Ollerenshaw S L, Woolcock A J
David Read Laboratory, Department of Medicine, University of Sydney, New South Wales, Australia.
Am Rev Respir Dis. 1992 Apr;145(4 Pt 1):922-7. doi: 10.1164/ajrccm/145.4_Pt_1.922.
Although the characteristics of the histopathologic changes present in subjects who die with status asthmaticus are well documented, the structural changes present in subjects with mild to moderately severe asthma are not well described and the inflammatory changes in the large airways of subjects with chronic airflow limitation (CAL) and asthma have not been compared. Ten subjects with asthma, five taking inhaled corticosteroids and five taking beta 2-agonist aerosols, five subjects with CAL, and four subjects with no respiratory illness had four biopsies taken from airways 10 mm in diameter. The length of intact epithelium, thickness of basement membrane, and number of lymphocytes, neutrophils, eosinophils, plasma cells, monocytes, and mast cells in the lamina propria, bronchial smooth muscle, and submucosa were measured. Intact epithelium was present along 56% of the basement membrane in the asthmatic subjects, along 54% in the subjects with CAL, and along 84% in the control subjects. In the asthmatic subjects there was no direct relationship between the severity of asthma and the amount of epithelial cell loss or the number of inflammatory cells. The basement membrane was thickened in all asthmatic subjects but not in normal subjects or subjects with CAL. There was a significant increase in the number of lymphocytes, eosinophils, and mast cells in the asthmatic airways, particularly in the lamina propria, compared with the CAL subjects. There were no eosinophils or mast cells in any of the control subjects. The airways of subjects with CAL contained significantly more inflammatory cells than the control subjects. Subjects with asthma on inhaled corticosteroids had significantly fewer lymphocytes, eosinophils, and mast cells compared with subjects taking only beta 2-agonists.(ABSTRACT TRUNCATED AT 250 WORDS)
虽然死于哮喘持续状态的患者所呈现的组织病理学变化特征已有充分记录，但轻度至中度严重哮喘患者的结构变化描述不足，且慢性气流受限（CAL）合并哮喘患者大气道的炎症变化尚未进行比较。10例哮喘患者，5例使用吸入性糖皮质激素，5例使用β2受体激动剂气雾剂，5例CAL患者，以及4例无呼吸系统疾病的患者，对直径10mm的气道进行了4次活检。测量了固有层、支气管平滑肌和黏膜下层完整上皮的长度、基底膜厚度以及淋巴细胞、中性粒细胞、嗜酸性粒细胞、浆细胞、单核细胞和肥大细胞的数量。哮喘患者中56%的基底膜有完整上皮，CAL患者为54%，对照患者为84%。在哮喘患者中，哮喘严重程度与上皮细胞丢失量或炎症细胞数量之间无直接关系。所有哮喘患者的基底膜均增厚，而正常受试者和CAL患者则未增厚。与CAL患者相比，哮喘患者气道中的淋巴细胞、嗜酸性粒细胞和肥大细胞数量显著增加，尤其是在固有层。对照受试者中均无嗜酸性粒细胞或肥大细胞。CAL患者气道中的炎症细胞明显多于对照受试者。使用吸入性糖皮质激素的哮喘患者的淋巴细胞、嗜酸性粒细胞和肥大细胞明显少于仅使用β2受体激动剂的患者。（摘要截短于250字）
