Lipid-laden macrophage index and inflammation in bronchoalveolar lavage fluids in children
Lipid-laden macrophage index and inflammation in bronchoalveolar lavage fluids in children
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DOI：
10.1183/09031936.01.00047301
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发表时间：
2001-11-01
影响因子：
24.3
通讯作者：
Noah, TL
中科院分区：
文献类型：
--
作者：
Kazachkov, MY;Muhlebach, MS;Noah, TL
在临床中，肺泡巨噬细胞中脂质的存在已被用作吸入的指标，在动物模型中，这一过程与肺部炎症增加有关。假设肺泡巨噬细胞中的脂质数量（以脂质负荷指数（LLI）测量）与儿科患者的肺部炎症有关。慢性呼吸道症状患儿（21例囊性纤维化，24例非囊性纤维化）行支气管镜下支气管肺泡灌洗（BAL）和24小时食管内pH监测临床指征。测定所有儿童支气管肺泡灌洗液（BALF）中的总细胞计数、中性粒细胞和巨噬细胞的数量和百分比以及LLI。还从8名健康的年轻不吸烟的成年人中获得了半胱氨酸（BALF）作为比较。非cf儿童LLI为6.9 +/-3.5（平均+/- SEM），高于健康成人（1.0 +/-0.4），差异有统计学意义（p=0.045）。与健康成人（p=0.014）和非CF儿童（p= 0.045）相比，CF儿童的lli非常高（19.2 +/-4.5）。各组LLI与气道炎症无相关性。pH探针异常患儿的LLI有高于pH探针正常患儿的趋势，但差异无统计学意义（p=0.098）。结论：与健康成人相比，患有慢性呼吸道症状的儿童的脂质指数显著升高，患有囊性纤维化的儿童与患有其他慢性呼吸道疾病的儿童相比，脂质指数显著升高。然而，脂质负荷指数与支气管肺泡灌洗液炎症的数量无关。儿童的脂质指数可能在一定程度上反映了除吸入性外的其他过程，如气道阻塞。
The presence of lipids in alveolar macrophages has been used clinically as an indicator of aspiration, a process associated with increased lung inflammation in animal models. The hypothesis is that the quantity of lipids in alveolar macrophages, measured as lipid-laden index (LLI), would correlate with lung inflammation in paediatric patients.Children with chronic respiratory symptoms (21 cystic fibrosis (CF), 24 non-CF) underwent flexible bronchoscopy with bronchoalveolar lavage (BAL) and 24-h intraoesophageal pH monitoring for clinical indications. Total cell counts, number and per cent of neutrophils and macrophages, and LLI were determined in the bronchoalveolar lavage fluids (BALF) from all children. BALF were also obtained from eight healthy, young nonsmoking adults for comparison.LLI in non-CF children were 6.9 +/-3.5 (mean +/- SEM) which were higher than LLI in healthy adults (1.0 +/-0.4), (p=0.045). Children with CF had very high LLIs (19.2 +/-4.5) compared with both healthy adults (p=0.014) and children without CF (P=0.045). LLI did not correlate with airway inflammation in any group. LLI in children with abnormal pH probes had a tendency to be higher than in children with normal pH probes, but the difference was not significant (p=0.098).It is concluded that the lipid-laden index was significantly elevated in children with chronic respiratory symptoms compared with healthy adults, and in children with cystic fibrosis compared wi ih those who have other chronic respiratory conditions. However, the lipid-laden index did not correlate with the quantity of bronchoalveolar lavage fluid inflammation. The lipid-laden index in children may, in part, reflect processes other than aspiration, such as airways obstruction.