Analysis of sputum taken from wheezy and asthmatic infants and children, with special reference to respiratory infections
Analysis of sputum taken from wheezy and asthmatic infants and children, with special reference to respiratory infections
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DOI：
10.1034/j.1399-3038.2001.0o044.x
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发表时间：
2001-12-01
影响因子：
4.4
通讯作者：
Kiyofumi, O
中科院分区：
文献类型：
--
作者：
Nagayama, Y;Tsubaki, T;Kiyofumi, O
注定要患哮喘的儿童被认为易受各种呼吸道病原体的影响。为了阐明这些儿童中的呼吸道炎症，我们测量了三组不同喘息婴幼儿痰液中嗜酸性粒细胞阳离子蛋白（ECP）和类胰蛋白酶的水平：首次喘息（n = 15）;反复喘息（n = 27）和反复喘息伴呼吸窘迫，即哮喘（n = 56）。还结合ECP和类胰蛋白酶水平评价了通过痰液样本显微镜分析确定的嗜酸性粒细胞或异染性细胞数量。虽然痰液ECP和类胰蛋白酶都不是区分三种不同类型喘息性疾病的明确区分标志物，但哮喘组痰液ECP水平明显高于哮喘组（22，2269.2 +/-6，216.8 ng/g）高于反复喘息组（440.3 +/-1，199.8 ng/g）或首次喘息组（209.0 +/-172.9 ng/g）。痰液中类胰蛋白酶水平也有类似的趋势，但三组间无显著差异。哮喘患儿痰液中嗜酸性粒细胞明显增多。然而，在1岁的哮喘婴儿中未发现痰中嗜酸性粒细胞的积累（即使存在痰ECP水平升高），此后嗜酸性粒细胞的数量迅速增加，直到儿童达到5岁。值得注意的是，从1岁和2岁的哮喘婴儿中提取的病原菌阳性样本具有显示高水平ECP但嗜酸性粒细胞数量减少的趋势。沿着由病毒感染引起的喘息发作，主要和偶尔合并继发性细菌感染，可发生嗜酸性粒细胞活化和浸润。这些对各种病原体的预定免疫反应可能与触发哮喘发作有关。
Children who are destined to develop asthma are considered to be susceptible to a variety of respiratory pathogens. To elucidate respiratory inflammation among these children, we measured the levels of eosinophil cationic protein (ECP) and tryptase in sputum taken from three different groups of wheezy infants and young children: those with a first wheeze (n = 15); those with recurrent wheeze (n = 27), and those with recurrent wheeze with respiratory distress, namely asthma (n = 56). The numbers of eosinophils or metachromatic cells determined by microscopic analysis of sputum samples were also evaluated in combination with the ECP and tryptase levels. Although neither sputum ECP nor tryptase was a clear discriminative marker that differentiated the three different types of wheezy disease, ECP levels in sputum from the asthma group were significantly higher (22,2269.2+/-6,216.8 ng/g) than those in the recurrent wheezy group (440.3+/-1,199.8 ng/g) or in the first-wheeze group (209.0+/-172.9 ng/g). A similar trend was observed with tryptase levels in sputum, but there were no significant differences among the three groups. Sputum taken from asthmatic children showed a marked accumulation of eosinophils. However, an accumulation of eosinophils in sputum (even in the presence of an elevated level of sputum ECP) was not identified in the asthmatic infants 1 year old and thereafter the eosinophils rapidly increased in number until the children reached 5 years of age. It was noteworthy that sputa positive for pathogenic bacteria, taken from the 1- and 2-year-old asthmatic infants, had a tendency to show high levels of ECP but a reduced number of eosinophils. Along with the wheezy episodes induced by viral infection, primarily and occasionally in combination with secondary bacterial infection, eosinophil activation and infiltration may develop. These predestined immune reactions to various pathogens might be associated with triggering the onset of asthma.