Pavord I D, Ward R, Woltmann G, Wardlaw A J, Sheller J R, Dworski R
Department of Respiratory Medicine and Thoracic Surgery, Glenfield Hospital, Leicester, United Kingdom.
Am J Respir Crit Care Med. 1999 Dec;160(6):1905-9. doi: 10.1164/ajrccm.160.6.9903114.
Further definition of the role of leukotrienes (LT) and prostaglandins (PG) in asthma would be helped by a noninvasive method for assessing airway production. The supernatant from sputum induced with hypertonic saline and dispersed using dithiotrietol has been successfully used to measure other molecular markers of airway inflammation and might be a useful method. We have measured induced sputum supernatant LTC(4)/D(4)/E(4) concentrations using enzyme immunoassay and PGE(2), PGD(2), TXB(2), and PGF(2alpha) using gas chromatography-negative ion chemical ionization-mass spectroscopy in 10 normal subjects and in 26 subjects with asthma of variable severity. Sputum cysteinyl-leukotrienes concentrations were significantly greater in subjects with asthma (median, 9.5 ng/ml) than in normal control subjects (6.4 ng/ml; p < 0.02) and greater in subjects with persistent asthma requiring inhaled corticosteroids (median, 11.4 ng/ml) or studied within 48 h of an acute severe exacerbation of asthma (13 ng/ml) than in subjects with episodic asthma treated with inhaled beta(2)-agonists only (7.2 ng/ml). There were no significant differences in the concentrations of other eicosanoids between groups, although there was a negative correlation between the percentage sputum eosinophil count and sputum PGE(2) concentration (r = -0.48; p < 0.01) in subjects with asthma. We conclude that induced sputum contains high concentrations of eicosanoids and that sputum LTC(4)/D(4)/E(4) concentrations are significantly greater in subjects with asthma than in normal subjects. The inverse relationship between eosinophilic airway inflammation and sputum PGE(2) concentration would be consistent, with the latter having an anti-inflammatory role.
一种用于评估气道生成的非侵入性方法将有助于进一步明确白三烯（LT）和前列腺素（PG）在哮喘中的作用。用高渗盐水诱导并使用二硫苏糖醇分散后的痰液上清液已成功用于测量气道炎症的其他分子标志物，可能是一种有用的方法。我们使用酶免疫测定法测量了诱导痰液上清液中LTC(4)/D(4)/E(4)的浓度，并使用气相色谱 - 负离子化学电离 - 质谱法测量了PGE(2)、PGD(2)、TXB(2)和PGF(2α)的浓度，研究对象包括10名正常受试者和26名病情严重程度各异的哮喘患者。哮喘患者痰液中半胱氨酰白三烯的浓度（中位数为9.5 ng/ml）显著高于正常对照受试者（6.4 ng/ml；p < 0.02），且需要吸入糖皮质激素治疗的持续性哮喘患者（中位数为11.4 ng/ml）或在哮喘急性重度加重发作后48小时内进行研究的患者（13 ng/ml）的痰液中半胱氨酰白三烯浓度高于仅使用吸入β(2) - 激动剂治疗的发作性哮喘患者（7.2 ng/ml）。尽管哮喘患者痰液嗜酸性粒细胞计数百分比与痰液PGE(2)浓度之间存在负相关（r = -0.48；p < 0.01），但两组之间其他类花生酸的浓度没有显著差异。我们得出结论，诱导痰液中含有高浓度的类花生酸，且哮喘患者痰液中LTC(4)/D(4)/E(4)的浓度显著高于正常受试者。嗜酸性气道炎症与痰液PGE(2)浓度之间的负相关关系是一致的，后者具有抗炎作用。
