Wehlin Lena, Löfdahl Magnus, Lundahl Joachim, Sköld Magnus
Division of Clinical Immunology and Allergy, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, L2:04, S-171 76 Stockholm, Sweden.
Chest. 2005 Oct;128(4):2051-8. doi: 10.1378/chest.128.4.2051.
COPD is characterized by irreversible airflow obstruction. It has, however, become clear that COPD also is a systemic disease. In the present study, we sought to investigate its impact on different peripheral leukocyte subpopulations that are recognized as important effector cells in the lung tissue.
We enrolled 20 patients with stable, moderate COPD (FEV1, 33 to 69%). Ten asymptomatic smokers and 10 nonsmokers served as control groups. Flow cytometry and whole blood analysis were used to minimize unwanted ex vivo modulation. Oxidative burst and adhesion molecule mobilization were analyzed on freshly drawn cells and after in vitro activation.
We found reduced oxidative burst in neutrophils, monocytes, and eosinophils after in vitro stimulation with tumor necrosis factor (TNF) and the bacterial peptide N-formyl-methionyl-leucyl-phenylalanine (fMLP) in both COPD patients and asymptomatic smokers as compared to nonsmoking control subjects. Vascular involvement was determined as increased soluble intercellular adhesion molecule-1 (sICAM-1) in the COPD group. There were no differences in adhesion molecule expression among the three groups. However, in COPD patients who had smoked the same morning prior to blood sampling, we found a reduced ability to mobilize adhesion molecule CD11b after TNF plus fMLP activation in all investigated cell types. "Acute" smoking did not significantly alter respiratory burst measurements.
Both COPD patients and asymptomatic smokers have increased levels of sICAM-1 and a reduced intracellular oxidative burst in vitro, indicating a vascular endothelial activation and a possible state of refractoriness in circulating phagocytes in COPD. Although expression and mobilization of adhesion molecules were similar between groups, the acute smoke effect on CD11b points out the value of information on smoking behavior when analyzing function of peripheral inflammatory cells in a smoking population.
慢性阻塞性肺疾病(COPD)的特征是不可逆的气流阻塞。然而,现已明确COPD也是一种全身性疾病。在本研究中,我们试图调查其对不同外周血白细胞亚群的影响,这些亚群被认为是肺组织中的重要效应细胞。
我们纳入了20例稳定期、中度COPD患者(第1秒用力呼气容积[FEV1]为33%至69%)。10名无症状吸烟者和10名非吸烟者作为对照组。采用流式细胞术和全血分析以尽量减少不必要的体外调节。对新鲜采集的细胞以及体外激活后的细胞进行氧化爆发和黏附分子动员分析。
我们发现,与非吸烟对照受试者相比,COPD患者和无症状吸烟者在经肿瘤坏死因子(TNF)和细菌肽N-甲酰甲硫氨酰亮氨酰苯丙氨酸(fMLP)体外刺激后,中性粒细胞、单核细胞和嗜酸性粒细胞的氧化爆发均降低。血管受累表现为COPD组可溶性细胞间黏附分子-1(sICAM-1)升高。三组之间黏附分子表达无差异。然而,在采血当天上午吸烟的COPD患者中,我们发现所有研究细胞类型在TNF加fMLP激活后黏附分子CD11b的动员能力降低。“急性”吸烟并未显著改变呼吸爆发测量结果。
COPD患者和无症状吸烟者的sICAM-1水平均升高,体外细胞内氧化爆发降低,表明血管内皮激活以及COPD患者循环吞噬细胞可能存在不应性状态。尽管各组之间黏附分子的表达和动员相似,但急性吸烟对CD11b的影响指出了在分析吸烟人群外周炎症细胞功能时吸烟行为信息的价值。