Amin K, Lúdvíksdóttir D, Janson C, Nettelbladt O, Björnsson E, Roomans G M, Boman G, Sevéus L, Venge P
Section of Human Anatomy, Department of Medical Cell Biology, University of Uppsala, Sweden.
Am J Respir Crit Care Med. 2000 Dec;162(6):2295-301. doi: 10.1164/ajrccm.162.6.9912001.
The aim of the present study was to compare the cellular pattern and structural changes in the airway walls of atopic and nonatopic patients with asthma. Bronchial biopsy specimens were obtained from 13 atopic subjects with asthma, nine nonatopic patients with asthma, and seven healthy control subjects and investigated using immunohistochemical methods. The number of eosinophils increased in both asthma groups, but significantly more in the atopic group. The number of mast cells increased similarly in the two asthma groups, whereas the number of neutrophils increased only in the nonatopic asthma group. The number of T-lymphocytes (CD3-, CD4-, CD8-, CD-25-positive cells) was higher in patients with atopic asthma compared with nonatopic asthma. Interleukin-4 (IL-4) and IL-5-positive cells were more frequently found in the atopic asthma group, whereas cells staining for IL-8 were more frequent in the nonatopic group. The degree of epithelial damage was significantly higher in the atopic asthma group compared with the control subjects and the nonatopic asthmatics. The tenascin and laminin layer was significantly thicker in the atopic group compared with the group of nonatopic asthmatics. In the atopic group, there was a significant negative correlation between epithelial integrity (defined as the relative length of intact epithelium) and the eosinophil count and also between the number of CD25-positive cells and epithelial integrity. The number of mast cells correlated positively with the thickness of tenascin- and laminin-positive layers. In conclusion, we provide evidence of different patterns of involvement of inflammatory cells in atopic and nonatopic patients with asthma. There were also structural differences in the bronchial mucous membrane between atopic asthma and nonatopic asthma. This suggests that there are differences in the extent of the immunopathologic response of these clinically distinct forms of asthma.
本研究的目的是比较特应性和非特应性哮喘患者气道壁的细胞模式和结构变化。从13名特应性哮喘患者、9名非特应性哮喘患者和7名健康对照者获取支气管活检标本，并采用免疫组织化学方法进行研究。两个哮喘组的嗜酸性粒细胞数量均增加，但特应性组增加更为显著。两个哮喘组的肥大细胞数量增加相似，而中性粒细胞数量仅在非特应性哮喘组增加。与非特应性哮喘患者相比，特应性哮喘患者的T淋巴细胞（CD3、CD4、CD8、CD25阳性细胞）数量更高。白细胞介素-4（IL-4）和IL-5阳性细胞在特应性哮喘组中更常见，而IL-8染色细胞在非特应性组中更常见。与对照组和非特应性哮喘患者相比，特应性哮喘组的上皮损伤程度显著更高。与非特应性哮喘组相比，特应性组的腱生蛋白和层粘连蛋白层显著更厚。在特应性组中，上皮完整性（定义为完整上皮的相对长度）与嗜酸性粒细胞计数之间以及CD25阳性细胞数量与上皮完整性之间存在显著负相关。肥大细胞数量与腱生蛋白和层粘连蛋白阳性层的厚度呈正相关。总之，我们提供了证据表明特应性和非特应性哮喘患者炎症细胞的参与模式不同。特应性哮喘和非特应性哮喘之间的支气管黏膜也存在结构差异。这表明这些临床不同形式的哮喘在免疫病理反应程度上存在差异。
