Sputum level

Yamamoto C, Yoneda T, Yoshikawa M, Fu A, Tokuyama T, Tsukaguchi K, Narita N. Airway inflammation in COPD assessed by sputum levels of interleukin-8. Chest 1997 112 505-510. 

Simon and Gatzemeier (1979) measured peak serum levels in healthy human volunteers of 17.7 xg/ml after a 500-mg dose and 27.3 pg/ml after a 1-g dose. Urinary recovery after 9 hr was reported to be 62% compared to 85% with cephalexin. Sputum levels were reported to be 8-l()% of the serum levels in patients. 

Monitor for changes in pulmonary symptoms such as cough, sputum production, respiratory rate, and oxygen saturation. Symptoms of an acute exacerbation should improve with antibiotics and aggressive airway clearance therapy. Pulmonary function tests should be markedly increased after 1 week and trend back to pre-exacerbation levels after 2 weeks of therapy, ft improvement lags, 3 weeks of therapy may be needed. 

Sekiya T, Yamada H, Yamaguchi M, et al. Increased levels of a TH2-type CC chemokine thymus and activation-regulated chemokine (TARC) in serum and induced sputum of asthmatics. Allergy 2002 57(2) 173-177. 

A further example of the ability of doxycycline to penetrate into secretions is provided by a report [53] of a comparative trial of the drug and ampicillin in acute exacerbations in chronic bronchitis. It was found that 100 mg doxycycline daily and ampicillin 250 mg four times daily were clinically equally effective. Bacterio-logically, however, it was found that H. influenzae re-appeared in sputum more often during ampicillin therapy than y ith doxycycline. This was attributed, following earlier workers, to the failure of ampicillin (in the dose used) to reach adequate levels in sputum. By inference, therefore, doxycycline (at one tenth of the daily dosage) achieves adequate levels more readily. 

An interesting report [54] of oxytetracycline levels in bronchial secretions has provided evidence that the drug often fails to reach therapeutic concentrations in sputum but that concurrent administration of bromhexine greatly increases its levels in such exudate. This property has been briefly alluded to above in connection with penetration of doxycycline into sinus secretions. The authors [54] attribute this higher antibiotic concentration in sputum to increased capillary permeability, without quoting authority. 

Mean Immunoglobulin Levels in Sera op Sputum-Positive Patients AND Controls op Similar Age Groups"... 

Penicillin concentrations in most tissues are equal to those in serum. Penicillin is also excreted into sputum and milk to levels 3-15% of those in the serum. Penetration into the eye, the prostate, and the central nervous system is poor. However, with active inflammation of the meninges, as in bacterial meningitis, penicillin concentrations of 1-5 mcg/mL can be achieved with a daily parenteral dose of 18-24 million units. These concentrations are sufficient to kill susceptible strains of pneumococci and meningococci. 

Sputum samples collected from 13 patients between December 1969 and May 1970 all contained PCBs. Contamination was highest in December, with detection less common by May, and PCB levels were lower. Autopsy... 

Methods of measurement of pesticide exposures can be separated into two categories direct and indirect (Bristol et al., 1984 Nigg et al., 1990). Direct methods measure a pesticide residue in environmental media or on the skin surface before it has entered the body in order to estimate the potential dose. Indirect methods estimate the minimum absorbed dose by measuring residues in excreta, body fluids or tissues after exposure has occurred. Examples of direct methods are those that determine residues in air, water, food and on surfaces. Indirect methods may involve determination of the levels of specific pesticides, their metabolites or biological indicators ( biomarkers ), such as protein- or DNA-adducts, in blood, urine, feces, sputum, sebum, cerumen or adipose tissue. This chapter covers direct measurement methods only. 

Indirect method Estimates the minimum absorbed dose by measuring residues in excreta, body fluids or tissues after exposure has occurred. Indirect methods may involve determination of the levels of specific pesticides, their metabolites or biological indicators ( biomarkers ), such as protein- or DNA-adducts, in blood, urine, feces, sputum, sebum, cerumen or adipose tissue (Lewis, Ch. 3). 

The most reliable test to determine if you have been exposed to asbestos is the detection of microscopic asbestos fibers in pieces of lung tissue removed by surgery, but this is a very invasive test. A test can also be run to determine the presence of asbestos fibers in material rinsed out of the lung. However, this test can cause some discomfort. Asbestos fibers can also be detected in mucus (sputum), urine, or feces, but these tests are not reliable for determining how much asbestos may be in your lungs. Low levels of asbestos fibers are found in these materials for nearly all people. Higher-than-average levels can show that you have been exposed to asbestos. 

Analyses of bronchoalveolar lavage fluid samples or sputum samples can directly reflect alveolar concentrations of retained fibers and, although they do not reflect the proportion of deposited fibers that may move to the interstitium (Case 1994 Pinkerton et al. 1984), can provide information regarding past exposure to asbestos, especially to amphibole fibers. Obtaining sputum samples is much less invasive than obtaining bronchoalveolar lavage samples. In Libby, Montana vermiculite miners and millers exposed to fibrous tremolite, counts of asbestos bodies in sputum samples closely reflected intensity and duration of past exposure (Sebastien et al. 1988b), but asbestos body counts in sputum samples from volunteers from other cohorts of workers exposed to asbestos (predominately chrysotile or lower levels of amphibole fibers than in Libby) did not reliably reflect past levels of exposure (McDonald et al. 1988, 1992). 

Rose, C University of Colorado Health Sciences Center, Denver, CO Sputum cytology and urinary bombesinlike peptide levels NCRR... 

Traves SL, Culpitt S, Russell REK, Barnes PJ, Donnelly LE. Elevated levels of the chemokines GRO-a and MCP-1 in sputum samples from COPD patients. Thorax 2002 57 590-595. 

Dornase alfa is phosphorylated glycosylated recombinant human deoxyribonuclease. It is given daily by inhalation of a nebulised solution containing 2500 units (2.5 mg). It is of modest value only in patients with cystic fibrosis, whose genetic defect in chloride transport causes particularly viscous sputum. The blocked airways, as well as the sputum itself, are a trap for pathogens and the lysis of invading neutrophils leads to substantial levels of free and very viscous DNA within the CF airways. 

Frigas, E., Loegerir, D.A., Solley, G.O., Farrow, G.M. and Gleich, G.J. (1981). Elevated levels of eosinophil granule major basic protein in the sputum of patients with bronchial asthma. Mayo Clinic Proc. 56, 345-353. 

Documented cases of human poisoning by ricin aerosol exposure are unknown. Cautious inferences may be drawn from observations of NHP exposed to ricin under controlled laboratory settings. Human toxicity from ricin inhalation would be expected to occur after a latency period of 24—72 h that may be characterized by loss of appetite and listlessness. Based on extrapolation from NHP studies, other signs and symptoms expected in humans after ricin inhalation may include listlessness, high fever, dyspnea, and coughing or bloody sputum that is delayed for 4—8 h after exposure, as well as bilateral abnormalities on chest radiographs, arterial hypoxemia, neutrophilic leukocytosis, and elevated protein levels in bronchial aspirates (Balint, 1974 Wilhelmsen and Pitt, 1996 Franz and Jaax, 1997). 

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