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支气管哮喘患者下呼吸道中鼻病毒的存在情况。

The presence of rhinovirus in lower airways of patients with bronchial asthma.

作者信息

Wos Monika, Sanak Marek, Soja Jerzy, Olechnowicz Henryk, Busse William W, Szczeklik Andrew

机构信息

University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.

出版信息

Am J Respir Crit Care Med. 2008 May 15;177(10):1082-9. doi: 10.1164/rccm.200607-973OC. Epub 2008 Feb 14.

Abstract

RATIONALE

The common cold virus, human rhinovirus (HRV), is the most frequent cause of asthma exacerbations. However, a possible contribution of HRV to the pathogenesis of chronic, persistent asthma has not been defined.

OBJECTIVES

To determine if patients with stable asthma, who are free of clinical signs of a respiratory infection for at least 3 weeks, harbor HRV in their bronchi more frequently than nonasthmatic control subjects, and whether clinical features of asthma are associated with the presence of HRV.

METHODS

Immunohistochemistry and the indirect in situ reverse transcription-polymerase chain reaction method were used to detect the presence of HRV in bronchial mucosal biopsies in patients with asthma and nonasthmatic control subjects.

MEASUREMENTS AND MAIN RESULTS

HRV was found by immunohistochemistry in 9 of 14 bronchial biopsies from subjects with asthma (64.3%) and 2 of 6 nonasthmatic control subjects (33.3%) (P = 0.38). With the more sensitive indirect in situ reverse transcription-polymerase chain reaction method, HRV was found in the mucosal biopsies of 73% of patients with asthma and 22% of nonasthmatic control subjects (P < 0.001). Subjects positive for HRV had lower pulmonary function, higher numbers of blood eosinophils and leukocytes, and eosinophilic infiltration in bronchial mucosa.

CONCLUSIONS

HRV was detected in the lower airway tissue of patients with asthma significantly more often than in nonasthmatic subjects, and its presence was associated with clinical features of more severe disease.

摘要

理论依据

普通感冒病毒,即人鼻病毒(HRV),是哮喘加重的最常见原因。然而,HRV对慢性持续性哮喘发病机制的可能作用尚未明确。

目的

确定至少3周无呼吸道感染临床体征的稳定期哮喘患者,其支气管中携带HRV的频率是否高于非哮喘对照受试者,以及哮喘的临床特征是否与HRV的存在相关。

方法

采用免疫组织化学和间接原位逆转录聚合酶链反应方法,检测哮喘患者和非哮喘对照受试者支气管黏膜活检标本中HRV的存在情况。

测量指标与主要结果

通过免疫组织化学方法,在14例哮喘受试者的支气管活检标本中有9例(64.3%)检测到HRV,6例非哮喘对照受试者中有2例(33.3%)检测到HRV(P = 0.38)。采用更敏感的间接原位逆转录聚合酶链反应方法,在73%的哮喘患者和22%的非哮喘对照受试者的黏膜活检标本中检测到HRV(P < 0.001)。HRV阳性的受试者肺功能较低,血液嗜酸性粒细胞和白细胞数量较多,支气管黏膜有嗜酸性粒细胞浸润。

结论

哮喘患者下气道组织中检测到HRV的频率明显高于非哮喘受试者,且其存在与更严重疾病的临床特征相关。

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