Beeh K M, Kornmann O, Lill J, Buhl R
Pulmonary Department, Internal Medicine, University Hospital, 55131 Mainz, Germany.
Thorax. 2001 Jul;56(7):557-60. doi: 10.1136/thorax.56.7.557.
Sputum induction is a non-invasive procedure for measuring inflammatory processes of the lower respiratory tract. The aim of this study was to establish sputum cell counts and differentials in patients after lung transplantation (LTx), with or without chronic transplant rejection.
Sputum induction was performed in 41 LTx patients (25 single LTx (sLTx), 16 double LTx (dLTx) and 15 healthy non-smoking volunteers. Sputum was processed according to standard protocols. Total cell count was calculated as mean (SE) cells x 10(6)/ml sputum and cell differential (%) was evaluated after staining. Cellular profiles were correlated with lung function.
Total sputum cell counts were increased in sLTx (9 (1.9) cells x 10(6)/ml, p=0.01) and dLTx patients (7.2 (1.5) x 10(6)/ml, p=0.01) compared with healthy controls (2.6 (0.6) x 10(6)/ml). There was also a marked sputum neutrophilia in both patient groups (59 (6)% and 62 (6)%, respectively, p<0.001 v controls). Moreover, in both sLTx and dLTx patients with chronic transplant rejection there was an increased number of sputum neutrophils compared with patients with normal graft function (p<0.05 both comparisons), and neutrophils were inversely correlated with lung function (forced expiratory volume in one second (FEV(1)) % predicted): sLTx, r=-0.61, p=0.001; dLTx, r=-0.75, p=0.001, respectively). Sputum lymphocytes and eosinophils were similar in both groups. No relevant side effects occurred during sputum induction.
Sputum induction is a safe and non-invasive tool for monitoring lower respiratory tract inflammation in LTx patients. Both sLTx and dLTx patients with chronic rejection had increased sputum neutrophils compared with patients with normal transplant function. These data support findings of other authors highlighting a possible role for neutrophils in the pathogenesis of chronic transplant rejection.
痰液诱导是一种用于测量下呼吸道炎症过程的非侵入性检查。本研究的目的是确定肺移植（LTx）术后患者（无论有无慢性移植排斥反应）的痰液细胞计数及分类情况。
对41例肺移植患者（25例单肺移植（sLTx）、16例双肺移植（dLTx））和15名健康非吸烟志愿者进行痰液诱导。痰液按标准方案处理。计算总细胞计数为平均（标准误）细胞数×10⁶/ml痰液，并在染色后评估细胞分类（%）。细胞谱与肺功能相关。
与健康对照组（2.6（0.6）×10⁶/ml）相比，单肺移植患者（9（1.9）×10⁶/ml，p = 0.01）和双肺移植患者（7.2（1.5）×10⁶/ml，p = 0.01）的痰液总细胞计数增加。两组患者痰液中中性粒细胞也显著增多（分别为59（6）%和62（6）%，与对照组相比p<0.001）。此外，与移植功能正常的患者相比，单肺移植和双肺移植合并慢性移植排斥反应的患者痰液中性粒细胞数量均增加（两组比较p<0.05），且中性粒细胞与肺功能（一秒用力呼气量（FEV₁）占预计值百分比）呈负相关：单肺移植，r = -0.61，p = 0.001；双肺移植，r = -0.75，p = 0.001。两组痰液淋巴细胞和嗜酸性粒细胞相似。痰液诱导过程中未出现相关副作用。
痰液诱导是监测肺移植患者下呼吸道炎症的一种安全、非侵入性工具。与移植功能正常的患者相比，合并慢性排斥反应的单肺移植和双肺移植患者痰液中性粒细胞均增多。这些数据支持了其他作者的研究结果，突出了中性粒细胞在慢性移植排斥反应发病机制中的可能作用。
