Jang A S, Choi I S, Koh Y I, Jeong T K, Lee K Y, Kim Y S, Lee J U, Park C S
Department of Internal Medicine, Seonam University College of Medicine, Namwon, Korea.
J Korean Med Sci. 2000 Oct;15(5):521-8. doi: 10.3346/jkms.2000.15.5.521.
Corticosteroids are considered to be one of the most effective medicine for asthma by suppressing airway inflammation. This study was carried out to investigate the effects of prednisolone in the sputum of exacerbated asthmatics. Clinical severity, cell differentials, levels of interleukin (IL)-5, eosinophil cationic protein (ECP), EG2+ eosinophils, and nitric oxide (NO) metabolites were measured. Sputum was examined 2 weeks apart in 13 exacerbated asthmatics before and after prednisolone treatment, and once in 12 stable asthmatics. We used a sandwich ELISA for IL-5, fluoroimmunoassay for ECP, immunohistochemical staining for EG2+ eosinophils, a NO metabolites assay using modified Griess reaction. Exacerbated asthmatics, in comparison with stable asthmatics, had significantly higher proportion of eosinophils, higher level of ECP, higher percentage of EG2+ eosinophils, and NO metabolites. Exacerbated asthmatics after treatment with prednisolone had reduced the proportions of eosinophils, reduced level of IL-5, ECP and percentage of EG2+ eosinophils. FEV1 was correlated with the proportion of eosinophils, ECP, and IL-5 respectively. These findings suggest that prednisolone is considered to be effective medicine for asthma by suppressing eosinophil activation through IL-5.
通过抑制气道炎症,皮质类固醇被认为是治疗哮喘最有效的药物之一。本研究旨在调查泼尼松龙对哮喘急性加重期患者痰液的影响。测量了临床严重程度、细胞分类、白细胞介素(IL)-5、嗜酸性粒细胞阳离子蛋白(ECP)、EG2 +嗜酸性粒细胞和一氧化氮(NO)代谢产物的水平。在13例哮喘急性加重期患者中,在泼尼松龙治疗前后每隔2周检查一次痰液,在12例病情稳定的哮喘患者中检查一次痰液。我们使用夹心ELISA法检测IL-5,荧光免疫分析法检测ECP,免疫组织化学染色检测EG2 +嗜酸性粒细胞,使用改良的Griess反应检测NO代谢产物。与病情稳定的哮喘患者相比,哮喘急性加重期患者的嗜酸性粒细胞比例显著更高,ECP水平更高,EG2 +嗜酸性粒细胞百分比更高,NO代谢产物水平更高。泼尼松龙治疗后的哮喘急性加重期患者嗜酸性粒细胞比例降低,IL-5、ECP水平降低,EG2 +嗜酸性粒细胞百分比降低。第一秒用力呼气容积(FEV1)分别与嗜酸性粒细胞比例、ECP和IL-5相关。这些发现表明,泼尼松龙被认为是通过IL-5抑制嗜酸性粒细胞活化来治疗哮喘的有效药物。