INTRAEPITHELIAL MAST-CELLS IN ALLERGIC AND NONALLERGIC ASTHMA - ASSESSMENT USING BRONCHIAL BRUSHINGS
INTRAEPITHELIAL MAST-CELLS IN ALLERGIC AND NONALLERGIC ASTHMA - ASSESSMENT USING BRONCHIAL BRUSHINGS
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DOI：
10.1164/ajrccm/148.1.80
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发表时间：
1993-07-01
期刊：
影响因子：
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通讯作者：
HARGREAVE, FE
中科院分区：
文献类型：
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作者：
GIBSON, PG;ALLEN, CJ;HARGREAVE, FE
已知肥大细胞介质有助于哮喘的发病机制。关于哮喘粘膜中肥大细胞的数量存在一些分歧。在这项研究中，开发了标准化支气管刷技术，并用于评估过敏性和非过敏性哮喘和非哮喘受试者的上皮内肥大细胞和其他炎症细胞。总共 10 名非哮喘患者（5 名过敏患者）和 13 名哮喘患者（8 名过敏患者）仅接受 β 受体激动剂治疗，哮喘得到稳定控制，并通过病史、肺活量测定、过敏点刺试验和乙酰甲胆碱气道反应性进行评估。在纤维支气管镜检查期间，从中叶进行支气管肺泡灌洗（BAL），并从中叶和左下叶支气管进行标准化支气管刷检。在不考虑受试者临床特征的情况下进行定量细胞计数。刷牙的平均总细胞回收率为 1.04 (SEM 0.09) x 10(6) ml，细胞活力为 64% (53%)。从两个肺叶支气管的刷检中获得可重复的总细胞和肥大细胞计数（ICC 0.86）。与非哮喘受试者相比，哮喘受试者的肥大细胞显着升高（1.5 +/- 0.34 vs 0.15 +/- 0.06%）。过敏性哮喘受试者的肥大细胞数量最多（1.86 +/- 0.48%）；然而，非过敏性哮喘受试者刷牙时的数量也有所增加（1.03 +/- 0.45%）。肥大细胞具有粘膜肥大细胞的染色特征，福尔马林可封闭的异染性染色和类胰蛋白酶阳性染色。两个哮喘组的 BAL 嗜酸性粒细胞也升高，非过敏性哮喘受试者的中性粒细胞升高。我们得出的结论是，支气管刷检是对上皮内肥大细胞进行采样的有用技术，并且哮喘患者气道上皮内肥大细胞的积累与过敏无关。支气管上皮内的微环境可能有利于肥大细胞积累和特定肥大细胞表型的获得，这反过来可能导致哮喘中持续的气道炎症和高反应性。
Mast cell mediators are known to contribute to the pathogenesis of asthma. There is some disagreement concerning the numbers of mast cells in asthmatic mucosa. In this study a standardized bronchial brush technique was developed and used to assess intraepithelial mast cells and other inflammatory cells in allergic and nonallergic asthmatic and nonasthmatic subjects. A total of 10 nonasthmatic (5 allergic) and 13 asthmatic (8 allergic) subjects with stable controlled asthma treated with beta-agonist only were assessed by history, spirometry, allergy prick tests, and methacholine airway responsiveness. During fiberoptic bronchoscopy, bronchoalveolar lavage (BAL) was performed from the middle lobe and standardized bronchial brushings were taken from the lingula and left lower lobe bronchi. Quantitative cell counts were performed blind to the clinical characteristics of the subjects. The average total cell recovery from the brushings was 1.04 (SEM 0.09) x 10(6) ml, with a cell viability of 64% (53%). Reproducible total cell and mast cell counts were obtained from brushings taken from two lobar bronchi (ICC 0.86). Mast cells were significantly elevated in asthmatic compared with nonasthmatic subjects (1.5 +/- 0.34 versus 0.15 +/- 0.06%). Allergic asthmatic subjects had the greatest numbers of mast cells (1.86 +/- 0.48%); however, the numbers present in brushings from nonallergic asthmatic subjects were also increased (1.03 +/- 0.45%). The mast cells had the staining characteristics of mucosal mast cells, with formalin-blockable metachromatic staining and positive staining for tryptase. Both asthmatic groups also had elevated BAL eosinophils, and neutrophils were elevated in nonallergic asthmatic subjects. We conclude that bronchial brushings are a useful technique for sampling intraepithelial mast cells and that there is an accumulation of mast cells within the airway epithelium in asthma that is independent of allergy. The microenvironment within the bronchial epithelium may favor mast cell accumulation and the acquisition of a particular mast cell phenotype, which in turn may contribute to persisting airway inflammation and hyperresponsiveness in asthma.