Bronchoalveolar lavage cytokine profiles in acute asthma and acute bronchiolitis
Bronchoalveolar lavage cytokine profiles in acute asthma and acute bronchiolitis
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DOI：
10.1067/mai.2003.1618
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发表时间：
2003-07-01
影响因子：
14.2
通讯作者：
Koh, YY
中科院分区：
文献类型：
--
作者：
Kim, CK;Kim, SW;Koh, YY
背景资料：急性毛细支气管炎与哮喘的发病机制尚未完全阐明。目的：本研究的目的是比较这两种疾病的气道细胞因子反应（T（H）1或T（H）2）模式。方法：通过使用支气管肺泡灌洗（BAL）技术，本研究调查了急性哮喘儿童（n = 18）的BAL液细胞因子水平，这些儿童没有可识别的呼吸道合胞病毒（RSV）感染。RSV引起的急性毛细支气管炎患儿22例。与正常对照组（n = 14）进行比较。结果：与对照组相比，哮喘组和RSV诱导的毛细支气管炎组的IL-5水平（P <0.001）和IL-5/IFN-γ比值（P <0.001）均显著升高。当毛细支气管炎组的婴儿被分为嗜酸性粒细胞阳性和嗜酸性粒细胞阴性亚组时，与对照组相比，嗜酸性粒细胞阳性亚组的IL-5水平（P <0.001）和IL-5/IFN-γ比值（P <0.01）显著升高，但在嗜酸性粒细胞阴性亚组中未诱导类似的细胞因子反应。哮喘组和对照组BALF中嗜酸性粒细胞百分比与BALF中IL-5水平显著相关（r = 0.80，P = .000）和毛细支气管炎组（r = 0.82，P = .000）。这些发现表明RSV诱导的细支气管炎组的一个亚组导致T（H）2型反应，这可能为解释呼吸道合胞病毒引起的细支气管炎和哮喘之间的联系提供了一个有价值的框架。
Background: The pathogenetic basis for the relationship between acute bronchiolitis and asthma has not yet been completely elucidated.Objective: The aim of this study was to compare these 2 diseases in terms of their patterns of airway cytokine response (T(H)1 or T(H)2).Methods: By using a bronchoalveolar lavage (BAL) technique, this study investigated the cytokine levels of BAL fluid in children with acute asthma who had no identifiable respiratory syncytial virus (RSV) infection (n = 18) and in infants with acute bronchiolitis caused by RSV (n = 22). Comparisons were made with normal control subjects (n = 14). IFN-gamma (T(H)1) and IL-4 and IL-5 (T(H)2) levels were measured in concentrated BAL fluids by means of ELISA.Results: The IL-5 level (P < .001) and IL-5/IFN-gamma ratio (P < .001) were significantly increased in the asthmatic group with no identifiable RSV infection and in the RSV-induced bronchiolitis group compared with values in the control group. When infants in the bronchiolitis group were divided into eosinophil-positive and eosinophil-negative subgroups, the eosinophil-positive subgroup had significantly increased IL-5 levels (P < .001) and IL-5/IFN-gamma ratios (P < .01) compared with those in the control group, but similar cytokine responses were not induced in the eosinophil-negative subgroup. The percentage of BAL eosinophils correlated significantly with levels of BAL IL-5 in both the asthma group (r = 0.80, P = .000) and the bronchiolitis group (r = 0.82, P = .000).Conclusions: These findings suggest that a subgroup of the RSV-induced bronchiolitis group results in a T(H)2-type response, and this could provide a valuable framework to explain the link between RSV-induced bronchiolitis and asthma.