Muiño Juan C, Garnero Roberto, Caillet Bois Ricardo, Gregorio María J, Ferrero Mercedes, Romero-Piffiguer Marta
Rev Fac Cien Med Univ Nac Cordoba. 2002;59(1):71-82.
The asthmatic inflammatory responses present different type of cells involved in this process, such as: Lymphocytes and Eosinophils. In experienced hands the bronchoalveolar lavage (BAL) is a well-tolerated and valuable tool for investigation of basic mechanisms in asthma and other immunological respiratory diseases. The purpose of this work was to study the different cells involved in asthmatic inflammatory responses in allergic and aspirin sensitivity patients and compared with Extrinsic Allergic Alveolitis patients (EAA) by BAL procedure. We studied 27 asthmatic patients. This group was divided by etiological conditions in: allergic asthmatic patients (a) (n: 19), (9 male and 10 female) demonstrated by reversible fall of FEV 1 (3) 20% and 2 or more positive skin test for common aeroallergens. The aspirin asthmatic patients (b) (n: 8) (5 male and 3 female) demonstrated by progressive challenge with aspirin and fall of FEV 1 (3) 20%. The third group with compatible symptoms and signs of EAA, demonstrated by lung biopsy, (n: 9) (8 male and 1 female) (c). We determined in all patients: Total IgE serum level by ELISA test. BAL was performed by standard procedure in all patients. The cells count were performed in BAL and were separated in Eosinophils, T lymphocytes defined by monoclonal anti CD 3 antibody, Lymphocytes CD 4 and CD 8 by monoclonal anti CD 4 and CD 8 antibodies respectively. The B lymphocytes defined by surface immunoglobulin isotypes IgG, IgM, IgA and IgE. The IgE level was in (a) 630 +/- 350 kU/L, in (b) it was 85 +/- 62 kU/L and in EAA (c) 55 +/- 23 kU/L, p < .0005. Eosinophil percentage in (a) was 25 +/- 13% of cells, in (b) was 28 +/- 15% of cells, NS, and 0 in (c), p < .0005. Lymphocytes T level was 43 +/- 15% of cells in (a), it was 32 +/- 15% of cells in (b) and it was 54 +/- 19% of cells in (c), NS. Lymphocytes CD 4 (+) level was 30 +/- 10% of cells in (a), it was 24 +/- 11% of cells in (b) and it was 8 +/- 6% of cells in (c), p < .005. Lymphocytes CD8 level was 8 +/- 6% of cells in (a), it was 7 +/- 4% of cells in (b) and it was 44 +/- 15% of cells in EAA (c), p < .005. Lymphocytes B level was 8 +/- 4% cells in (a), it was 2.9 +/- 2.5% cells in (b) and it was 3 +/- 2.7% of cells in (c), p < .025. The features described here suggest the importance of the Eosinophils and CD 4 +/- Lymphocytes in asthmatic response of allergic asthmatic patients as well as in aspirin sensitivity asthmatic patients. The LBA cellular profile of E.AA patients presented eosinophilia and CE8+ Lymphocite predominance when compared with both asthmatic cellular profile.
哮喘炎症反应涉及参与此过程的不同类型细胞，如淋巴细胞和嗜酸性粒细胞。在经验丰富的医生手中，支气管肺泡灌洗（BAL）是一种耐受性良好且有价值的工具，可用于研究哮喘及其他免疫性呼吸道疾病的基本机制。本研究的目的是通过BAL程序，研究变应性和阿司匹林敏感性患者哮喘炎症反应中涉及的不同细胞，并与外源性变应性肺泡炎患者（EAA）进行比较。我们研究了27例哮喘患者。该组患者按病因分为：变应性哮喘患者（a）（n = 19），（9例男性和10例女性），其FEV₁可逆性下降≥20%，且对常见气传变应原的皮肤试验有2次或更多次阳性。阿司匹林哮喘患者（b）（n = 8）（5例男性和3例女性），通过阿司匹林激发试验及FEV₁下降≥20%确诊。第三组有EAA的相符症状和体征，经肺活检确诊（n = 9）（8例男性和1例女性）（c）。我们测定了所有患者的：通过ELISA试验检测血清总IgE水平。所有患者均采用标准程序进行BAL。对BAL中的细胞进行计数，并分离出嗜酸性粒细胞、由单克隆抗CD3抗体定义的T淋巴细胞、分别由单克隆抗CD4和抗CD8抗体定义的CD4和CD8淋巴细胞。由表面免疫球蛋白同种型IgG、IgM、IgA和IgE定义B淋巴细胞。IgE水平在（a）组为630±350 kU/L，在（b）组为85±62 kU/L，在EAA（c）组为55±23 kU/L，p < 0.0005。嗜酸性粒细胞百分比在（a）组为细胞总数的25±13%，在（b）组为细胞总数的28±15%，无显著差异，在（c）组为0，p < 0.0005。T淋巴细胞水平在（a）组为细胞总数的43±15%，在（b）组为细胞总数的32±15%，在（c）组为细胞总数的54±19%，无显著差异。CD4（+）淋巴细胞水平在（a）组为细胞总数的30±10%，在（b）组为细胞总数的24±11%，在（c）组为细胞总数的8±6%，p < 0.005。CD8淋巴细胞水平在（a）组为细胞总数的8±6%，在（b）组为细胞总数的7±4%，在EAA（c）组为细胞总数的44±15%，p < 0.005。B淋巴细胞水平在（a）组为细胞总数的8±4%，在（b）组为细胞总数的2.9±2.5%，在（c）组为细胞总数的3±2.7%，p < 0.025。此处描述的特征表明嗜酸性粒细胞和CD4±淋巴细胞在变应性哮喘患者以及阿司匹林敏感性哮喘患者的哮喘反应中具有重要性。与两种哮喘细胞图谱相比，E.AA患者的LBA细胞图谱表现为嗜酸性粒细胞增多和CD8 +淋巴细胞占优势。
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