Cellular profiles in asthmatic airways: A comparison of induced sputum, bronchial washings, and bronchoalveolar lavage fluid
Cellular profiles in asthmatic airways: A comparison of induced sputum, bronchial washings, and bronchoalveolar lavage fluid
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DOI：
10.1136/thx.52.4.372
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发表时间：
1997-04-01
期刊：
影响因子：
10
通讯作者：
Barnes, PJ
中科院分区：
文献类型：
--
作者：
Keatings, VM;Evans, DJ;Barnes, PJ
背景-支气管肺泡灌洗液的分析提高了我们对哮喘发病机制的认识。安全问题和专家资源的获取限制了该技术作为研究工具的能力，诱导痰是一种非侵入性的收集气道液体的方法，适用于不同程度的气流阻塞受试者，不同组间痰的收集和处理方法不同，本研究对诱导痰和支气管镜下收集的液体进行了比较。方法：16例轻度稳定期哮喘患者随机进行支气管冲洗和支气管肺泡灌洗（BAL）诱导痰和支气管镜检查，每隔12天进行一次检查，处理气道液并染色进行鉴别细胞计数。结果：与支气管洗涤液和BAL液相比，诱导痰中中性粒细胞和嗜酸性粒细胞相对丰富(BAL液、支气管洗涤液和诱导痰中中性粒细胞的平均SE分别为1.3(0.4)%、5.0(2.7)%和36.4(3.7)%，嗜酸性粒细胞的平均SE分别为0.6(0.1)%、1.6（0.6)%和3.3(1.1)%）。诱导痰中获得的细胞比例与支气管洗涤液相关，而与BAL液无关（中性粒细胞和嗜酸性粒细胞的r分别为0.6和0.7）。P < 0.05)。相比之下，诱导痰中淋巴细胞和巨噬细胞的比例低于支气管洗涤液或BAL液，但无相关性。结论-诱导痰富含中性粒细胞和嗜酸性粒细胞，淋巴细胞较少，提示其起源于大气道，诱导痰充分反映了直接支气管镜检查所收集的液体的发现。
Background - Analysis of bronchoalveolar lavage fluid has improved our understanding of the pathogenesis of asthma. Safety issues and access to expert resources limit this technique as a research tool, Induced sputum is a non-invasive method of collecting airway fluid which is applicable to subjects with a range of severity of airflow obstruction, The method of sputum collection and processing differs between groups, A study was undertaken to compare induced sputum with bronchoscopically collected fluid.Methods - Sixteen patients with mild stable asthma underwent both sputum induction and bronchoscopic examination with bronchial washings and bronchoalveolar lavage (BAL) in random order, with each procedure being separated by an interval of 12 days, Airway fluid was processed and stained for differential cell counting.Results - Induced sputum was relatively rich in neutrophils and eosinophils compared with bronchial washings and BAL fluid (mean (SE) 1.3 (0.4)%, 5.0 (2.7)%, and 36.4 (3.7)% neutrophils and 0.6 (0.1)%, 1.6 (0.6)%, and 3.3 (1.1)% eosinophils in BAL fluid, bronchial washings, and induced sputum, respectively), The proportions of cells obtained at sputum induction correlated with those in bronchial washings but not BAL fluid (r = 0.6 and 0.7 for neutrophils and eosinophils, respectively, p < 0.05). By contrast, induced sputum had a lower proportion of lymphocytes and macrophages than bronchial washings or BAL fluid, without any correlation.Conclusion - Induced sputum is rich in neutrophils and eosinophils and poor in lymphocytes, suggesting an origin in the larger airways, Induced sputum adequately reflects the findings in fluid collected by direct bronchoscopy.