Berry M, Hargadon B, Morgan A, Shelley M, Richter J, Shaw D, Green R H, Brightling C, Wardlaw A J, Pavord I D
Dept. of Respiratory Medicine and Thoracic Surgery, Institute for Lung Health, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.
Eur Respir J. 2005 Jun;25(6):986-91. doi: 10.1183/09031936.05.00132404.
Recent studies have suggested that alveolar nitric oxide (NO) concentration is a noninvasive test of distal lung inflammation. The current study determined whether alveolar NO concentration can be measured in patients with asthma of varying severity, tested the hypothesis that there is an association between alveolar NO and bronchoalveolar lavage (BAL) eosinophil count and determined whether refractory asthma is characterised by a raised alveolar NO concentration. Finally, the present authors assessed the effect of 2 weeks of prednisolone (30 mg q.d.) on alveolar NO concentration. Alveolar NO concentration was both measurable and repeatable in patients with refractory asthma. A positive correlation was found between alveolar NO concentration and BAL eosinophil count but not with bronchial wash or sputum eosinophil count. Alveolar NO concentration was increased in patients with refractory asthma (7.1 ppb) compared with mild-to-moderate asthma (3.4 ppb) and normal controls (3.4 ppb) and reduced by treatment with prednisolone. In conclusion, these findings support the hypothesis that alveolar nitric oxide is a measure of distal airway inflammation and suggest that distal lung inflammation is present in refractory asthma.
近期研究表明，肺泡一氧化氮（NO）浓度是一种用于检测远端肺部炎症的非侵入性测试。本研究旨在确定不同严重程度的哮喘患者是否能够测量肺泡NO浓度，验证肺泡NO与支气管肺泡灌洗（BAL）嗜酸性粒细胞计数之间存在关联的假设，并确定难治性哮喘是否以肺泡NO浓度升高为特征。最后，作者评估了泼尼松龙（30mg每日一次）治疗2周对肺泡NO浓度的影响。难治性哮喘患者的肺泡NO浓度是可测量且可重复的。发现肺泡NO浓度与BAL嗜酸性粒细胞计数呈正相关，但与支气管冲洗液或痰液嗜酸性粒细胞计数无关。与轻度至中度哮喘患者（3.4ppb）和正常对照组（3.4ppb）相比，难治性哮喘患者的肺泡NO浓度升高（7.1ppb），且泼尼松龙治疗可使其降低。总之，这些发现支持了肺泡一氧化氮是远端气道炎症指标的假设，并表明难治性哮喘存在远端肺部炎症。
