Induced sputum inflammatory mediator concentrations in eosinophilic bronchitis and asthma
Induced sputum inflammatory mediator concentrations in eosinophilic bronchitis and asthma
复制标题
DOI：
10.1164/ajrccm.162.3.9909064
复制
发表时间：
2000-09-01
影响因子：
24.7
通讯作者：
Pavord, ID
中科院分区：
文献类型：
--
作者：
Brichtling, CE;Ward, R;Pavord, ID
嗜酸性粒细胞性支气管炎是慢性咳嗽的常见原因，其与哮喘一样以痰嗜酸性粒细胞增多为特征，但与哮喘相反，没有可变的气流阻塞或气道高反应性。我们的假设是气道病理生理学的差异可能是由于嗜酸粒细胞性支气管炎的气道炎症活动较少，重要效应介质的释放减少。我们测定了8例嗜酸性支气管炎患者、17例与痰嗜酸性粒细胞计数匹配的哮喘患者和10例正常人诱导痰无细胞上清液中各种促炎介质的浓度。半胱氨酰-白三烯（cys-LT）采用酶免疫法测定，嗜酸性阳离子蛋白（ECP）采用荧光免疫法测定，前列腺素（PGE（2）、PGD（2）、TXB 2和PGF（2 α））采用气相色谱-负离子化学电离-质谱法测定，组胺采用放射酶法测定。哮喘（13.4%）和嗜酸性支气管炎（12.5%）的痰嗜酸性粒细胞计数几何平均值相似。嗜酸性支气管炎患者的痰液cys-LT和ECP平均值（95% CI）分别为对照组的1.6倍（1.1，2.5）和6.4倍（1.4，28），哮喘患者分别为对照组的1.9倍（1.3，2.9）和7.7倍（1.2，46）（几何平均值分别为5.9和95 ng/ml）。在嗜酸性支气管炎中，痰PGD（2）的平均浓度（0.79 ng/ml）和组胺（968 ng/ml）显著高于哮喘（PGD（2）浓度的平均绝对差异，0.47 ng/ml [95%CI，0.19至0.74]和组胺浓度的平均倍数差异，6.7 [95% CI 1.7 - 26]）和正常受试者（0.64 ng/ml [0.36 - 0.90]和11倍[3.3 - 36]）。总之，嗜酸粒细胞性支气管炎与气道活动性炎症相关，气道活动性炎症伴随血管活性和支气管收缩介质释放增加。
Eosinophilic bronchitis is a common cause of chronic cough, which like asthma is characterized by sputum eosinophilia, but in contrast to asthma there is no variable airflow obstruction or airway hyperresponsiveness. Our hypothesis was that the differences in airway pathophysiology maybe due to less active airway inflammation in eosinophilic bronchitis, with reduced release of important effector mediators. We measured the concentration of various proinflammatory mediators in induced sputum cell-free supernatant in eight patients with eosinophilic bronchitis, 17 patients with asthma matched for sputum eosinophil count, and 10 normal subjects. Cysteinyl-leukotrienes (cys-LT) were measured by enzyme immunoassay, eosinophilic cationic protein (ECP) by fluoroimmunoassay, prostanoids (PGE(2), PGD(2), TXB2, and PGF(2 alpha)) by gas chromatography-negative ion chemical ionization-mass spectroscopy, and histamine by radioenzymic assay. The geometric mean sputum eosinophil count was similar in asthma (13.4%) and eosinophilic bronchitis (12.5%). Sputum cys-LT and ECP were a mean (95% CI) 1.6-fold (1.1, 2.5) and 6.4-fold (1.4, 28) higher in eosinophilic bronchitis and 1.9-fold (1.3, 2.9) and 7.7-fold (1.2, 46) higher in asthma compared with that in control subjects (geometric mean, 5.9 and 95 ng/ml, respectively). In eosinophilic bronchitis the mean concentration of sputum PGD(2) (0.79 ng/ml) and histamine (968 ng/ml) were significantly higher than in asthma (mean absolute difference in PGD(2) concentration, 0.47 ng/ml [95% CI, 0.19 to 0.74] and mean-fold difference in histamine concentration, 6.7 [95% CI 1.7 to 26]) and normal subjects (0.64 ng/ml [0.36 to 0.90] and 11-fold [3.3 to 36]), respectively. In conclusion, eosinophilic bronchitis is associated with active airway inflammation with increased release of vasoactive and bronchoconstrictor mediators.