Di Lorenzo Gabriele, Pacor Maria Luisa, Morici Giuseppina, Drago Agata, Esposito-Pellitteri Maria, Candore Giuseppina, Lo Bianco Claudia, Caruso Calogero
Dipartimento di Medicina Clinica e delle Patologie Emergenti, Dipartimento di Biopatologia e Metodologie Biomediche, Università degli Studi di Palermo, Via del Vespro 141, I-90127 Palermo, Italy.
Int Arch Allergy Immunol. 2002 Apr;127(4):308-15. doi: 10.1159/000057748.
The aim of this study was to assess the relevance of immunoinflammatory markers on the response to short acting beta(2)-agonist in acute asthma exacerbation. Thus, we measured serum eosinophil cationic protein (ECP) levels and sIL-2R at acute exacerbation in 52 adult patients with atopic asthma, and assessed forced expiratory volume in 1 s (FEV(1)) before and after the administration of aerosolized salbutamol. After a cumulative dose of salbutamol causing a 10% improvement in FEV(1) from baseline [CD10, i.e. cumulative doses of salbutamol (800 microg) causing an improvement in FEV(1) from baseline to 10%] the patients were divided into two groups: group A with CD <10 and group B with CD >10. The bronchodilator response, as defined by a DeltaFEV(1) (percentage of predictive value of FEV(1)) of > or =10 predictive value, was shown by 40% of the patients. After 200, 400 and 800 microg of salbutamol, significant differences of FEV(1) with respect to baseline values were, respectively, p = 0.049, 0.0039 and 0.0014. In contrast, no significant difference of the means of FEV(1) between the doses of salbutamol was observed. Significant differences of DeltaFEV(1) between 200 and 400 microg (p = 0.0002) and between 200 and 800 microg (p < 0.0001) were observed, but not between 400 and 800 microg of salbutamol. There were significant correlations between baseline values of predictive FEV(1) and serum ECP levels (rho = -0.60, p < 0.0001) and sIL-2R levels (rho = -0.35, p = 0.01) respectively. Besides, a correlation between DeltaFEV(1) and serum ECP levels (rho = -0.53, p < 0.0001) was observed, whereas no correlation was found between DeltaFEV(1) and sIL-2R. By analyzing differences between the two groups (A and B) for serum ECP levels, sIL-2R and blood eosinophil count, a significant difference was found for serum ECP levels. We conclude that subjects with acute exacerbation of asthma show high serum levels of ECP and sIL-2R and, more interestingly, that the response to brochodilator was higher in patients with lower serum ECP levels.
本研究的目的是评估免疫炎症标志物与急性哮喘加重期对短效β₂受体激动剂反应的相关性。因此，我们测量了52例成年特应性哮喘患者急性加重期的血清嗜酸性粒细胞阳离子蛋白（ECP）水平和可溶性白细胞介素-2受体（sIL-2R），并评估了雾化沙丁胺醇给药前后的第1秒用力呼气容积（FEV₁）。在给予沙丁胺醇累积剂量使FEV₁较基线水平改善10%[CD10，即沙丁胺醇累积剂量（800μg）使FEV₁从基线水平改善至10%]后，将患者分为两组：A组CD＜10，B组CD＞10。40%的患者表现出支气管扩张剂反应，定义为ΔFEV₁（FEV₁预测值的百分比）≥10%预测值。给予200、400和800μg沙丁胺醇后，FEV₁相对于基线值的显著差异分别为p = 0.049、0.0039和0.0014。相比之下，未观察到沙丁胺醇不同剂量之间FEV₁均值的显著差异。观察到200和400μg之间（p = 0.0002）以及200和800μg之间（p＜0.0001）的ΔFEV₁有显著差异，但400和800μg沙丁胺醇之间没有。预测FEV₁的基线值与血清ECP水平（ρ = -0.60，p＜0.0001）和sIL-2R水平（ρ = -0.35，p = 0.01）之间分别存在显著相关性。此外，观察到ΔFEV₁与血清ECP水平之间存在相关性（ρ = -0.53，p＜0.0001），而未发现ΔFEV₁与sIL-2R之间存在相关性。通过分析两组（A组和B组）血清ECP水平、sIL-2R和血液嗜酸性粒细胞计数的差异，发现血清ECP水平存在显著差异。我们得出结论，哮喘急性加重期患者血清ECP和sIL-2R水平较高，更有趣的是，血清ECP水平较低的患者对支气管扩张剂的反应更高。
