Basyigit Ilknur, Yildiz Fusun, Kacar Ozkara Sevgiye, Boyaci Hasim, Ilgazli Ahmet, Ozkarakas Oktay
Department of Pulmonary Diseases, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Respirology. 2004 Nov;9(4):514-20. doi: 10.1111/j.1440-1843.2004.00631.x.
Inhaled corticosteroids, leukotriene receptor antagonists, and theophylline are recommended for the treatment of mild persistent asthma. The aim of this study was to compare the changes in sputum total cell and eosinophil counts, and eosinophil cationic protein (ECP) levels in serum and sputum following treatment with leukotriene receptor antagonists, inhaled corticosteroids, and theophylline in patients with mild persistent asthma.
Total cell counts, eosinophil percentage, and ECP levels in induced sputum and serum were determined both before and after treatment. Prior to sputum induction, FEV1 and PEF values and symptom scores were recorded at baseline and after 8 weeks of treatment. After baseline measurements, the asthmatic patients (n = 30) were randomized into three groups. A total of 10 patients were treated with zafirlukast, 20 mg bd, 10 with budesonide inhaler 200 microg bd, and 10 with theophylline 200 mg bd.
There were significant decreases in sputum total cell counts and eosinophil percentage in all treatment groups. However, the decrease in sputum eosinophil counts was more significant in the corticosteroid-treated group. Although sputum ECP levels decreased significantly in the groups treated with zafirlukast and budesonide (zafirlukast group, 580-135 microg/L, P < 0.01; budesonide group, 683-268 microg/L, P < 0.01), the decrease was not statistically significant in the theophylline-treated group (498-361 microg/L, P > 0.05). In contrast, there were no significant changes in serum ECP levels in any of the treatment groups.
All three treatments resulted in significant decreases in sputum total cell counts and eosinophil percentage, but the decrease in sputum ECP level was only seen in the groups treated with budesonide and zafirlukast. These results suggest that although all three treatments are considered as first-line treatments in most consensuses, theophylline seems to have less of an inhibitory effect on eosinophil activation.
吸入性糖皮质激素、白三烯受体拮抗剂和茶碱被推荐用于治疗轻度持续性哮喘。本研究的目的是比较白三烯受体拮抗剂、吸入性糖皮质激素和茶碱治疗轻度持续性哮喘患者后痰液总细胞和嗜酸性粒细胞计数以及血清和痰液中嗜酸性粒细胞阳离子蛋白（ECP）水平的变化。
在治疗前后测定诱导痰液和血清中的总细胞计数、嗜酸性粒细胞百分比和ECP水平。在诱导痰液之前，记录基线和治疗8周后的FEV1和PEF值以及症状评分。在基线测量后，将哮喘患者（n = 30）随机分为三组。每组10例，分别接受扎鲁司特20 mg bid治疗、布地奈德吸入剂200 μg bid治疗和茶碱200 mg bid治疗。
所有治疗组的痰液总细胞计数和嗜酸性粒细胞百分比均显著下降。然而，糖皮质激素治疗组的痰液嗜酸性粒细胞计数下降更为显著。虽然扎鲁司特和布地奈德治疗组的痰液ECP水平显著下降（扎鲁司特组，580 - 135 μg/L，P < 0.01；布地奈德组，683 - 268 μg/L，P < 0.01），但茶碱治疗组的下降无统计学意义（498 - 361 μg/L，P > 0.05）。相反，任何治疗组的血清ECP水平均无显著变化。
所有三种治疗均导致痰液总细胞计数和嗜酸性粒细胞百分比显著下降，但仅在布地奈德和扎鲁司特治疗组中观察到痰液ECP水平下降。这些结果表明，尽管在大多数共识中所有三种治疗均被视为一线治疗，但茶碱对嗜酸性粒细胞活化的抑制作用似乎较小。
