Emad Ali, Emad Yasaman
Pulmonary Department, Shiraz University of Medical Sciences, Shiraz, Iran.
J Aerosol Med. 2007 Fall;20(3):342-51. doi: 10.1089/jam.2007.0589.
The objective of this article was to evaluate the relationship between the bronchial reactivity to methacholine and distilled cold water and inflammatory bronchial alveolar lavage (BAL) cells in mustard gas-induced asthma. This was a randomized, crossover clinical study set in a university hospital. The patients were 17 veterans with mustard gas-induced asthma and 17 normal veterans as a control group. Inhalation challenges with ultrasonically nebulized distilled water and methacholine and BAL via bronchoscopy and were performed in all patients and subjects. All patients did sustain a 20% fall in FEV(1) after methacholine, whereas two of them did not with distilled cold water. The patients were sensitive to distilled cold water with a median PD20 of 8.44 +/- 6.55 mL and sensitive to methacholine with the median PC20 of 4.88 +/- 4.22 mg/mL. Significant correlation was found between PC20 of methacholine and PD20 of distilled cold water (r = -0.74, p = 0.005). The proportion of BAL macrophages was significantly lower in patients with asthma than in the control group (p = 0.001). The proportions of lymphocytes and neutrophils were similar in the two groups. The percentage of eosinophils was higher in BAL fluid from the asthmatics compared with that in BAL fluid from the control group (p < 0.001). The percentage of the BAL eosinophils significantly correlated with both PC20 of methacholine (r = - 0.58, p = 0.01) and PD20 of distilled cold water (r = -0.81, p = 0.002). No relationship between PC20 of methacholine or PD20 of distilled cold water was found for other inflammatory BAL cells. This study showed that in patients with mustard gas-induced asthma, the degree of airway responsiveness to both methacholine and distilled water was associated with the percentage of BAL eosinophils.
本文的目的是评估芥子气诱导的哮喘患者中，支气管对乙酰甲胆碱和蒸馏水的反应性与支气管肺泡灌洗（BAL）炎性细胞之间的关系。这是一项在大学医院进行的随机交叉临床研究。患者为17名患有芥子气诱导哮喘的退伍军人，另有17名正常退伍军人作为对照组。所有患者和受试者均接受了经支气管镜的超声雾化蒸馏水和乙酰甲胆碱吸入激发试验以及BAL检查。所有患者在吸入乙酰甲胆碱后FEV(1)均下降了20%，而其中两名患者吸入蒸馏水后未出现这种情况。患者对蒸馏水敏感，PD20中位数为8.44±6.55 mL，对乙酰甲胆碱敏感，PC20中位数为4.88±4.22 mg/mL。发现乙酰甲胆碱的PC20与蒸馏水的PD20之间存在显著相关性（r = -0.74，p = 0.00）。哮喘患者BAL巨噬细胞的比例显著低于对照组（p = 0.001）。两组淋巴细胞和中性粒细胞的比例相似。与对照组BAL液相比，哮喘患者BAL液中嗜酸性粒细胞的百分比更高（p < 0.001）。BAL嗜酸性粒细胞的百分比与乙酰甲胆碱的PC20（r = - 0.58，p = 0.01）和蒸馏水的PD20（r = -0.81，p = 0.002）均显著相关。未发现乙酰甲胆碱的PC20或蒸馏水的PD20与其他BAL炎性细胞之间存在关系。这项研究表明，在芥子气诱导的哮喘患者中，气道对乙酰甲胆碱和蒸馏水的反应程度与BAL嗜酸性粒细胞的百分比有关。
