Watt A P, Courtney J, Moore J, Ennis M, Elborn J S
Respiratory Research Group, The Queen's University of Belfast, Grosvenor Road, Belfast BT12 6BJ, UK.
Thorax. 2005 Aug;60(8):659-64. doi: 10.1136/thx.2004.038240.
Cystic fibrosis (CF) is characterised by chronic endobronchial bacterial infection and neutrophil mediated inflammation. Neutrophil apoptosis is essential for the resolution of inflammation. This study assessed the relationship between levels of neutrophil apoptosis and sputum microbiology in matched clinically stable patients with CF.
Sputum was induced from 34 patients (nine with no Gram negative infection, 10 colonised with Pseudomonas aeruginosa, 10 with Burkholderia cenocepacia, and five with other infections). Apoptotic neutrophils measured by flow cytometric Annexin V/propidium iodide staining and morphology were similar in all groups.
Patients infected with P aeruginosa or B cenocepacia had a significantly lower percentage of viable neutrophils in the sputum than those with no Gram negative infection (Kruskal-Wallis p = 0.01, median (interquartile range (IQR)) 14.2% (9.4-21.6), 15.8% (12.3-19.5), and 48.4% (23.0-66.4); p = 0.003 and p = 0.002, respectively). They also had significantly higher levels of secondary necrotic granulocytes in sputum than patients with no Gram negative infection (Kruskal-Wallis p<0.0001, median (IQR) 55.5% (48.4-64.5), 50.4% (44.6-61.9), and 24.8% (14.4-30.5); p<0.0001 and p<0.0001, respectively). Neutrophils (x 10(6)/g sputum) in P aeruginosa infected patients (Kruskal-Wallis p = 0.05, median (IQR) 6.3 (3.5-12.7)) and B cenocepacia infected patients (5.7 (1.5-14.5)) were significantly higher than in the group with no Gram negative infection (0.5 (0.5-4.3), p = 0.03 and 0.04, respectively).
These results suggest that cell death and clearance may be altered in patients with CF colonised with P aeruginosa and B cenocepacia compared with those with no Gram negative infection.
囊性纤维化（CF）的特征为慢性支气管内细菌感染和中性粒细胞介导的炎症。中性粒细胞凋亡对于炎症的消退至关重要。本研究评估了临床病情稳定的配对CF患者中性粒细胞凋亡水平与痰液微生物学之间的关系。
对34例患者（9例无革兰阴性菌感染，10例被铜绿假单胞菌定植，10例被洋葱伯克霍尔德菌定植，5例有其他感染）进行痰液诱导。通过流式细胞术膜联蛋白V/碘化丙啶染色和形态学测量的凋亡中性粒细胞在所有组中相似。
感染铜绿假单胞菌或洋葱伯克霍尔德菌的患者痰液中存活中性粒细胞的百分比显著低于无革兰阴性菌感染的患者（Kruskal-Wallis检验p = 0.01，中位数（四分位间距（IQR））分别为14.2%（9.4 - 21.6）、15.8%（12.3 - 19.5）和48.4%（23.0 - 66.4）；p分别为0.003和0.002）。他们痰液中继发性坏死粒细胞水平也显著高于无革兰阴性菌感染的患者（Kruskal-Wallis检验p<0.0001，中位数（IQR）分别为55.5%（48.4 - 64.5）、50.4%（44.6 - 61.9）和24.8%（14.4 - 30.5）；p均<0.0001）。铜绿假单胞菌感染患者（Kruskal-Wallis检验p = 0.05，中位数（IQR）6.3（3.5 - 12.7））和洋葱伯克霍尔德菌感染患者（5.7（1.5 - 14.5））痰液中的中性粒细胞（×10⁶/g痰液）显著高于无革兰阴性菌感染组（0.5（0.5 - 4.3），p分别为0.03和0.04）。
这些结果表明，与无革兰阴性菌感染的CF患者相比，被铜绿假单胞菌和洋葱伯克霍尔德菌定植的CF患者细胞死亡和清除可能发生改变。
