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Background . Respiratory infections are a major cause of asthma exacerbations where neutrophilic inflammation dominates and is associated with steroid refractory asthma. Structural airway cells in asthma differ from nonasthmatics; however it is unknown if neutrophils differ. We investigated neutrophil immune responses in patients who have good (A Good ) and suboptimal (A Subopt ) asthma symptom control.  Methods . Peripheral blood neutrophils from A Good  (ACQ < 0.75,  n  = 11), A Subopt  (ACQ > 0.75,  n  = 7), and healthy controls (HC) ( n  = 9) were stimulated with bacterial (LPS (1  μ g/mL), fMLF (100 nM)), and viral (imiquimod (3  μ g/mL), R848 (1.5  μ g/mL), and poly I:C (10  μ g/mL)) surrogates or live rhinovirus (RV) 16 (MOI1). Cell-free supernatant was collected after 1 h for neutrophil elastase (NE) and matrix metalloproteinase- (MMP-) 9 measurements or after 24 h for CXCL8 release.  Results . Constitutive NE was enhanced in A Good  neutrophils compared to HC. fMLF stimulated neutrophils from A Subopt  but not A Good  produced 50% of HC levels. fMLF induced MMP-9 was impaired in A Subopt  and A Good  compared to HC. fMLF stimulated CXCL8 but not MMP-9 was positively correlated with FEV 1  and FEV 1 /FVC. A Subopt  and A Good  responded similarly to other stimuli.  Conclusions . Circulating neutrophils are different in asthma; however, this is likely to be related to airflow limitation rather than asthma control.

Altered Innate Immune Responses in Neutrophils from Patients with Well- and Suboptimally Controlled Asthma