Xiang Li, Guo De-yu, Jiang Zai-fang, Liu Shi-ying, Xiong Zhen-yi
Respiratory function laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital affiliated to Capital University of Medical Sciences, Beijing 100045, China.
Zhonghua Er Ke Za Zhi. 2005 Jun;43(6):414-7.
Inhaled glucocorticosteroids (ICS) remains the first line controller medication for chronic airway inflammation in asthma till now. If the impact of allergen could not be eliminated, how would the improvement of airway inflammation be achieved with inhaled glucocorticosteroids therapy? What was its effect on airway remodeling? In this study, an animal model of asthma was established and the effects of budesonide on airway allergic inflammation and extracellular matrix (ECM) deposition in sensitized guinea pigs with repeated exposure to allergen were investigated.
Thirty-two male Hartley guinea pigs were randomly divided into four groups with 8 in each group: (A) Group of repeated exposure to ovalbumin (OVA), (B) Group of repeated exposure to OVA plus budesonide (BUD) intervention, (C) Group of stopping repeated exposure to OVA plus stopping BUD intervention, (D) Control group. At 24 h after the last OVA challenge (8 weeks after the first OVA challenge), bronchoalveolar lavage fluid (BALF) was collected from each animal. Total and differential leukocyte counts in BALF was performed on cell suspension smear stained with May-Grünwald-Giemsa (MGG) method. The upper lobe of right lung was removed and regularly fixed, then paraffin embedded lung tissues sections were prepared. The count of eosinophils infiltrated in the airway wall was performed on H&E stained lung tissue sections with LEICA Q500IW computerized image analysis system. Fibronectin and collagen type III (Col-III) deposited in the airway wall were detected by immunohistochemical staining on the paraffin embedded lung tissues sections. The intensity of positive reaction of fibronectin or Col-III deposited in the airway wall was analyzed with LEICA Q500IW computerized image analysis system.
The count of eosinophils in BALF (x 10(5)/ml) of group A and B were higher than that of group C and D (35.70 +/- 25.22, 11.49 +/- 5.51 vs. 1.00 +/- 0.90, 1.02 +/- 0.78, P < 0.01), the difference between group A and B, group B and C was significant. The count of eosinophils infiltrated at each level of airway wall in group A and B were higher than that of group C and D (large airway: 6.95 +/- 2.28, 1.54 +/- 1.09 vs. 0.76 +/- 0.45, 0.88 +/- 0.25; medial airway: 9.22 +/- 3.89, 3.99 +/- 2.3 vs. 1.25 +/- 1.20, 0.64 +/- 0.36; small airway: 11.56 +/- 4.02, 2.67 +/- 1.15 vs. 1.32 +/- 0.83, 0.43 +/- 0.24, P < 0.01), the difference between group A and B, group B and C was significant. The gray values of fibronectin deposited in medial and small airway of group A and B were lower than those of group C and D (medial airway 122 +/- 22, 174 +/- 23 vs. 219 +/- 34, 229 +/- 20; small airway 135 +/- 29, 165 +/- 41 vs. 236 +/- 20, 220 +/- 16, P < 0.05), the difference between group A and B, group B and C was significant. The gray values of Col-III deposited in medial and small airway of group A and B were lower than those of group C and D (medial airway 153 +/- 21, 174 +/- 22 vs. 189 +/- 14, 200 +/- 18; small airway 133 +/- 23, 176 +/- 20 vs. 191 +/- 14, 198 +/- 20, P < 0.05), the difference between group A and B was significant.
Inhaled budesonide could partially inhibit allergic inflammation and ECM deposition in airway wall in guinea pig chronic asthma model with repeated exposure to allergen. Early inhaled budesonide combined with avoidance of OVA exposure could completely inhibit allergic inflammation and ECM deposition. These results suggest that the inhibitory effect on airway allergic inflammation and airway remodeling of inhaled glucocorticosteroids would be limited when the allergen factor could not be avoided.
迄今为止,吸入性糖皮质激素(ICS)仍是治疗哮喘慢性气道炎症的一线控制药物。若无法消除变应原的影响,吸入性糖皮质激素治疗如何实现气道炎症的改善?其对气道重塑有何作用?本研究建立哮喘动物模型,探讨布地奈德对反复暴露于变应原的致敏豚鼠气道过敏性炎症及细胞外基质(ECM)沉积的影响。
32只雄性Hartley豚鼠随机分为4组,每组8只:(A)反复暴露于卵清蛋白(OVA)组;(B)反复暴露于OVA加布地奈德(BUD)干预组;(C)停止反复暴露于OVA加停止BUD干预组;(D)对照组。在末次OVA激发后24小时(首次OVA激发后8周),收集每只动物的支气管肺泡灌洗液(BALF)。采用May-Grünwald-Giemsa(MGG)法对细胞悬液涂片进行BALF中白细胞总数及分类计数。切除右肺上叶并常规固定,然后制备石蜡包埋的肺组织切片。用LEICA Q500IW计算机图像分析系统对苏木精-伊红(H&E)染色的肺组织切片进行气道壁嗜酸性粒细胞浸润计数。通过对石蜡包埋的肺组织切片进行免疫组织化学染色,检测气道壁中沉积的纤连蛋白和III型胶原(Col-III)。用LEICA Q500IW计算机图像分析系统分析气道壁中纤连蛋白或Col-III沉积的阳性反应强度。
A组和B组BALF中嗜酸性粒细胞计数(×10⁵/ml)高于C组和D组(35.70±25.22,11.49±5.51 vs. 1.00±0.90,1.02±0.78,P<0.01),A组与B组、B组与C组之间差异有统计学意义。A组和B组气道壁各水平嗜酸性粒细胞浸润计数高于C组和D组(大气道:6.95±2.28,1.54±1.09 vs. 0.76±0.45,0.88±0.25;中气道:9.22±3.89,3.99±2.3 vs. 1.25±1.20,0.64±0.36;小气道:11.56±4.02,2.67±1.15 vs. 1.32±0.83,0.43±0.24,P<0.01),A组与B组、B组与C组之间差异有统计学意义。A组和B组中气道和小气道中纤连蛋白沉积的灰度值低于C组和D组(中气道122±22,174±23 vs. 219±34,229±20;小气道135±29,165±41 vs. 236±20,220±16,P<0.05),A组与B组、B组与C组之间差异有统计学意义。A组和B组中气道和小气道中Col-III沉积的灰度值低于C组和D组(中气道153±21,174±22 vs. 189±14,200±18;小气道133±23,176±20 vs. 191±14,198±20,P<0.05),A组与B组之间差异有统计学意义。
在反复暴露于变应原的豚鼠慢性哮喘模型中,吸入布地奈德可部分抑制气道过敏性炎症及气道壁ECM沉积。早期吸入布地奈德联合避免OVA暴露可完全抑制过敏性炎症及ECM沉积。这些结果表明,当变应原因素无法避免时,吸入性糖皮质激素对气道过敏性炎症及气道重塑的抑制作用将受到限制。