Granulocyte-macrophage colony-stimulating factor expression in induced sputum and bronchial mucosa in asthma and COPD
Granulocyte-macrophage colony-stimulating factor expression in induced sputum and bronchial mucosa in asthma and COPD
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DOI：
10.1136/thx.2008.108290
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发表时间：
2009-08-01
期刊：
影响因子：
10
通讯作者：
Brightling, C. E.
中科院分区：
文献类型：
--
作者：
Saha, S.;Doe, C.;Brightling, C. E.
背景：粒细胞巨噬细胞集落刺激因子(GM-CSF)在哮喘和慢性阻塞性肺疾病(COPD)的发病机制中起重要作用。然而，GM-CSF及其受体在哮喘和COPD不同病情的气道标本中的表达有待进一步研究。方法：检测18例正常对照组、45例哮喘患者和47例COPD患者的痰GM-CSF。对29例正常对照组、36例哮喘患者和10例慢性阻塞性肺疾病患者的支气管黏膜下层和气道平滑肌束进行GM-CSF阳性细胞计数。结果：中、重度哮喘组、COPD GOLD(全球慢性阻塞性肺疾病倡议)II期(7/16)、III期(8/17)、IV期(7/14)患者痰中可检测到GM-CSF的比例明显高于对照组(1/18)和轻度哮喘组(0/13)，P=0.001。中、重度哮喘患者痰中GM-CSF值与痰嗜酸粒细胞增多呈正相关(r(S)=0.41p=0.018)。重度哮喘组粘膜下层GM-CSF+和GM-CSFR+细胞数的中位数(四分位数范围)分别为1.43.0和2.18.4mm2，明显高于轻中度哮喘组(0(2.5%)和1.1%(5例))和健康对照组(0(0.5%和0(1.6%)例)，(p=0.004和p=0.02)。结论：GM-CSF在哮喘和COPD中具有潜在的作用，痰和支气管黏膜中GM-CSF的过度表达是重症哮喘的一个特殊特征。
Background: Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been implicated as an important mediator in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). However, the expression of GM-CSF and its receptor in airway samples in asthma and COPD across disease severity needs to be further defined.Methods: Sputum GM-CSF was measured in 18 control subjects, 45 subjects with asthma and 47 subjects with COPD. Enumeration of GM-CSF+ cells in the bronchial submucosa and airway smooth muscle bundle was performed in 29 control subjects, 36 subjects with asthma and 10 subjects with COPD.Results: The proportion of subjects with measurable GMCSF in the sputum was raised in those with moderate (7/14) and severe (11/18) asthma, and in those with COPD GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage II (7/16), III (8/17) and IV (7/14) compared with controls (1/18) and those with mild asthma (0/13); p = 0.001. The sputum GM-CSF concentration was correlated with the sputum eosinophilia in subjects with moderate to severe asthma (r(s)= 0.41; p = 0.018). The median (interquartile range) GM-CSF+ and GM-CSFR+ cells/mm(2) of submucosa was increased in severe asthma (1.4 (3.0) and 2.1 (8.4)) compared with those with mild to moderate asthma (0 (2.5) and 1.1 (5)) and healthy controls (0 (0.5) and 0 (1.6)), (p = 0.004 and p = 0.02, respectively).Conclusions: The findings support a potential role for GM-CSF in asthma and COPD and suggest that overexpression of GM-CSF in sputum and the bronchial mucosa is a particular feature of severe asthma.