Crooks S W, Bayley D L, Hill S L, Stockley R A
Dept of Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Eur Respir J. 2000 Feb;15(2):274-80. doi: 10.1034/j.1399-3003.2000.15b09.x.
Neutrophils recruited to the airways in chronic obstructive pulmonary disease (COPD) are thought to mediate tissue destruction. Neutrophil recruitment is increased during bacterial exacerbations. The inflammatory process was studied in patients with an acute exacerbation of COPD in order to ascertain the role of leukotriene B4 (LTB4). The sputum of eight subjects with a bacterial exacerbation of COPD was analysed for neutrophil products (myeloperoxidase, elastase) and chemoattractants (interleukin-8 (IL-8) and LTB4). The contribution of LTB4 to the chemotactic activity of the sputum sol phase was determined using the LTB4 receptor antagonist LY293111. The concentrations of the serum acute phase proteins alpha1-proteinase inhibitor, alpha1-antichymotrypsin and C-reactive protein were measured. All patients received appropriate broad-spectrum antibiotic treatment for 7-14 days. Initially, the sputum myeloperoxidase activity was high, indicating neutrophil influx; this was associated with high levels of IL-8 and LTB4. All these concentrations fell with treatment (p<0.01). The chemotactic activity of the sputum was raised on presentation and fell with treatment (p<0.01). LTB4 contributed approximately 30% of the total chemotactic activity on presentation; this diminished with therapy. All acute phase proteins were raised on presentation and fell with therapy (p<0.01). These findings suggest that leukotriene B4 contributes to neutrophil influx into the airway in chronic obstructive pulmonary disease and may influence disease progression.
在慢性阻塞性肺疾病（COPD）中，募集到气道的中性粒细胞被认为会介导组织破坏。在细菌感染加重期间，中性粒细胞的募集会增加。为了确定白三烯B4（LTB4）的作用，对COPD急性加重患者的炎症过程进行了研究。分析了8例COPD细菌感染加重患者痰液中的中性粒细胞产物（髓过氧化物酶、弹性蛋白酶）和趋化因子（白细胞介素-8（IL-8）和LTB4）。使用LTB4受体拮抗剂LY293111确定LTB4对痰液溶解相趋化活性的贡献。测定了血清急性期蛋白α1-蛋白酶抑制剂、α1-抗糜蛋白酶和C反应蛋白的浓度。所有患者均接受了7-14天的适当广谱抗生素治疗。最初，痰液髓过氧化物酶活性较高，表明有中性粒细胞流入；这与高水平的IL-8和LTB4有关。所有这些浓度在治疗后均下降（p<0.01）。痰液的趋化活性在就诊时升高，治疗后下降（p<0.01）。就诊时，LTB4约占总趋化活性的30%；随着治疗，这一比例降低。所有急性期蛋白在就诊时升高，治疗后下降（p<0.01）。这些发现表明，白三烯B4在慢性阻塞性肺疾病中有助于中性粒细胞流入气道，并可能影响疾病进展。
