轻度哮喘患者诱导痰细胞计数与液相嗜酸性粒细胞阳离子蛋白及临床或生理特征之间的关系

Relationship between induced sputum cell counts and fluid-phase eosinophil cationic protein and clinical or physiologic profiles in mild asthma.

作者信息

Gutiérrez V, Prieto L, Torres V, Trenor R, Pérez C, Bertó J M, Marín J

机构信息

Sección de Alergología, Hospital Dr. Peset, Valencia, Spain.

出版信息

Ann Allergy Asthma Immunol. 1999 Jun;82(6):559-65. doi: 10.1016/S1081-1206(10)63167-5.

DOI:10.1016/S1081-1206(10)63167-5

PMID:10400484

Abstract

BACKGROUND

Sputum analysis is the only non-invasive method to examine airway inflammatory processes in subjects with asthma. The aim of this study was to investigate the relationship between cell counts and fluid phase levels in induced sputum in subjects with mild asthma, and the severity of asthma as assessed by clinical, physiologic and blood measurements.

METHODS

Forty patients with mild asthma, aged 17 to 49 years were studied (good sputum sample only from 31). On the first day, spirometry and methacholine challenges were performed. After 2 to 4 days, venous blood for absolute eosinophil count and eosinophil cationic protein (ECP) measurement was obtained and sputum was induced by inhalation of hypertonic saline. For the next 15 days subjects recorded their peak expiratory flow (PEF), symptom scores, and beta2-agonist requirements twice daily. Differential counts of leukocytes were done on cytospin preparations of homogenized sputum and the supernatant was examined for eosinophil cationic protein (ECP).

RESULTS

Sputum eosinophil counts and not neutrophil, epithelial cells, macrophages, or lymphocytes, were inversely correlated to FEV1/FVC % (r = -.57, P = .0008) and to PC20-methacholine (r = -.40, P = .024). No statistical relationship was obtained between eosinophil counts and either symptom scores, bronchodilator requirements, or daily PEF variability. Sputum ECP values were correlated to FEV1/FVC% (r = -.41, P = .026) but not to PC20 (r = -.32, P = .08) or clinical scores or PEF variation. A trend to significance was appreciated between peripheral blood and sputum eosinophil counts (r = .34, P = .067) and no relationship was found between sputum and serum ECP values (r = .10, P = .38).

CONCLUSIONS

Although sputum markers give some information about disordered lung function and physiologic changes in the airways, they are not the only factors concerned in the clinical expression of mild asthma.

摘要

背景

痰液分析是检查哮喘患者气道炎症过程的唯一非侵入性方法。本研究的目的是调查轻度哮喘患者诱导痰中的细胞计数与液相水平之间的关系，以及通过临床、生理和血液测量评估的哮喘严重程度。

方法

研究了40名年龄在17至49岁之间的轻度哮喘患者（仅31名获得了良好的痰样本）。第一天，进行肺活量测定和乙酰甲胆碱激发试验。2至4天后，采集静脉血用于绝对嗜酸性粒细胞计数和嗜酸性粒细胞阳离子蛋白（ECP）测量，并通过吸入高渗盐水诱导痰液。在接下来的15天里，受试者每天记录两次呼气峰值流速（PEF）、症状评分和β2激动剂需求量。对匀化痰液的细胞涂片制剂进行白细胞分类计数，并检测上清液中的嗜酸性粒细胞阳离子蛋白（ECP）。

结果

痰液嗜酸性粒细胞计数而非中性粒细胞、上皮细胞、巨噬细胞或淋巴细胞计数与FEV1/FVC%呈负相关（r = -0.57，P = 0.0008），与PC20-乙酰甲胆碱呈负相关（r = -0.40，P = 0.024）。嗜酸性粒细胞计数与症状评分、支气管扩张剂需求量或每日PEF变异性之间未获得统计学关系。痰液ECP值与FEV1/FVC%相关（r = -0.41，P = 0.026），但与PC20无关（r = -0.32，P = 0.08），也与临床评分或PEF变化无关。外周血和痰液嗜酸性粒细胞计数之间有显著趋势（r = 0.34，P = 0.067），痰液和血清ECP值之间未发现关系（r = 0.10，P = 0.38）。