Dysfunction of pulmonary surfactant in asthmatics after segmental allergen challenge
Dysfunction of pulmonary surfactant in asthmatics after segmental allergen challenge
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DOI：
10.1164/ajrccm.159.6.9806145
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发表时间：
1999-06-01
影响因子：
24.7
通讯作者：
Krug, N
中科院分区：
文献类型：
--
作者：
Hohlfeld, JM;Ahlf, K;Krug, N
哮喘气道阻力增加可能部分是由于肺表面活性物质功能低下所致。本研究观察了正常对照组（n = 9）和轻度过敏性哮喘患者（n = 15）节段性激发前后支气管肺泡灌洗液（BALF）的炎症变化和BALF表面活性物质的性能。BALF的基线值，并在24小时后，在一个肺段用生理盐水溶液和过敏原在另一个。分析了细胞计数、磷脂和蛋白质浓度以及小表面活性剂聚集体与大表面活性剂聚集体的比率（SA/LA）。用脉动气泡表面张力计测定表面张力，用毛细管表面张力计评估BALF表面活性剂维持气道通畅的能力。对照组和哮喘组的基线值没有差异。用盐水和抗原激发，对照组和哮喘组的总炎性细胞均升高。过敏原激发哮喘患者，但不是健康志愿者，显着增加嗜酸性粒细胞，蛋白质，SA/LA，和表面张力在最小的气泡大小，并减少了时间的毛细管是开放的。总之，哮喘患者过敏原激发诱导表面活性物质功能障碍，可能主要是因为抑制蛋白。在哮喘发作期间，狭窄的传导气道可能会阻塞，这可能导致气道阻力增加。
Increased airway resistance in asthma may be partly due to poor function of pulmonary surfactant. This study investigated the inflammatory changes of bronchoalveolar lavage fluid (BALF) and the performance of BALF surfactant in healthy control subjects (n = 9) and patients with mild allergic asthma (n = 15) before and after segmental challenge. BALF was obtained for baseline values, and 24 h after challenge with saline solution in one lung segment and with allergen in another. Cell counts, phospholipid and protein concentrations, and ratios of small to large surfactant aggregates (SA/LA) were analyzed. Surface tension was determined with a pulsating bubble surfactometer, and the ability of the BALF surfactant to maintain airway patency was assessed with a capillary surfactometer. Baseline values of control subjects and asthmatics were not different. Challenge with saline and antigen raised total inflammatory cells in both control subjects and asthmatics. Allergen challenge of asthmatics, but not of healthy volunteers, significantly increased eosinophils, proteins, SA/LA, and surface tension at minimum bubble size, and diminished the time the capillary tube is open. In conclusion, allergen challenge in asthmatics induced surfactant dysfunction, probably mainly because of inhibiting proteins. During an asthma attack, narrow conducting airways may become blocked, which might contribute to an increased airway resistance.