van den Berg Jan W K, Slebos Dirk-Jan, Postma Dirkje S, Dijkhuizen Brigitte, Koëter Gerard H, Timens Wim, der van Bij Wim, Kauffman Henk F
Department of Pulmonary Diseases and Lung Transplantation, University Hospital Groningen, Groningen, The Netherlands.
Clin Transplant. 2004 Oct;18(5):605-12. doi: 10.1111/j.1399-0012.2004.00237.x.
Sputum induction (SI) is nowadays being applied as a non-invasive and safe method to investigate airway inflammation in pulmonary diseases. We investigated the feasibility of SI after lung transplantation (LTX), and compared sputum and bronchoalveolar lavage (BAL) cellular characteristics and interleukin-8 (IL-8) levels. Results were also compared with 11 healthy subjects. SI as performed between 26 and 1947 d after LTX in 19 recipients, was successful in 16 of 22 attempts (73%). Six patients failed to produce sputum after induction, mostly just post-LTX and with having a lower forced expiratory volume in 1 s (FEV1). The success rate in clinically stable patients after the first month post-LTX was 93%. Side-effects were absent. Sputum recovery, viability and squamous cell contamination were comparable between LTX patients and healthy subjects. In the LTX group, total cell counts, neutrophil percentages and IL-8 levels were much higher in SI than BAL (1.6 x 10(6)/mL, 65.5% and 54.2 ng/mL vs. 0.1 x 10(6)/mL, 3.0% and 0.01 ng/mL; p < 0.001). Although LTX-neutrophil percentages in SI and BAL correlated properly (rho=0.72, p=0.04), both techniques are not interchangeable. We conclude that sputum induction is feasible, well tolerated, and without major side-effects in stable patients after the first month post-LTX. Induced sputum may be a useful tool to study inflammatory changes of the airways after LTX, and because of the large quantity of neutrophils sampled, especially for further studies on the pathogenesis of bronchiolitis obliterans.
痰液诱导（SI）如今被用作一种无创且安全的方法来研究肺部疾病中的气道炎症。我们研究了肺移植（LTX）后进行痰液诱导的可行性，并比较了痰液和支气管肺泡灌洗（BAL）的细胞特征以及白细胞介素-8（IL-8）水平。还将结果与11名健康受试者进行了比较。19名接受者在LTX后26至1947天进行了痰液诱导，22次尝试中有16次成功（73%）。6名患者在诱导后未能咳出痰液，大多是在LTX后不久，且第1秒用力呼气量（FEV1）较低。LTX后第一个月临床稳定的患者成功率为93%。无副作用。LTX患者和健康受试者之间的痰液回收率、活力和鳞状细胞污染情况相当。在LTX组中，痰液诱导中的总细胞计数、中性粒细胞百分比和IL-8水平远高于BAL（分别为1.6×10⁶/mL、65.5%和54.2 ng/mL，对比0.1×10⁶/mL、3.0%和0.01 ng/mL；p<0.001）。尽管LTX患者痰液诱导和BAL中的中性粒细胞百分比相关性良好（rho=0.72，p=0.04），但两种技术不可互换。我们得出结论，在LTX后第一个月，痰液诱导对稳定患者是可行的、耐受性良好且无主要副作用。诱导痰液可能是研究LTX后气道炎症变化的有用工具，并且由于采集到大量中性粒细胞，尤其适用于进一步研究闭塞性细支气管炎的发病机制。
