Hanxiang N, Jiong Y, Yanwei C, Dunshuang W, Xuhong D, Xiaojun W, Changsheng L
Department of Respiratory Medicine, Renmin Hospital of Wuhan University, Wuhan, China.
Int J Clin Pract. 2008 Apr;62(4):599-605. doi: 10.1111/j.1742-1241.2007.01373.x. Epub 2007 May 30.
A proportion of asthmatic patients can achieve total control according to the Global Initiative for Asthma/National Institute of Health guidelines. The aim of this study was to investigate whether total control of asthma is accompanied by the remission of airway inflammation and bronchial hyperresponsiveness.
We assessed the number of eosinophil and the levels of eosinophil cationic protein (ECP) and interleukin (IL)-5 in induced sputum and bronchial responsiveness to methacholine in 76 patients with totally controlled asthma in comparison with 30 current untreated asthmatics and 20 healthy subjects.
We found significantly higher number of eosinophil and higher levels of ECP and IL-5 in the total control group than those in healthy subjects (6.9% +/- 3.6% and 1.3% +/- 1.1%, 129.0 +/- 53.8 mug/l and 48.9 +/- 20.4 mug/l, 22.1 +/- 15.2 mug/l and 10.6 +/- 5.2 mug/l, respectively; p < 0.001), but lower than those in current asthma group (16.2% +/- 8.6%, 362.2 +/- 151.6 mug/l, 50.6 +/-25.8 mug/l, respectively; p < 0.001). Sixty-five (85.5%) patients with totally controlled asthma showed positive methacholine challenge test. In the total control group, number of eosinophil and the levels of ECP and IL-5 in induced sputum of patients with negative methacholine challenge test were significantly lower than those in subjects with positive methacholine challenge test (p < 0.001), whereas sputum number of eosinophil and the levels of ECP and IL-5 in patients with negative methacholine challenge test and those of healthy subjects were similar (p > 0.05).
The results of this study suggest that airway inflammation and bronchial hyperresponsiveness still persisted during total control of asthma.
根据全球哮喘防治创议/美国国立卫生研究院指南，一部分哮喘患者可实现完全控制。本研究旨在调查哮喘完全控制是否伴随着气道炎症和支气管高反应性的缓解。
我们评估了76例完全控制的哮喘患者诱导痰中嗜酸性粒细胞数量、嗜酸性粒细胞阳离子蛋白（ECP）和白细胞介素（IL）-5水平，以及对乙酰甲胆碱的支气管反应性，并与30例当前未治疗的哮喘患者和20名健康受试者进行比较。
我们发现完全控制组的嗜酸性粒细胞数量、ECP和IL-5水平显著高于健康受试者（分别为6.9%±3.6%和1.3%±1.1%，129.0±53.8μg/l和48.9±20.4μg/l，22.1±15.2μg/l和10.6±5.2μg/l；p<0.001），但低于当前哮喘组（分别为16.2%±8.6%，362.2±151.6μg/l，50.6±25.8μg/l；p<0.001）。65例（85.5%）完全控制的哮喘患者乙酰甲胆碱激发试验呈阳性。在完全控制组中，乙酰甲胆碱激发试验阴性患者诱导痰中的嗜酸性粒细胞数量、ECP和IL-5水平显著低于激发试验阳性患者（p<0.001），而激发试验阴性患者的痰嗜酸性粒细胞数量、ECP和IL-5水平与健康受试者相似（p>0.05）。
本研究结果表明，在哮喘完全控制期间，气道炎症和支气管高反应性仍然存在。
