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肺结节病患者呼出气冷凝物中的炎症标志物。

Inflammatory markers in the exhaled breath condensate of patients with pulmonary sarcoidosis.

作者信息

Rozy A, Czerniawska J, Stepniewska A, Woźbińska B, Goljan A, Puścińska E, Górecka D, Chorostowska-Wynimko J

机构信息

Laboratory of Molecular Diagnostics, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.

出版信息

J Physiol Pharmacol. 2006 Sep;57 Suppl 4:335-40.

Abstract

Pulmonary sarcoidosis may progress to fibrosis in some patients, so that close monitoring of its activity is essential for recommending clinical strategy. Examination of airway inflammatory markers in bronchoalveolar lavage (BAL) is one of the methods applied to assess the disease severity. Recently, the expired breath condensate (EBC) has become another source of cytokines and mediators. In sarcoidosis, except for NO and oxidative stress markers, no other mediators have yet been estimated in the exhaled air. In the present study we attempted to answer the question of whether airway inflammatory markers in pulmonary sarcoidosis patients might be assessable in EBC and to what extend these markers might reflect the disease activity in the lungs IL-6, TNF-alpha, PAI-1, and IGF-1 were measured by Elisa method in EBC and BALF samples from 9 patients with newly-diagnosed pulmonary sarcoidosis. TNF-alpha, IGF-1, and PAI-1 levels in EBC and BAL samples were comparable and closely positively correlated [TNF-alpha (r=0.79, P<0.001), IGF-1 (r=0.94, P<0.001), and PAI-1 (r=0.81, P<0.001)]. In contrast, IL-6 concentration in EBC was significantly lower compared with that in BALF, while the correlation between both materials was negative (r=-0.47, P<0.05). An important distinction in IL-6 performance, which might explain this inconsistency, is its tendency to form more complex molecular forms of a higher weight than that of other cytokines. Our study shows that EBC reflects cytokine production in the lung as effectively as BALF, providing that the characteristics of proteins evaluated allow their easy transfer into the exhaled air. Further studies are required before accepting EBC samples as an equivalent to BALF.

摘要

部分肺结节病患者可能会进展为肺纤维化,因此密切监测其活动情况对于制定临床策略至关重要。检测支气管肺泡灌洗(BAL)中的气道炎症标志物是评估疾病严重程度的方法之一。近年来,呼出气冷凝液(EBC)已成为细胞因子和介质的另一个来源。在结节病中,除了一氧化氮和氧化应激标志物外,呼出气中尚未对其他介质进行评估。在本研究中,我们试图回答肺结节病患者气道炎症标志物是否可在EBC中进行评估,以及这些标志物在多大程度上可反映肺部疾病活动情况。采用酶联免疫吸附测定(ELISA)法对9例新诊断的肺结节病患者的EBC和支气管肺泡灌洗液(BALF)样本中的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、纤溶酶原激活物抑制剂-1(PAI-1)和胰岛素样生长因子-1(IGF-1)进行检测。EBC和BAL样本中TNF-α、IGF-1和PAI-1水平具有可比性且呈密切正相关 [TNF-α(r = 0.79,P < 0.001),IGF-1(r = 0.94,P < 0.001),PAI-1(r = 0.81,P < 0.001)]。相比之下,EBC中IL-6浓度显著低于BALF,且两者之间呈负相关(r = -0.47,P < 0.05)。IL-6表现的一个重要差异可能解释了这种不一致性,即与其他细胞因子相比,它倾向于形成分子量更高的更复杂分子形式。我们的研究表明,只要所评估蛋白质的特性允许其轻松转移到呼出气中,EBC就能像BALF一样有效地反映肺部细胞因子的产生情况。在将EBC样本视为等同于BALF样本之前,还需要进一步研究。

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