Bronchoalveolar cells in children < 3 years old with severe recurrent wheezing
Bronchoalveolar cells in children < 3 years old with severe recurrent wheezing
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DOI：
10.1378/chest.122.3.791
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发表时间：
2002-09-01
期刊：
影响因子：
9.6
通讯作者：
de Blic, J
中科院分区：
文献类型：
--
作者：
Le Bourgeois, M;Goncalves, M;de Blic, J
研究目的：确定患有严重复发性喘息的婴儿的 BAL 细胞谱，这些婴儿在调查时并未患有急性疾病，表明存在持续的炎症。设计和患者：在一项回顾性研究中，我们确定了 83 名 4 至 32 个月的喘息儿童的 BAL 细胞谱（平均值 +/- SD，11.3 +/- 5.5 个月）。对吸入类固醇无反应的严重复发性喘息性支气管炎儿童进行了纤维支气管镜检查。这些儿童与 17 名患有各种非喘息性肺部疾病的 6 至 36 个月（平均 15.1 +/- 7.5 个月）儿童进行了比较。如果儿童没有支气管内炎症且没有特应性，则将其作为对照受试者。 结果：喘息幼儿的 BAL 细胞谱通常包括显着较高的细胞计数（平均值为 644.4 +/- 956.8 x 10(3)/mL 对比 313 +/- 203.2 x 10(3)/mL，p = 0.008）、显着较高的中性粒细胞百分比（平均值为 9与对照受试者相比，+/- 12.1% vs 2.1 +/- 2.2%，p = 0.003），中性粒细胞计数较高（平均值为 43.2 +/- 81.6 x 10(3)/mL vs 7.9 +/- 11.8 x 10(3)/mL，p = 0.003）。喘息儿童中性粒细胞数量较多与细菌或病毒感染、年龄、性别或特应性状态无关。与哮喘成人的情况相反，喘息儿童的嗜酸性粒细胞水平并不高于对照组（平均值为 0.09 +/- 0.27% vs 0.08 +/- 0.25%）。结论：中性粒细胞介导的气道炎症似乎更能表征 < 3 岁儿童的严重复发性喘息。
Study objective: To determine the cell profile of BAL from infants with severe recurrent wheezing who were not acutely ill at the time of investigation, suggesting an ongoing inflammation.Design and patients: In a retrospective study, we determined BAL cell profiles for 83 children with wheezing aged 4 to 32 months (mean +/- SD, 11.3 +/- 5.5 months). Fiberoptic bronchoscopy was performed in children with severe recurrent wheezy bronchitis unresponsive to inhaled steroids. These children were compared with 17 children aged 6 to 36 months (mean, 15.1 +/- 7.5 months) with various nonwheezing pulmonary diseases. Children were included as control subjects if they had no endobronchial inflammation and no atopy.Results: The BAL cell profile of young children with wheezing typically includes a significantly higher cell count (mean, 644.4 +/- 956.8 x 10(3)/mL vs 313 +/- 203.2 x 10(3)/mL, p = 0.008), a significantly higher percentage of neutrophils (mean, 9 +/- 12.1% vs 2.1 +/- 2.2%, p = 0.003), and a higher neutrophil count (mean, 43.2 +/- 81.6 x 10(3)/mL vs 7.9 +/- 11.8 x 10(3)/mL, p = 0.003), as compared with control subjects. The larger number of neutrophils in children with wheezing was not correlated with bacterial or viral infection, or with age, sex, or atopic status. In contrast to the situation in asthmatic adults, eosinophil levels were not higher in children with wheezing than in control subjects (mean, 0.09 +/- 0.27% vs 0.08 +/- 0.25%).Conclusion: Neutrophil-mediated inflammation in the airways appears to better characterize severe recurrent wheezing in children < 3 years old.