LATENT ADENOVIRAL INFECTION IN FOLLICULAR BRONCHIECTASIS
LATENT ADENOVIRAL INFECTION IN FOLLICULAR BRONCHIECTASIS
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DOI：
10.1164/ajrccm.151.1.7812549
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发表时间：
1995-01-01
影响因子：
24.7
通讯作者：
HOGG, JC
中科院分区：
文献类型：
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作者：
BATEMAN, ED;HAYASHI, S;HOGG, JC
Whitwell 最初描述的滤泡型支气管扩张症 (1) 与腺病毒感染有关。本研究比较了 16 名滤泡性支气管扩张患者（其中 10 名确诊为非病毒性病因）和 8 名非滤泡性组织学模式患者的肺切除标本。使用腺病毒基因组 E1A 区域和人类 HLA DQ α 基因的引物，对从 45 个石蜡包埋的肺样本切片中分离出的 DNA 进行聚合酶链式反应 (PCR)。使用整个腺病毒 5 基因组的探针对从同一块切下的不同切片进行原位杂交 (ISH)。 E1A 在 8 名非滤泡性支气管扩张 (non-FB) 患者中的 6 名 (75%) 和 16 名滤泡性支气管扩张 (FB) 患者中的 4 名 (25%) 中得到证实（p < 0.03，Fisher 精确检验）。 FB 中 PCR E1A 产物的光密度比（样本 E1A 产物与 1 pg 腺病毒 DNA 产物的比率）显着低于非 FB（0.057 +/- 0.054 与 0.365 +/- 0.223 [平均值 +/- SEM]，p < 0.05）。此外，支气管标本中没有E1A的患者的支气管扩张症状持续时间显着短于E1A PCR产物阳性的患者（3.09+/-1.44与14.41+/-3.33年；p<0.05）。通过 ISH，在 3 名 FB 患者和 2 名非 FB 患者中发现了腺病毒（分别占组织块的 17.2% 和 18.8%；NS）。这些发现表明，潜伏性腺病毒的患病率低于肺功能正常的吸烟者，并且它们无法支持腺病毒感染（潜伏性或溶解性）与这种晚期疾病状态下的支气管扩张之间的因果关系。这表明在支气管扩张过程中建立的支气管粘膜防御可能会消除大多数成人肺部中发现的腺病毒。
The follicular form of bronchiectasis originally described by Whitwell (1) has been associated with adenoviral infection. The present study compares resected lungs from 16 patients with follicular bronchiectasis (in 10 of whom a nonviral etiology was identified) with those from eight patients with a nonfollicular histologic pattern. DNA isolated from sections of 45 paraffin-embedded lung samples was subjected to the polymerase chain reaction (PCR) using primers for the E1A region of the adenovirus genome and the human HLA DQ alpha gene. In situ hybridization (ISH) was performed on separate sections cut from the same blocks using a probe for the entire adenovirus 5 genome. E1A was demonstrated in six of eight patients (75%) with nonfollicular bronchiectasis (non-FB) and in four of 16(25%) with follicular bronchiectasis (FB) (p < 0.03, Fisher's exact test). The optical density ratio for the E1A product of PCR (ratio of E1A product from specimen to that from 1 pg adenovirus DNA) was significantly lower in FB than in non-FB (0.057 +/- 0.054 versus 0.365 +/- 0.223 [mean +/- SEM], p < 0.05). Moreover, the duration of symptoms of bronchiectasis in patients without E1A in bronchial specimens was significantly shorter than that of patients with positive E1A PCR products (3.09 +/- 1.44 versus 14.41 +/- 3.33 yr; p < 0.05). By ISH, adenovirus was demonstrated in three patients with FB and in two with non-FB (17.2 and 18.8% of tissue blocks, respectively; NS). These findings represent a lower prevalence of latent adenovirus than that found in smokers with normal lung function, and they fail to support a causal link between adenovirus infections (latent or lytic) and bronchiectasis at this late state of disease. This suggests that the bronchial mucosal defenses mounted during the development of bronchiectasis may eliminate the adenovirus found in the majority of adult lungs.