Leukotriene B4 in exhaled breath condensate and sputum supernatant in patients with COPD and asthma
Leukotriene B4 in exhaled breath condensate and sputum supernatant in patients with COPD and asthma
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DOI：
10.1378/chest.127.5.1553
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发表时间：
2005-05-01
期刊：
影响因子：
9.6
通讯作者：
Loukides, S
中科院分区：
文献类型：
--
作者：
Kostikas, K;Gaga, M;Loukides, S
研究目的：部分COPD患者在接受支气管扩张治疗后表现出明显的气流受限可逆性。白三烯B-4(LTB4)参与了慢性阻塞性肺疾病和哮喘的病理生理过程。我们验证了气流可逆性COPD患者和吸烟的哮喘患者呼气冷凝液(EBC)和痰上清液中LTB4水平相似的假设。设计：前瞻性、横断面研究。患者或参与者：我们研究了30名COPD患者(15名吸烟者[FEV1，预测56%；SD，预测6%]；15名患者支气管扩张后呼吸道阻塞明显可逆性[FEV1，预测14%；SD，预测2%])。15例吸烟、FEV1和可逆性相似的哮喘患者也进行了研究。单位：某医院研究实验室。干预：首次就诊时进行肺活量测定和可逆性试验。结果：慢性阻塞性肺疾病患者和哮喘患者外周血中LTB_4水平分别为86.7pg/m L、19pg/m L、97.5pg/m l、15pg/m L，均高于对照组(均为32.3pg/m l、10pg/m l、p<；0.0001)。有气流可逆性的COPD患者(平均99.8pg/m L；SD，12pg/m L)与哮喘患者(平均97.5pg/m L；SD，15pg/m L；p=0.2)相似，但高于无气流可逆性的慢性阻塞性肺病患者(平均73.7pg/m L；SD，17 pg/m L；p=0.002)。在痰上清液中也观察到类似的结果。哮喘患者和可逆性COPD患者外周血和痰中LTB_4水平高于不可逆性COPD患者和健康吸烟者。这种差异可能主要归因于呼吸道阻塞存在可逆性，可能是共同的潜在炎症过程的一部分。
Study objectives: Some patients with COPD present with significant reversibility of airflow limitation after receiving bronchodilation therapy. Leukotriene B-4 (LTB4) has been implicated in the pathophysiology of both COPD and asthma. We tested the hypothesis that COPD patients with airflow reversibility and asthmatic patients who smoke might have similar levels of LTB4 in exhaled breath condensate (EBC) and sputum supernatant. The repeatability and stability of LTB4 measurements were additionally studied.Design: Prospective, cross-sectional study.Patients or participants: We studied 30 patients with COPD (15 smokers [FEV1, 56% predicted; SD, 6% predicted]; 15 patients with significant reversibillity in airway obstruction after bronchodilation [FEV1, 14% predicted; SD, 2% predicted]). Fifteen asthmatic patients who smoked, with similar FEV1 and reversibility were also studied. Ten healthy smokers served as control subjects.Setting: A hospital research laboratory.Interventions: Spirometry and reversibility testing were performed on the first visit. On the following day, EBC was collected for the measurement of LTB4, and induced sputum was collected for differential cell counts and LTB4 measurement in the sputum supernatant.Measurements and results: LTB4 levels in EBC [mean (SD)] were increased in COPD patients (mean, 86.7 pg/mL; SD, 19 pg/mL) and asthmatic patients (mean, 97.5 pg/mL; SD, 15 pg/mL) compared to control subjects (mean, 32.3 pg/mL; SD, 10 pg/mL; p < 0.0001 for both groups). COPD patients with airflow reversibility (mean, 99.8 pg/mL; SD, 12 pg/mL) had values similar to those of asthmatic patients (mean, 97.5 pg/mL; SD, 15 pg/mL; p = 0.2) and higher than those of COPD patients without airflow reversibility (mean, 73.7 pg/mL; SD, 17 pg/mL; p = 0.002). Similar results were observed in the sputum supernatant. Measurements of LTB4 in EBC and sputum were repeatable on two consecutive days, but measurements in the frozen samples of EBC and sputum were not stable after 3 weeks.Conclusions: Patients with asthma and reversible COPD presented with higher LTB4 values compared to patients with nonreversible COPD and healthy smokers. This difference may be mainly attributed to the presence of reversibility in airway obstruction, probably as part of a common underlying inflammatory process.