Erpenbeck Veit J, Jörres Rudolf A, Discher Marc, Krentel Harald, Tsikas Dimitrios, Luettig Birgit, Krug Norbert, Hohlfeld Jens M
Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany.
Nitric Oxide. 2005 Sep;13(2):125-33. doi: 10.1016/j.niox.2005.05.008.
Nitric oxide (NO) levels are increased in the exhaled air of asthmatics. As NO levels correlate with allergic airway inflammation, NO measurement has been suggested for disease monitoring. In patients with asthma, we previously demonstrated that intrabronchial treatment with a natural porcine surfactant enhanced airway inflammation after segmental allergen provocation. We studied whether local levels of NO reflect the degree of allergic airway inflammation following segmental allergen challenge with or without surfactant pretreatment. Segmental NO, as well as nitrite and nitrate in bronchoalveolar lavage (BAL) fluid, was measured before and after segmental challenge with either saline, saline plus allergen, or surfactant plus allergen in 16 patients with asthma and five healthy subjects. The data were compared with inflammatory BAL cells. Segmental NO levels were increased after instillation of saline (p < 0.05), or surfactant plus allergen in asthmatics (p < 0.05), and values were higher after surfactant plus allergen compared to saline challenge. Nitrate BAL levels were not altered after saline challenge but increased after allergen challenge (p < 0.05) and further raised by surfactant (p < 0.05), whereas nitrite levels were not altered by any treatment. Segmental NO and nitrate levels correlated with the degree of eosinophilic airway inflammation, and nitrate levels also correlated with neutrophil and lymphocyte numbers in BAL. In healthy subjects, NO, nitrite, and nitrate were unaffected. Thus, segmental NO and nitrate levels reflect the degree of allergic airway inflammation in patients with asthma. Measurement of both markers can be useful in studies using segmental allergen provocation, to assess local effects of potential immunomodulators.
哮喘患者呼出气体中的一氧化氮（NO）水平升高。由于NO水平与过敏性气道炎症相关，因此有人建议通过测量NO来监测疾病。我们之前曾证明，对于哮喘患者，在进行节段性过敏原激发后，支气管内给予天然猪表面活性剂会加剧气道炎症。我们研究了在有无表面活性剂预处理的情况下，节段性过敏原激发后局部NO水平是否反映过敏性气道炎症的程度。对16例哮喘患者和5名健康受试者进行节段性激发，分别给予生理盐水、生理盐水加过敏原或表面活性剂加过敏原，在激发前后测量节段性NO以及支气管肺泡灌洗（BAL）液中的亚硝酸盐和硝酸盐水平。将这些数据与炎性BAL细胞进行比较。在哮喘患者中，滴注生理盐水（p < 0.05）或表面活性剂加过敏原后，节段性NO水平升高（p < 0.05），与生理盐水激发相比，表面活性剂加过敏原后的数值更高。生理盐水激发后，BAL液中的硝酸盐水平未改变，但过敏原激发后升高（p < 0.05），表面活性剂进一步使其升高（p < 0.05），而亚硝酸盐水平不受任何处理的影响。节段性NO和硝酸盐水平与嗜酸性气道炎症程度相关，硝酸盐水平也与BAL液中的中性粒细胞和淋巴细胞数量相关。在健康受试者中，NO、亚硝酸盐和硝酸盐均未受影响。因此，节段性NO和硝酸盐水平反映了哮喘患者过敏性气道炎症的程度。在使用节段性过敏原激发的研究中，测量这两种标志物有助于评估潜在免疫调节剂的局部作用。
