Different airway responsiveness profiles in atopic asthma, nonatopic asthma, and Sjogren's syndrome
Different airway responsiveness profiles in atopic asthma, nonatopic asthma, and Sjogren's syndrome
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DOI：
10.1034/j.1398-9995.2000.00252.x
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发表时间：
2000-03-01
期刊：
影响因子：
12.4
通讯作者：
Valtysdóttir, S
中科院分区：
文献类型：
--
作者：
Lúdvíksdottir, D;Janson, C;Valtysdóttir, S
背景：不同疾病的支气管高反应性（BHR）可能存在不同的机制。本研究的目的是调查三种不同的挑战试验，乙酰甲胆碱，直接simulus，和两个间接刺激，腺苷5'-磷酸（AMP）和冷空气，在受试者与哮喘和干燥综合征patients with Sjogren's syndrome. Methods：研究人群包括40例成人哮喘患者，18例干燥综合征，和20名对照。每次激发前采集血样，测定血清嗜酸性粒细胞过氧化物酶（S-EPO）和嗜酸性粒细胞阳离子蛋白（S-ECP）。结果：哮喘特应性患者对AMP的反应性明显高于哮喘非特应性患者（P = 0.01）和干燥综合征患者（P = 0.02）。在乙酰甲胆碱或冷空气激发的情况下，特应性和非特应性哮喘受试者之间没有差异。在特应性哮喘受试者中，乙酰甲胆碱和AMP激发（r = 0.91，P = 0.0001）和乙酰甲胆碱和冷空气激发（r = 0.83，P = 0.004）之间存在显著相关性，但在非特应性哮喘受试者中，乙酰甲胆碱和AMP或冷空气激发之间未见显著相关性。在特应性哮喘患者中，AMP的剂量反应斜率与S-EPO相关（r =-0.56; P = 0.01）与S-ECP（r =-0.51，P =0.02），而在其他两组患者中未发现BHR与炎症标志物之间的相关性。本研究的结果表明，哮喘患者和干燥综合征患者对不同的激发剂表现出不同的支气管反应性。过敏性哮喘患者比非过敏性哮喘患者和干燥综合征患者对AMP的反应性更高。可能需要不止一次激发来检测支气管反应性的不同方面。
Background: Different mechanisms may underlie bronchial hyperresponsiveness (BHR) in different diseases. The aim of this study was to investigate the bronchial responsiveness profile produced by three different challenge tests, methacholine, a direct simulus, and two indirect stimuli, adenosine 5'-monophosphate (AMP) and cold air, in subjects with asthma and patients with Sjogren's syndrome.Methods: The study population comprised 40 adult patients with asthma, 18 subjects with Sjogren's syndrome, and 20 controls. Blood samples were collected before each challenge for measurements of serum eosinophil peroxidase (S-EPO) and eosinophil cationic protein (S-ECP). The investigated subjects recorded peak expiratory how and kept a symptom diary.Results: Atopic subjects with asthma were significantly more hyperresponsive to AMP than nonatopic subjects with asthma (P = 0.01) and subjects with Sjogren's syndrome (P = 0.02). No difference was seen between atopic and nonatopic subjects with asthma in the case of challenges with methacholine or cold air. In atopic subjects with asthma, a significant correlation was found between challenges with methacholine and AMP (r = 0.91, P = 0.0001) and methacholine and cold air (r = 0.83, P = 0.004), but, in nonatopic subjects with asthma, no significant correlation was seen between methacholine and AMP or cold air challenges. In atopic subjects with asthma, the dose-response slope for AMP was correlated to S-EPO (r = - 0.56; P = 0.01) and S-ECP (r = - 0.51, P = 0.02), while no correlation between BHR and inflammation markers was found in the two other patient groups.Conclusions: The results of this study suggest that patients with asthma and subjects with Sjogren's syndrome display different bronchial responsiveness profiles for different challenge agents. Atopic subjects with asthma are more hyperresponsive to AMP than nonatopic subjects and patients with Sjogren's syndrome. More than one challenge may be required to detect different aspects of bronchial responsiveness.