Loukides Stelios, Bouros Demosthenes, Papatheodorou Georgios, Panagou Panos, Siafakas Nikolaos M
Department of Pneumonology and Clinical Research Unit, Athens Army General Hospital, Athens, Greece.
Chest. 2002 Feb;121(2):338-46. doi: 10.1378/chest.121.2.338.
To investigate which cells are the main source of hydrogen peroxide (H(2)O(2)) production in stable patients with asthma and the associations among H(2)O(2) levels, airway inflammation, and disease severity.
Inpatient respiratory unit and outpatient clinic in tertiary-care hospital.
Fifty stable asthmatic patients with disease severity ranging from mild to moderate.
H(2)O(2) was measured in expired breath condensate and was correlated with variables expressing both asthma severity (ie, FEV(1) percent predicted, peak expiratory flow rate [PEFR] variability, symptom score, and histamine airways responsiveness) and airway inflammation (ie, differential cell counts from induced sputum and levels of eosinophil cationic protein [ECP]).
The mean (95% confidence interval [CI]) concentration of H(2)O(2) was significantly elevated in patients with asthma compared to that in control subjects (mean, 0.67 microM [95% CI, 0.56 to 0.77 microM] vs 0.2 microM [95% CI, 0.16 to 0.24 microM]; p < 0.0001). The difference was primarily due to the elevation of H(2)O(2) in patients with moderate asthma whose expired breath H(2)O(2) level of 0.95 microM (95% CI, 0.76 to 1.12 microM) was significantly higher from that of patients with mild-persistent and mild-intermittent asthma (mean, 0.59 microM [95% CI, 0.47 to 0.7 microM] and 0.27 [95% CI, 0.23 to 0.32 microM], respectively; p < 0.0001). H(2)O(2) concentration was positively related to sputum eosinophilia as well as to ECP concentration. A similar correlation was found between H(2)O(2) and neutrophils in patients with moderate asthma. A positive correlation was observed between H(2)O(2) level, symptom score, and PEFR variability. H(2)O(2) level was negatively related to FEV(1) percent predicted. Further analysis showed that only patients with moderate asthma who were not receiving inhaled steroids were found to have a strong relationship with the variables tested.
Eosinophils are the predominate cells that generate H(2)O(2) in all forms of the disease, while neutrophils might be responsible for the highest levels that are observed in the more severe forms of the disease. The role of H(2)O(2) concentration in predicting the severity of the disease as well as in the inflammatory process is limited and depends on the use of inhaled steroid therapy and the classification of the severity of the disease.
调查哮喘稳定期患者中过氧化氢（H₂O₂）产生的主要细胞来源，以及H₂O₂水平、气道炎症和疾病严重程度之间的关联。
三级医疗医院的住院呼吸科和门诊。
50例病情严重程度从轻度到中度的稳定期哮喘患者。
测量呼出气冷凝物中的H₂O₂，并将其与表示哮喘严重程度的变量（即预测的第一秒用力呼气容积百分比[FEV₁]、呼气峰值流速[PEFR]变异性、症状评分和组胺气道反应性）以及气道炎症变量（即诱导痰中的细胞分类计数和嗜酸性粒细胞阳离子蛋白[ECP]水平）进行关联分析。
与对照组相比，哮喘患者中H₂O₂的平均（95%置信区间[CI]）浓度显著升高（平均，0.67微摩尔/升[95%CI，0.56至0.77微摩尔/升]对0.2微摩尔/升[95%CI，0.16至0.24微摩尔/升]；p<0.0001）。这种差异主要是由于中度哮喘患者中H₂O₂升高，其呼出气H₂O₂水平为0.95微摩尔/升（95%CI，0.76至1.12微摩尔/升），显著高于轻度持续性和轻度间歇性哮喘患者（平均，0.59微摩尔/升[95%CI，0.47至0.7微摩尔/升]和0.27微摩尔/升[95%CI，0.23至0.32微摩尔/升]，分别；p<0.0001）。H₂O₂浓度与痰嗜酸性粒细胞增多以及ECP浓度呈正相关。在中度哮喘患者中，H₂O₂与中性粒细胞之间也发现了类似的相关性。H₂O₂水平与症状评分和PEFR变异性之间呈正相关。H₂O₂水平与预测的FEV₁百分比呈负相关。进一步分析表明，仅未接受吸入性类固醇治疗的中度哮喘患者与所测试的变量有密切关系。
嗜酸性粒细胞是所有疾病形式中产生H₂O₂的主要细胞，而中性粒细胞可能是在更严重疾病形式中观察到的最高水平的原因。H₂O₂浓度在预测疾病严重程度以及炎症过程中的作用有限，并且取决于吸入性类固醇治疗的使用和疾病严重程度的分类。
