Davidsson Anette, Soderstrom Mats, Sjosward Kerstin Naidu, Schmekel Birgitta
Faculty of Health Sciences, Department of Medicine and Care, Section of Clinical Physiology, University Hospital, Linkoping, Sweden.
Respiration. 2007;74(2):184-91. doi: 10.1159/000091300. Epub 2006 Feb 1.
Infiltration of inflammatory cells in bronchial mucosa and glandular hypersecretion are hallmarks of asthma. It has been postulated that exhaled breath condensate (EBC) mirrors events in epithelial lining fluid of airways, such as presence of local inflammation as well as glandular hypersecretion. It is also well known that eosinophil cationic protein (ECP) and cysteinyl-leukotrienes (cys-LT) are released by circulating inflammatory cells when triggered by antigen stimulation in asthma patients.
The aim of this study was to evaluate whether chlorine and/or cys-LT in EBC would reflect changes of exposure of airborne pollen in patients with asthma.
EBC and serum were collected from 23 patients with allergic asthma during a pollen season and repeated 5 months later during a period with no aeroallergens. Chlorine was measured by means of a sensitive coulometric technique and cys-LT by an EIA technique. Serum ECP was measured and lung function tests were performed and symptoms noted during both occasions.
Significantly higher concentrations of chlorine in EBC (p = 0.007) and ECP in serum (p = 0.003) were found during the pollen season compared to post-season. Chlorine levels tended to be higher in patients who reported of chest symptoms compared to those who denied symptoms during the pollen season (p = 0.06). Areas under the receiver-operated characteristic curves (AUC(ROC)) were compared and similar discriminative power to identify exacerbations of asthma was recorded by chlorine in EBC (range 0.67-0.78) and ECP in serum (range 0.64-0.78).
It is concluded that chlorine in EBC and ECP in serum decreased significantly post-season, and this is suggested to mirror the decrement in airborne antigen. It is furthermore proposed that chlorine in EBC and ECP in serum tend to have a similar capacity to identify seasonal variations in airborne pollen in patients with asthma.
支气管黏膜中炎性细胞浸润和腺体分泌亢进是哮喘的特征。据推测，呼出气冷凝液（EBC）反映了气道上皮衬液中的情况，如局部炎症的存在以及腺体分泌亢进。众所周知，在哮喘患者中，抗原刺激会触发循环中的炎性细胞释放嗜酸性粒细胞阳离子蛋白（ECP）和半胱氨酰白三烯（cys-LT）。
本研究旨在评估EBC中的氯和/或cys-LT是否能反映哮喘患者空气中花粉暴露的变化。
在花粉季节收集23例过敏性哮喘患者的EBC和血清，并在5个月后无空气变应原的时期重复收集。采用灵敏的库仑法测定氯，采用酶免疫分析法测定cys-LT。在两个时期均测定血清ECP、进行肺功能测试并记录症状。
与花粉季节后相比，花粉季节期间EBC中的氯浓度显著更高（p = 0.007），血清中的ECP浓度显著更高（p = 0.003）。在花粉季节，报告有胸部症状的患者的氯水平往往高于否认有症状的患者（p = 0.06）。比较了受试者工作特征曲线下面积（AUC(ROC)），EBC中的氯（范围0.67 - 0.78）和血清中的ECP（范围0.64 - 0.78）在识别哮喘发作方面具有相似的判别能力。
得出结论，花粉季节后EBC中的氯和血清中的ECP显著降低，这表明反映了空气中抗原的减少。此外，提出EBC中的氯和血清中的ECP在识别哮喘患者空气中花粉的季节性变化方面往往具有相似的能力。
