Reichenberger F, Schauer J, Kellner K, Sack U, Stiehl P, Winkler J
Division of Pneumology, Department of Internal Medicine, University Hospital, Johannisalle 32, 04105 Leipzig, Germany.
Lung. 2001;179(3):163-74. doi: 10.1007/s004080000058. Epub 2002 Feb 4.
Endothelin (ET) is a broncho- and vasoconstrictive cytokine, but it also possesses proinflammatory and mitogenic activity. It is suggested to be involved in the pathogenesis of fibrotic lung diseases. We analyzed the concentration of ET 1 in the bronchoalveolar lavage (BAL) fluid in 95 patients with different lung diseases, among them 41 patients with interstitial lung diseases (13 fibrosing alveolitis in systemic sclerosis (FASS), 9 idiopathic pulmonary fibrosis (IFP), 8 sarcoidosis (S), 6 occupational lung disease (OLD), 5 other alveolitidies A), 27 patients with pneumonia, and 8 patients with chronic obstructive pulmonary disease (COPD). A heterogeneous group of 19 patients served as controls. The median ET concentration was 3.3 pg/ml. Significantly higher concentration was found in patients with FASS (5.8 pg/ml), IPF (5.0 pg/ml), and S (5.1 pg/ml) compared with OLD (2.8 pg/ml), A (1.9 pg/ml), COPD (1.5 pg/ml), and the control group (2.5 pg/ml). In pneumonia, the elevated ET concentration (4.1 pg/ml) was accompanied by a high alveolocapillary leakage. When normalized to BAL albumin concentration, only FASS presented with significantly elevated ET/albumin in the BAL compared with the control group (134.5 vs. 56.l pg/mg, p < 0.05). There were no correlations between ET and BAL differential cell count or pulmonary function tests. In current smokers, ET in BALF was significantly higher compared with non- or ex-smokers (3.9 vs. 2.0 pg/ml, p < 0.01), but not so the ET/albumin ratio (65.0 vs. 62.5 pg/mg). In summary, ET in the BAL is differentially expressed in distinct inflammatory and interstitial lung disease. Consistently high concentrations are found in FASS and elevated ET concentration could be discussed in IPF, sarcoidosis, and pneumonia. ET concentration in BAL is influenced by current smoking habits.
内皮素（ET）是一种支气管和血管收缩性细胞因子，但它也具有促炎和有丝分裂活性。据认为它参与了肺纤维化疾病的发病机制。我们分析了95例不同肺部疾病患者支气管肺泡灌洗（BAL）液中ET - 1的浓度，其中41例间质性肺疾病患者（13例系统性硬化症中的纤维化肺泡炎（FASS）、9例特发性肺纤维化（IFP）、8例结节病（S）、6例职业性肺病（OLD）、5例其他肺泡炎（A））、27例肺炎患者和8例慢性阻塞性肺疾病（COPD）患者。19例异质性患者作为对照组。ET浓度中位数为3.3 pg/ml。与OLD（2.8 pg/ml）、A（1.9 pg/ml）、COPD（1.5 pg/ml）和对照组（2.5 pg/ml）相比，FASS（5.8 pg/ml）、IPF（5.0 pg/ml）和S（5.1 pg/ml）患者的ET浓度显著更高。在肺炎中，ET浓度升高（4.1 pg/ml）伴随着高肺泡毛细血管渗漏。当以BAL白蛋白浓度进行标准化时，与对照组相比，只有FASS的BAL中ET/白蛋白显著升高（134.5对56.1 pg/mg，p < 0.05）。ET与BAL差异细胞计数或肺功能测试之间无相关性。在当前吸烟者中，BALF中的ET显著高于非吸烟者或已戒烟者（3.9对2.0 pg/ml，p < ；0.01），但ET/白蛋白比值并非如此（65.0对62.5 pg/mg）。总之，BAL中的ET在不同的炎症性和间质性肺疾病中表达不同。在FASS中发现浓度持续较高，在IPF、结节病和肺炎中ET浓度可能升高。BAL中的ET浓度受当前吸烟习惯影响。
