AIRWAY MUCOSAL INFLAMMATION EVEN IN PATIENTS WITH NEWLY DIAGNOSED ASTHMA
AIRWAY MUCOSAL INFLAMMATION EVEN IN PATIENTS WITH NEWLY DIAGNOSED ASTHMA
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DOI：
10.1164/ajrccm/147.3.697
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发表时间：
1993-03-01
期刊：
影响因子：
--
通讯作者：
HAAHTELA, T
中科院分区：
文献类型：
--
作者：
LAITINEN, LA;LAITINEN, A;HAAHTELA, T
我们研究了14例新诊断的哮喘患者(4名男性和10名女性)的支气管活检，他们有哮喘症状，平均7.4个月(2-12个月)，以及4名对照受试者。这些患者在研究之前没有接受皮质类固醇、色甘酸钠或茶碱的治疗，在局麻下使用硬管支气管镜从两个不同的呼吸道平面：(1)在右上叶内，(2)在右中叶开口--取支气管活检。对样品进行了光镜和电子显微镜检查。采用1×2 mm的狭缝网格，可以用图形化的AUTOCAD程序对大面积的薄片进行拍摄和分析。与正常对照组比较，新诊断哮喘患者肺上皮细胞肥大细胞(P<；0.001)、嗜酸性粒细胞(P<；005)、淋巴细胞(P<；005)和巨噬细胞(P<；005)数量均增加。在固有层，这些哮喘患者的嗜酸性粒细胞(p<；0.001)、淋巴细胞(p<；0.001)、巨噬细胞(p<；0.001)和浆细胞(p<；0.001)比对照组多。我们的结论是，在哮喘中，即使在疾病的临床早期阶段也存在呼吸道炎症过程。在哮喘的呼吸道中，有多种细胞类型引起的全身炎症反应的迹象。
We have studied bronchial biopsies from 14 patients with newly diagnosed asthma (four men and 10 women), who had had asthma symptoms, on average, 7.4 months (range, 2 to 12 months) and from four control subjects. The patients had not received corticosteroids, disodium cromoglycate, or theophylline before the study The bronchial biopsies were taken, using a rigid-tube bronchoscope under local anaesthesia, from two different airway levels: (1) inside the right upper lobe bronchus, and (2) at the opening of the right middle lobe. The specimens were prepared for both light and electron microscopy. The use of Slot grids 1 x 2 mm enabled a large area of the thin sections to be photographed and analyzed by applying a graphic Autocad program. There was an increase in the numbers of mast cells (p < 0.001), eosinophils (p < 0.05), lymphocytes (p < 0.05), and macrophages (p < 0.05) in the epithelium of patients with newly diagnosed asthma as compared with those in control subjects. In the lamina propria, these asthmatic patients had more eosinophils (p < 0.001), lymphocytes (p < 0.001), macrophages (p < 0.001), and plasma cells (p < 0.001) than did the control subjects. We conclude that, in asthma, an airway inflammatory process is present even at a clinically early stage of the disease. In the asthmatic airways, there are signs of a general inflammatory response caused by more than one cell type.