Methodological Aspects of Induced Sputum

Highlights: What are the main findings? Induced sputum is a valuable non-invasive and cost-effective method for obtaining lower airway secretions, especially in patients who cannot produce sputum naturally. Despite some technical demands and limitations, induced sputum offers significant advantages as a preferred alternative for large-scale and repeated airway sampling in respiratory conditions like asthma and COPD. What is the implication of the main finding? The use of induced sputum provides researchers and clinicians with valuable insights into the cellular and biochemical components of airway secretions, allowing for a better understanding of airway inflammation, immune responses, and treatment efficacy in several respiratory conditions. This allows for large-scale and repeated airway sampling, enabling researchers and clinicians to conduct comprehensive studies and monitor treatment responses over time, ultimately contributing to better patient care and improved outcomes. We aimed to conduct a state-of-the-art review of the current literature and offer further insights into the methodological aspects concerning induced sputum. The increasing popularity of sputum induction as a non-invasive and cost-effective method for obtaining lower airway secretions from patients who cannot produce sputum naturally has led to extensive research and applications in respiratory conditions like asthma and COPD. This technique allows for analysis of the cellular and biochemical components of the sputum to take place, providing insights into airway inflammation, immune cells, and help in predicting treatment response. Furthermore, induced sputum enables various analyses, including microRNA and gene expression studies and immunophenotyping. The procedure is generally safe and well tolerated, even in patients with airflow limitations; however, monitoring lung function is essential, especially in those with airway hyperresponsiveness. Optimal saline solution concentration and inhalation duration have been investigated, recommending a 15–20 min induction with hypertonic saline. Expectoration involves coughing at the end of each inhalation time. Careful handling during sputum processing is necessary for obtaining accurate results in cell cytology, immunocytochemistry, and in situ hybridization. Overall, induced sputum offers significant advantages as a preferred alternative for large-scale and repeated airway sampling, despite some technical demands and limitations. © 2023 by the authors.