Lymphocyte and eosinophil influx into alveolar tissue in nocturnal asthma
Lymphocyte and eosinophil influx into alveolar tissue in nocturnal asthma
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DOI：
10.1164/ajrccm.159.1.9804033
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发表时间：
1999-01-01
影响因子：
24.7
通讯作者：
Holgate, ST
中科院分区：
文献类型：
--
作者：
Kraft, M;Martin, RJ;Holgate, ST
我们在夜间哮喘中发现，与近端气道相比，肺泡组织嗜酸性粒细胞在夜间增加，并且它们与夜间肺功能下降相关。由于 CD4+ 细胞被认为是嗜酸性粒细胞募集的主要协调细胞，因此我们评估了其在夜间哮喘的近端和远端气道中的存在。下午 4:00，11 名夜间哮喘 (NA) 患者和 10 名非夜间哮喘 (NNA) 患者随机接受了两次支气管镜检查，包括近端气道支气管内活检和远端肺泡组织经支气管活检。凌晨 4:00相隔1周。使用免疫组织化学染色和形态分析来测定上皮、固有层和肺泡组织中每mm(2)的CD3+、CD4+和CD8+细胞以及EG2+嗜酸性粒细胞的数量。凌晨 4:00，NA 组肺泡组织中的 CD4+ 细胞数量显着高于 NNA 组（9.8 个细胞/mm(2) [5.6-30.8，四分位数 (IQ)] 与 1.5 个细胞/mm(2) [0-6.3，IQ]，p = 0.04）。在 NA 组中，下午 4:00 和下午 4:00 时，近端气道固有层中的 CD3+、CD4+、CD8+ 和 EG2+ 细胞数量明显多于远端气道。和凌晨 4:00在任一时间点，各组之间的上皮内没有差异。只有肺泡组织（而不是气道组织）的 CD4+ 细胞与凌晨 4:00 预测的 FEV1 百分比呈负相关。 （r = -0.68，p = 0.0018）并且与肺泡组织 EG2+ 细胞的数量呈正相关（r = 0.66，p = 0.01）。这些发现表明，与非夜间哮喘相比，夜间哮喘患者肺泡组织中的 CD4+ 淋巴细胞在夜间增加。
We have shown in nocturnal asthma that alveolar tissue eosinophils are increased at night as compared with the proximal airway, and that they correlate with the overnight decrement in lung function. As the CD4+ cell is thought to be the principal orchestrating cell in eosinophil recruitment, we evaluated its presence in the proximal and distal airways in nocturnal asthma. Eleven patients with nocturnal asthma (NA) and 10 patients with non-nocturnal asthma (NNA) underwent two bronchoscopies with proximal airway endobronchial and distal alveolar tissue transbronchial biopsy in a random order at 4:00 P.M. and at 4:00 A.M. separated by 1 wk. Immunohistochemical staining and morphometric analysis were used to determine the number of CD3+, CD4+, and CD8+ cells and EG2+ eosinophils per mm(2) in the epithelium, lamina propria, and alveolar tissue. At 4:00 A.M., the NA group had a significantly greater number of CD4+ cells in the alveolar tissue than the NNA group (9.8 cells/mm(2) [5.6-30.8, interquartile (IQ)] versus 1.5 cells/mm(2) [0-6.3, IQ], p = 0.04). Within the NA group, there were significantly greater numbers of CD3+, CD4+, CD8+, and EG2+ cells in the proximal airway lamina propria than in the distal airway at both 4:00 P.M. and 4:00 A.M. There were no differences within the epithelium between the groups at either time point. Only alveolar tissue, not airway tissue, CD4+ cells correlated inversely with the percentage predicted FEV1 at 4:00 A.M. (r = -0.68, p = 0.0018) and positively with the number of alveolar tissue EG2+ cells (r = 0.66, p = 0.01). These findings suggest that the CD4+ lymphocyte is increased in the alveolar tissue at night in nocturnal asthma as compared with non-nocturnal asthma.