NUMBER AND ACTIVITY OF INFLAMMATORY CELLS IN BRONCHOALVEOLAR LAVAGE FLUID IN ASTHMA AND THEIR RELATION TO AIRWAY RESPONSIVENESS
NUMBER AND ACTIVITY OF INFLAMMATORY CELLS IN BRONCHOALVEOLAR LAVAGE FLUID IN ASTHMA AND THEIR RELATION TO AIRWAY RESPONSIVENESS
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DOI：
10.1136/thx.43.9.684
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发表时间：
1988-09-01
期刊：
影响因子：
10
通讯作者：
WALTERS, EH
中科院分区：
文献类型：
--
作者：
KELLY, C;WARD, C;WALTERS, EH
对22例哮喘患者（10例吸烟者）和20例对照者（12例吸烟者）在纤维支气管镜检查前4 ~ 6天测定吸入乙酰甲胆碱的支气管反应性。哮喘患者的基线FEV 1大于60%预测值，PD 20 FEV 1（乙酰甲胆碱激发剂量导致FEV 1下降20%）为0.006-3.7 mg。20例对照受试者肺功能正常，PED 20 FEV 1高于乙酰甲胆碱的最大累积剂量6.4 mg。 支气管肺泡灌洗的中叶段（舌在四个科目）进行了三个连续的60毫升等分的无菌生理盐水。用胶乳刺激等份重悬细胞中的细胞代谢活性，并通过鲁米诺增强的化学发光来评估嗜中性粒细胞活性和光泽精增强的化学发光来评估巨噬细胞活性。哮喘组和对照组的平均绝对总细胞计数相似，但细胞分类计数存在差异，哮喘组嗜酸性粒细胞（p < 0.05）和淋巴细胞（p < 0.05）计数显著增加。PD 20 FEV 1与中性粒细胞计数呈负相关（p < 0.005）。鲁米诺增强的化学发光/1000中性粒细胞在哮喘患者中增加约2倍（p < 0.001），但与PD 20 FEV 1无关。光泽精增强的化学发光/1000巨噬细胞在哮喘患者中增加近4倍（p < 0.001），并与PD 20 FEV 1呈负相关（p < 0.01）。在两组中，目前吸烟者的巨噬细胞计数增加了两倍，但其他细胞数量没有显着改变。吸烟对两组的细胞代谢活动都没有影响。这项研究支持了哮喘患者气道中存在炎症过程的观点，并提示支气管反应性与中性粒细胞数量和巨噬细胞活性之间存在关系。
Bronchial responsiveness of inhaled methacholine was measured four to six days before fibreoptic bronchoscopy in 22 asthmatic patients (10 smokers) and 20 control subjects (12 smokers). The asthmatic patients had a baseline FEV1 greater than 60% predicted and a PD20FEV1 (provocative dose of methacholine causing a 20% fall in FEV1) of 0.006-3.7 mg. The 20 control subjects had normal pulmonary function and a PED20FEV1 above the maximum cumulative dose of methacholine of 6.4 mg. Bronchoalveolar lavage of a middle lobe segment (lingula in four subjects) was performed with three sequential 60 ml aliquots of sterile saline. Cellular metabolic activity was stimulated with latex in aliquots of resuspended cells, and measured by means of luminol enhanced chemiluminescence to assess neutrophil activity and lucigenin enhanced chemiluminescence to assess macrophage activity. Mean absolute total cell counts were similar in the asthmatic and control groups but there were differences in differential cell counts, with a significant increase in eosinophil (p < 0.05) and lymphocyte (p < 0.05) counts in asthma. PD20FEV1 was negatively correlated with percentaged neutrophil counts (p < 0.005). Luminol enhacned chemiluminescence/1000 neutrophils was increased about twofold in asthmatic subjects (p < 0.001), but was not correlated with PD20FEV1. Lucigenin enhanced chemiluminescence/1000 macrophages was increased nearly fourfold in asthmatic patients (p < 0.001) and showed a negative correlation with PD20FEV1 (p < 0.01). The macrophage count was increased twofold in current smokers in both groups, but other cell numbers were not altered significantly. Smoking did not affect cellular metabolic activity in either group. This study supports the idea that an inflammatory process is present in the airways of those with asthma, and suggests a relation between bronchial responsivess and both neutrophil numbers and macrophage activity.