Hypersegmented airway neutrophils and its association with reduced lung function in adults with obstructive airway disease: an exploratory study
Hypersegmented airway neutrophils and its association with reduced lung function in adults with obstructive airway disease: an exploratory study
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DOI：
10.1136/bmjopen-2018-024330
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Simpson, Jodie L.
中科院分区：
文献类型：
--
作者：
Lokwani, Ravi;Wark, Peter A. B.;Simpson, Jodie L.
目的 中性粒细胞炎症在阻塞性气道疾病中的意义仍存在争议。最近的研究表明，体循环中存在活跃的中性粒细胞群，其特征是超分叶形态，在炎症条件下具有高氧化爆发和功能可塑性。本研究的目的是根据核形态来表征阻塞性气道疾病参与者（哮喘、慢性阻塞性肺疾病（COPD）和支气管扩张）和健康对照的支气管灌洗（BL）中的中性粒细胞亚群，并评估中性粒细胞亚群与阻塞性气道疾病参与者的临床参数之间的关联。设计一项横断面探索性研究。设置于澳大利亚约翰亨特医院和亨特医学研究所。 78 名患有阻塞性气道疾病的成人，包括患有稳定哮喘 (n=39)、COPD (n=20) 和支气管扩张 (n=19) 的患者以及 20 名健康对照者。 材料和方法 制备细胞离心涂片器，并根据核形态将中性粒细胞亚群分类为超分叶（> 4 叶）、正常（2-4 叶）和带状（1 叶）中性粒细胞和枚举。结果在所有参与者中均鉴定出了每个子集的中性粒细胞。与健康对照相比，患有气道疾病的参与者的过度分叶中性粒细胞数量升高（p<0.001）。 COPD 参与者中超分叶中性粒细胞的数量和比例最高（中位值 (Q1-Q3) 分别为 1073.6 (258.8-2742) x 102/mL 和 24.5 (14.0-46.5)%）。气道疾病参与者中过度分叶的中性粒细胞比例增加与 1 秒用力呼气量/用力肺活量百分比较低显着相关（Spearman's r=-0.322，p=0.004）。结论 中性粒细胞异质性在 BL 中很常见，并且与成人气道疾病患者更严重的气流阻塞相关。需要进一步的工作来阐明多分叶中性粒细胞在疾病发病机制中的功能后果。
Objectives The significance of neutrophilic inflammation in obstructive airway disease remains controversial. Recent studies have demonstrated presence of an active neutrophil population in systemic circulation, featuring hypersegmented morphology, with high oxidative burst and functional plasticity in inflammatory conditions. The aim of this study was to characterise neutrophil subsets in bronchial lavage (BL) of obstructive airway disease participants (asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis) and healthy controls on the basis of nuclear morphology and to assess the association between neutrophil subsets and the clinical parameters of the obstructive airway disease participants.Design A cross-sectional exploratory study.Setting John Hunter Hospital and Hunter Medical Research Institute, Australia.Participants Seventy-eight adults with obstructive airway disease comprised those with stable asthma (n=39), COPD (n=20) and bronchiectasis (n=19) and 20 healthy controls.Materials and methods Cytospins were prepared and neutrophil subsets were classified based on nuclear morphology into hypersegmented (> 4 lobes), normal (2-4 lobes) and banded (1 lobe) neutrophils and enumerated.Results Neutrophils from each subset were identified in all participants. Numbers of hypersegmented neutrophils were elevated in participants with airway disease compared with healthy controls (p< 0.001). Both the number and the proportion of hypersegmented neutrophils were highest in COPD participants (median (Q1-Q3) of 1073.6 (258.8-2742) x 102/mL and 24.5 (14.0-46.5)%, respectively). An increased proportion of hypersegmented neutrophils in airway disease participants was significantly associated with lower forced expiratory volume in 1 s/forced vital capacity per cent (Spearman's r=-0.322, p= 0.004).Conclusion Neutrophil heterogeneity is common in BL and is associated with more severe airflow obstruction in adults with airway disease. Further work is required to elucidate the functional consequences of hypersegmented neutrophils in the pathogenesis of disease.