DOMESTIC ENDOTOXIN EXPOSURE AND CLINICAL SEVERITY OF ASTHMA
DOMESTIC ENDOTOXIN EXPOSURE AND CLINICAL SEVERITY OF ASTHMA
复制标题
DOI：
10.1111/j.1365-2222.1991.tb01684.x
复制
发表时间：
1991-07-01
影响因子：
6.1
通讯作者：
SERGYSELS, R
中科院分区：
文献类型：
--
作者：
MICHEL, O;GINANNI, R;SERGYSELS, R
内毒素是存在于几种自然环境和商业房屋灰尘提取物中的强效促炎物质。为了探讨慢性内毒素暴露对哮喘的可能影响，对28例常年性慢性哮喘患者（20例对屋尘螨过敏，8例内源性哮喘）进行了为期4个月的肺功能、临床和免疫学指标评价。同时，从每位患者家中采集2份屋尘样品，测定屋尘总重量（mg/m2）、内毒素浓度和屋尘螨抗原含量（用HPLC法以鸟嘌呤含量间接评价）。平均值（+/- s.d.）通过定量鲎试验测定的内毒素浓度为2.59（+/-3.41）ng/mg房屋灰尘，范围为0.12 - 20 ng/mg。平均鸟嘌呤含量为0.13（+/- 0.16）mg/100 mg屋尘。内毒素与屋尘螨浓度无相关性。根据粉尘、内毒素和鸟嘌呤的高低程度对患者进行比较。与低级别患者相比，（小于或等于5.6 ng/ml）暴露，受试者暴露于高内毒素浓度（> 5.6 ng/ml）显示呼吸困难显著增加（中位数2.6 vs 3.3; P < 0.05）和治疗（中位数14 vs 44.3; P < 0.01）评分，口服皮质类固醇（中位数0.0对13.5 mg/24 hr; P <0.01）和β-2-模拟物（中位数4对8喷/天; P < 0.01）摄入，并显着降低FEV 1/FVC（中位数84.5对67%的预测值; P < 0.01）。与此相反，暴露于低浓度（<0.07 mg/100 mg屋尘）和高浓度（大于或等于0.07 mg/100 mg屋尘）鸟嘌呤的两组之间没有发现差异。我们的结论是，内毒素是存在于正常的家庭环境中，并可能对慢性哮喘病的有害影响。
Endotoxins are potent pro-inflammatory substances present in several natural environments and in commercial house dust extracts. To investigate the possible effect of chronic endotoxin exposure on asthma, 28 patients with perennial chronic asthma (20 allergic to house dust mite and eight intrinsic asthmatics) were evaluated during a 4-month period (lung function, clinical and immunological criteria). At the same time, two house dust samples were collected from each patient's home to determine total house dust weight (mg/m2), endotoxin concentration and house dust mite antigen content (evaluated indirectly by guanine content with HPLC method). The mean (+/- s.d.) endotoxin concentration, as measured by quantitative Limulus assay was 2.59 (+/- 3.41) ng/mg house dust, ranging from 0.12 to 20 ng/mg. The mean guanine content was 0.13 (+/- 0.16) mg/100 mg house dust. There was no correlation between endotoxin and house dust mite concentrations. Patients were compared according to the low or high grade exposure to dust, endotoxins and guanine. Compared with patients with low grade (less-than-or-equal-to 5.6 ng/ml) exposure, subjects exposed to high endotoxin concentrations (> 5.6 ng/ml) showed a significant increase in dyspnea (median 2.6 vs 3.3; P < 0.05) and treatment (median 14 vs 44.3; P < 0.01) scores, oral corticosteroid (median 0.0 vs 13.5 mg/24 hr; P < 0.0 1) and beta-2-Mimetics (median four vs eight puffs/day; P < 0.01) intake, and a significant decrease in FEV1/FVC (median 84.5 vs 67% of predicted value; P < 0.01). In contrast, no differences were found between the two groups exposed to low (< 0.07mg/100 mg house dust) and high (greater-than-or-equal-to 0.07 mg/100 mg house dust) concentrations of guanine, respectively. We conclude that endotoxins arc present in normal domestic environment and could have a deleterious effect on the chronic asthmatic disease.