Lee So-Yeon, Kim Hyo-Bin, Kim Ja-Hyung, Kim Bong-Seong, Kang Mi-Jin, Jang Seong-Ok, Hong Soo-Jong
Department of Pediatrics, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Pediatr Pulmonol. 2006 Dec;41(12):1161-6. doi: 10.1002/ppul.20506.
Exercise-induced bronchoconstriction (EIB) was associated with eosinophilic airway inflammation, bronchial hyperresponsiveness (BHR), atopy and airway obstruction. To understand the pathogenesis of EIB, we determine whether eosinophil is more related to the mechanism of EIB than atopy, BHR and airway obstruction. This study comprised 268 asthmatic children who underwent lung function test, methacholine challenge test, exercise challenge test, and blood tests for total IgE levels and total eosinophil counts (TEC). Urine eosinophil protein X (EPX) levels after exercise were measured by using ELISA method. EIB was observed in 195 of 268 asthmatics (72.8%). Asthmatics with EIB showed significantly increased TEC (P < 0.01) and decreased log PC(20) as compared with asthmatics without EIB. Maximal percent fall in FEV(1) after exercise was significantly correlated with TEC, log IgE, FEF(25-75%), log PC(20) (P < 0.001, respectively) and FEV(1) (P = 0.013). When the same study was carried out in nonatopic asthmatics, those with EIB showed significantly increased TEC (P = 0.01) compared with those without EIB; however, log PC(20), FEV(1), and FEF(25-75%) showed no significant differences between the two groups of nonatopic asthmatics. In addition, there was a significant correlation between the severity of EIB and TEC in nonatopic asthmatics. Urine EPX/Cr levels after exercise were correlated with the severity of EIB (r = 0.238, P = 0.014). Blood eosinophils and urine EPX/Cr after exercise correlate significantly with the maximal percent fall in FEV(1) after exercise, therefore EIB may reflect a state of eosinophilic inflammation in the airway of asthmatic children.
运动诱发性支气管收缩（EIB）与嗜酸性气道炎症、支气管高反应性（BHR）、特应性和气道阻塞相关。为了解EIB的发病机制，我们确定嗜酸性粒细胞是否比特应性、BHR和气道阻塞更与EIB的机制相关。本研究纳入了268名哮喘儿童，他们接受了肺功能测试、乙酰甲胆碱激发试验、运动激发试验以及总IgE水平和嗜酸性粒细胞总数（TEC）的血液检测。运动后尿嗜酸性粒细胞蛋白X（EPX）水平采用ELISA法测定。268名哮喘患者中有195名（72.8%）观察到EIB。与无EIB的哮喘患者相比，有EIB的哮喘患者TEC显著升高（P < 0.01）且log PC(20)降低。运动后FEV(1)的最大下降百分比与TEC、log IgE、FEF(25 - 75%)、log PC(20)（分别为P < 0.001）和FEV(1)（P = 0.013）显著相关。当在非特应性哮喘患者中进行相同研究时，有EIB的患者与无EIB的患者相比TEC显著升高（P = 0.01）；然而，两组非特应性哮喘患者的log PC(20)、FEV(1)和FEF(25 - 75%)无显著差异。此外，非特应性哮喘患者中EIB的严重程度与TEC之间存在显著相关性。运动后尿EPX/Cr水平与EIB的严重程度相关（r = 0.238，P = 0.014）。运动后的血液嗜酸性粒细胞和尿EPX/Cr与运动后FEV(1)的最大下降百分比显著相关，因此EIB可能反映了哮喘儿童气道中的嗜酸性炎症状态。
