School examinations enhance airway inflammation to antigen challenge
School examinations enhance airway inflammation to antigen challenge
复制标题
DOI：
10.1164/ajrccm.165.8.2109065
复制
发表时间：
2002-04-15
影响因子：
24.7
通讯作者：
Busse, WW
中科院分区：
文献类型：
--
作者：
Liu, LY;Coe, CL;Busse, WW
心理压力可导致某些患者哮喘恶化。我们的假设是，应激效应可以通过增强过敏性炎症反应而发生。为了研究这种可能性，在20名轻度哮喘的大学生中进行了气道抗原激发试验，评估了低应激阶段（期中或期末考试后两周）和应激阶段（期末考试周）。受试者完成问卷调查以评估心理状态，并接受吸入抗原激发。在攻毒前、攻毒后6小时、24小时和7天采集痰液样本。计数痰液上清液中的白细胞并测定嗜酸性粒细胞源性神经毒素（EDN）。培养痰液细胞并用植物血凝素（10 μ g/ml）离体刺激，并通过酶联免疫吸附测定法测定培养上清液中的白细胞介素-5（IL-5）和干扰素-γ。激发后6小时和24小时痰液嗜酸性粒细胞和EDN水平显著升高，在应激期更明显（p < 0.01）。应激期间24小时，痰细胞产生的IL-5也增加，并与气道嗜酸性粒细胞相关（r（s）= 0.65，p < 0.05）。考试期间学生的焦虑和抑郁得分显著较高。我们的研究结果表明，与期末考试相关的压力可以作为一个辅助因素，增加嗜酸性粒细胞气道炎症抗原的挑战，从而可能增加哮喘的严重程度。
Psychological stress can lead to asthma exacerbations in some patients. It is our hypothesis that the stress effect can occur through an enhancement of allergic inflammatory response. To investigate this possibility, airway antigen challenge was evaluated in 20 college students with mild asthma during both a low-stress phase (midsemester or two weeks postfinal examination) and a stress phase (final examination week). Subjects completed questionnaires to assess psychological state and underwent inhaled antigen challenge. Sputum samples were collected before challenge, and six and 24 hours and seven days postchallenge. Leukocytes were counted and eosinophil-derived neurotoxin (EDN) was measured in sputum supernates. Sputum cells were cultured and stimulated ex vivo with phytohemagglutinin (10 mug/ml), and culture supernates were assayed for interleukin-5 (IL-5) and interferon-gamma by enzyme-linked immunosorbent assay. Sputum eosinophils and EDN levels significantly increased at six and 24 hours postchallenge and were enhanced during the stress phase (p < 0.01). IL-5 generation by sputum cells was also increased at 24 hours during stress and correlated with airway eosinophils (r(s) = 0.65, p < 0.05). Students' anxiety and depression scores were significantly higher during the examination period. Our findings suggest that stress associated with final examinations can act as a cofactor to increase eosinophilic airway inflammation to antigen challenge and thus may enhance asthma severity.