The immediate and late allergic response to segmental bronchopulmonary provocation in asthma
The immediate and late allergic response to segmental bronchopulmonary provocation in asthma
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DOI：
10.1164/ajrccm.155.5.9154851
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发表时间：
1997-05-01
影响因子：
24.7
通讯作者：
Busse, WW
中科院分区：
文献类型：
--
作者：
Jarjour, NN;Calhoun, WJ;Busse, WW
对抗原的反应是呼吸道炎症发生发展的重要因素。抗原的节段性支气管刺激(SEP)和随后的支气管肺泡灌洗(BAL)为过敏性炎症的机制提供了有价值的见解。为了解哮喘患者过敏性呼吸道反应的特点，对19例轻度哮喘患者进行了剂量依赖性抗原SEP检查。SEP中使用的抗原量为0(生理盐水)，以及将FEV1降低20%所需抗原量的1、5或20%(apd(20))。分别于SEP后5min和48h行BAL检查。抗原SEP后5min，BAL组胺水平略有升高。48h时，嗜酸性粒细胞和IL-5浓度显著增加，即使在组胺释放旺盛的气道段也是如此。此外，嗜酸性粒细胞与IL-5水平在48h时呈正相关(r=0.63p<；0.001)，而在5min时与BAL组胺浓度无关。抗原SEP后CM-CSF水平未见升高，与嗜酸性粒细胞无相关性。这些观察表明，哮喘受试者可以对抗原SEP产生剂量依赖的反应，其特征是在抗原暴露后立即组胺适度增加，并出现明显的嗜酸性粒细胞增多，按比例表现为大于组胺反应和相对大于过敏性非哮喘受试者的反应。这一特征可能对哮喘呼吸道炎症的最终发展具有重要意义。
The response to antigen is an important factor in the development of airway inflammation. Segmental bronchoprovocation (SEP) with antigen and subsequent bronchoalveolar lavage (BAL) have provided valuable insight into the mechanisms of allergic inflammation. To determine the features of allergic airway response in asthma, 19 subjects with mild asthma underwent antigen SEP in a dose-dependent manner. The amount of antigen used in SEP was 0 (saline), and 1, 5, or 20% of the antigen dose required to drop the FEV1 by 20% (APD(20)). BAL was done at 5 min and 48 h after SEP. BAL histamine levels increased modestly 5 min after antigen SEP. At 48 h, there was a marked increase in eosinophils and IL-5 concentration even in airway segments where the release of histamine was smart. Moreover, eosinophils correlated with IL-5 levels at 48 h (r = 0.63; p < 0.001), but not with BAL histamine concentrations at 5 min. CM-CSF levels did not increase after antigen SEP and did not correlate with eosinophils. These observations indicate that asthmatic subjects can develop a dose-dependent response to antigen SEP that is characterized by a modest increase in histamine immediately after antigen exposure, and marked eosinophilia, which appears proportionately greater than the histamine response and relatively greater than what is seen in allergic nonasthmatic subjects. This feature might be important to the eventual development of airway inflammation in asthma.