Strassburg A, Droemann D, van Zandbergen G, Kothe H, Dalhoff K
III. Dept of Medicine, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
Eur Respir J. 2004 Nov;24(5):772-8. doi: 10.1183/09031936.04.00139803.
Chronic bronchitis is a frequent underlying disease in community-acquired pneumonia (CAP). It is unclear to what extent an impaired or exaggerated innate immune response contributes to disease manifestations and severity. To assess the role of neutrophil activation and recruitment during acute pneumonic episodes, peripheral polymorphonulcear neutrophil (PMN) activation, chemotactic activity, interleukin-8 (CXCL-8) and CXCL-8 receptor (CXCR) expression and apoptosis rate were evaluated in CAP patients with and without chronic bronchitis. In addition, the expression of CXCRs and CXCL-8 was assessed on pulmonary neutrophils in chronic bronchitis patients to compare the activation of the chemokine system in different compartments. CAP severity was assessed by the simplified acute physiology score II and the prognosis of disease was assessed by the pneumonia severity index (PSI). An increased chemotactic activity of PMN from chronic bronchitis patients with CAP was found, which was not related to the expression of CXCRs. In addition, a decreased apoptosis rate of PMN was observed. Chemotactic activity was related to the PSI. Comparison of peripheral and pulmonary PMN revealed enhanced CXCL-8 levels and a decreased CXCR expression in the lung. In conclusion, neutrophil function in patients with chronic bronchitis and community-acquired pneumonia is characterised by an increased chemotactic activity combined with a decreased apoptosis rate. The downregulation of interleukin-8 receptors in the pulmonary compartment deserves further investigation.
慢性支气管炎是社区获得性肺炎（CAP）常见的基础疾病。目前尚不清楚先天免疫反应受损或过度在多大程度上导致了疾病的表现和严重程度。为了评估急性肺炎发作期间中性粒细胞激活和募集的作用，我们对患有和未患有慢性支气管炎的CAP患者的外周多形核中性粒细胞（PMN）激活、趋化活性、白细胞介素-8（CXCL-8）和CXCL-8受体（CXCR）表达以及凋亡率进行了评估。此外，还评估了慢性支气管炎患者肺中性粒细胞上CXCRs和CXCL-8的表达，以比较不同部位趋化因子系统的激活情况。通过简化急性生理学评分II评估CAP的严重程度，通过肺炎严重程度指数（PSI）评估疾病的预后。我们发现，患有CAP的慢性支气管炎患者的PMN趋化活性增加，这与CXCRs的表达无关。此外，还观察到PMN凋亡率降低。趋化活性与PSI相关。外周和肺PMN的比较显示，肺中CXCL-8水平升高，CXCR表达降低。总之，慢性支气管炎和社区获得性肺炎患者的中性粒细胞功能的特征是趋化活性增加，同时凋亡率降低。肺中白细胞介素-8受体的下调值得进一步研究。
