Sun Y, Luo W, Zhu Y
Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Jie He He Hu Xi Za Zhi. 1997 Feb;20(1):12-5.
To investigate the pathogenesis and treatment of steroid-resistant (SR) asthma.
Changes of serum levels of soluble interleukin-2 receptor (sIL-2R) after oral prednisone (20 mg/d) therapy were observed, and the peripheral blood T cell inhibitory effects of dexamethasone, oxymatrine and thymus-derived immunoinhibiting agents were studied in vitro by lymphocyte proliferation assay.
After prednisone therapy, serum levels of sIL-2R were significantly decreased in steroid-sensitive (SS) asthmatics (P < 0.001) but not in SR asthmatics (P > 0.5). The inhibitory effects of dexamethasone (10(-7) mol/L) on the proliferation of T cells from SR asthmatics were significantly less than those from SS asthmatics (P < 0.002). Oxymatrine and thymus-derived immuno-inhibiting agents inhibited T cell proliferation to a similar degree between SR and SS asthmatics.
Persistent T cell activation due to relative unresponsiveness of T cells to glucocorticoids was a feature of SR asthma. The therapeutic benefit of immuno-inhibiting agents other than glucocorticoids in the management of SR asthma deserves further investigation.
探讨激素抵抗型（SR）哮喘的发病机制及治疗方法。
观察口服泼尼松（20mg/d）治疗后血清可溶性白细胞介素-2受体（sIL-2R）水平的变化，并通过淋巴细胞增殖试验体外研究地塞米松、苦参碱及胸腺免疫抑制剂对外周血T细胞的抑制作用。
泼尼松治疗后，激素敏感型（SS）哮喘患者血清sIL-2R水平显著降低（P<0.001），而SR哮喘患者血清sIL-2R水平无明显变化（P>0.5）。地塞米松（10⁻⁷mol/L）对SR哮喘患者T细胞增殖的抑制作用明显低于SS哮喘患者（P<0.002）。苦参碱及胸腺免疫抑制剂对SR哮喘患者和SS哮喘患者T细胞增殖的抑制程度相似。
T细胞对糖皮质激素相对不敏感导致的持续性T细胞活化是SR哮喘的一个特征。糖皮质激素以外的免疫抑制剂在SR哮喘治疗中的益处值得进一步研究。
