de Kluijver J, Grünberg K, Pons D, de Klerk E P A, Dick C R, Sterk P J, Hiemstra P S
Department of Pulmonology, Leiden University Medical Center, The Netherlands.
Clin Exp Allergy. 2003 Oct;33(10):1415-8. doi: 10.1046/j.1365-2222.2003.01770.x.
Exacerbations of asthma are often associated with rhinovirus (RV)-induced common colds. During experimental RV-infection in healthy subjects, increased levels of the pro-inflammatory mediator IL-1beta and the anti-inflammatory IL-1 receptor antagonist (IL-1ra) have been found in nasal lavage.
We postulated that the balance between nasal pro- and anti-inflammatory mediator expression is disturbed in asthma, resulting in more extensive inflammation following RV-exposure in asthma.
We determined IL-1ra, IL-1beta, and IL-8 in nasal lavages (days -2, 3, and 6) of non-asthmatics and asthmatics (with and without pre-treatment with the inhaled steroid budesonide) before and after experimental RV16-infection (days 0 and 1).
Following RV16-infection, a significant increase in IL-8 was observed in the placebo- and budesonide-treated asthmatics (P=0.033 and 0.037, respectively), whereas IL-1beta only increased in the two asthma groups combined (P=0.035). A small, but significant, increase in IL-1ra was only observed in the budesonide-treated asthmatics (P=0.047). At baseline, IL-1ra levels were significantly higher in the non-asthmatics than in the placebo-treated asthmatics (P=0.017).
These results demonstrate differences between non-asthmatic and asthmatic subjects in the basal levels of nasal cytokines and their inhibitors, and in the effect of experimental RV-infection on these levels. The results indicate that RV may enhance inflammation more markedly in asthmatics, and suggest that this may in part be explained by lower IL-1ra levels. In addition, the observation that budesonide-treatment may result in higher nasal IL-1ra levels supports the hypothesis that steroids act in part by increasing the endogenous anti-inflammatory screen.
哮喘发作常与鼻病毒(RV)引起的普通感冒相关。在健康受试者的实验性RV感染期间,鼻灌洗液中促炎介质白细胞介素-1β(IL-1β)和抗炎性白细胞介素-1受体拮抗剂(IL-1ra)水平升高。
我们推测哮喘患者鼻内促炎和抗炎介质表达之间的平衡受到干扰,导致RV暴露后哮喘患者炎症更广泛。
我们在实验性RV16感染(第0天和第1天)前后,测定了非哮喘患者和哮喘患者(使用和未使用吸入性类固醇布地奈德预处理)鼻灌洗液(第-2天、第3天和第6天)中的IL-1ra、IL-1β和IL-8。
RV16感染后,安慰剂和布地奈德治疗的哮喘患者中IL-8显著增加(分别为P=0.033和0.037),而IL-1β仅在两个哮喘组合并时增加(P=0.035)。仅在布地奈德治疗的哮喘患者中观察到IL-1ra有小幅但显著的增加(P=0.047)。基线时,非哮喘患者的IL-1ra水平显著高于安慰剂治疗的哮喘患者(P=0.017)。
这些结果表明非哮喘患者和哮喘患者在鼻细胞因子及其抑制剂的基础水平以及实验性RV感染对这些水平的影响方面存在差异。结果表明RV可能在哮喘患者中更显著地增强炎症,并且提示这可能部分由较低的IL-1ra水平解释。此外,布地奈德治疗可能导致鼻内IL-1ra水平升高的观察结果支持了类固醇部分通过增加内源性抗炎屏障起作用的假说。