Crimi E, Balbo A, Milanese M, Miadonna A, Rossi G A, Brusasco V
Dipartimento di Scienze Motorie, Università di Genova, Italy.
Am Rev Respir Dis. 1992 Aug;146(2):507-12. doi: 10.1164/ajrccm/146.2.507.
We studied nine asthmatic patients with a history of exercise-induced asthma (EIA) in order to investigate whether inflammatory changes in the airways occur after exercise and are eventually associated with the development of a late-phase asthmatic response. On two separate study days, bronchoalveolar lavage (BAL), bronchial lavage (BL), and bronchial biopsy (BB) were performed 3 h after an exercise or a methacholine (MCh) challenge. On two other separate occasions, FEV1 was monitored for 12 h after identical exercise and MCh challenges not followed by BAL, BL, and BB. We found a greater percentage of eosinophils in BAL after exercise versus MCh challenge (p < 0.05). In five patients, BAL eosinophils after exercise were > or = 2% of total inflammatory and immunoeffector cells. In three of these patients an FEV1 fall > 20% of control was recorded 5 to 12 h after exercise. However, two of these patients had 2% or more eosinophils in BAL and similar late falls of FEV1 after MCh challenge. The percentage of degranulating mast cells in BB was higher (p < 0.05) after EIA than after MCh, but no significant differences were found in BL histamine and leukotrienes. We conclude that (1) exercise may enhance mast cell degranulation and eosinophilic inflammation of the airways, and (2) a delayed bronchoconstriction after exercise is not specific to EIA but is more likely the result of fluctuations in lung function associated with airway inflammation.
我们研究了9名有运动诱发性哮喘（EIA）病史的哮喘患者，以调查运动后气道是否会发生炎症变化，并最终与迟发性哮喘反应的发生相关。在两个不同的研究日，运动或乙酰甲胆碱（MCh）激发试验3小时后进行支气管肺泡灌洗（BAL）、支气管灌洗（BL）和支气管活检（BB）。在另外两个不同的时间点，在相同的运动和MCh激发试验后不进行BAL、BL和BB的情况下，监测12小时的第一秒用力呼气容积（FEV1）。我们发现运动后BAL中嗜酸性粒细胞的百分比高于MCh激发试验（p < 0.05）。在5名患者中，运动后BAL中的嗜酸性粒细胞占总炎症和免疫效应细胞的≥2%。其中3名患者在运动后5至12小时记录到FEV1下降>对照值的20%。然而，其中2名患者在MCh激发试验后BAL中有2%或更多的嗜酸性粒细胞，且FEV1有类似的后期下降。EIA后BB中脱颗粒肥大细胞的百分比高于MCh后（p < 0.05），但在BL中的组胺和白三烯方面未发现显著差异。我们得出结论：（1）运动可能会增强气道肥大细胞脱颗粒和嗜酸性粒细胞炎症，（2）运动后延迟的支气管收缩并非EIA所特有，更可能是与气道炎症相关的肺功能波动的结果。
