats:sub>1<\/jats:sub>, readily reversed with salbutamol. Sputum induction was successful in 28\/38 children, with a higher success rate in children \u2265\u200912 years than in younger children (87% vs. 50%, <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Only 9\/28 had abnormal sputum cytology; of these, 6 had predominant sputum eosinophilia (&gt;2.5% eosinophils, \u226454% neutrophils), while 3 had sputum neutrophilia (\u22642.5% eosinophils, &gt;54% neutrophils). Of 23 children with elevated eNO values, only 6 had sputum eosinophilia. In conclusion, sputum induction can be used to assess airway inflammation in children with difficult asthma, but abnormal sputum cytology is only present in a minority. Raised nitric oxide is only poorly predictive of sputum eosinophilia in these children. Pediatr Pulmonol. 2005; 39:318\u2013324. \u00a9 2005 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.20159","type":"journal-article","created":{"date-parts":[[2005,1,27]],"date-time":"2005-01-27T18:47:48Z","timestamp":1106851668000},"page":"318-324","source":"Crossref","is-referenced-by-count":76,"title":["Sputum induction in children with difficult asthma: Safety, feasibility, and inflammatory cell pattern"],"prefix":"10.1002","volume":"39","author":[{"given":"Christiane","family":"Lex","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald N.R.","family":"Payne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Zacharasiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert M.","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola M.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor T.","family":"Hansel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bush","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,2,24]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.1999.13e43.x"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.8.2101145"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.53.2.91"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.1999.13f25.x"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.5.1329"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.10.875"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11679-5"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00274402"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/136.1.225"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00293102"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.5.383"},{"key":"e_1_2_1_13_2","first-page":"5","article-title":"Lung volumes and forced ventilatory flows. 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