社区获得性肺炎患儿呼出的白三烯B4

Exhaled leukotriene B4 in children with community acquired pneumonia.

作者信息

Carraro Silvia, Andreola Barbara, Alinovi Rossella, Corradi Massimo, Freo Luisa, Da Dalt Liviana, Baraldi Eugenio

机构信息

Department of Pediatrics, University of Padova, Padova, Italy.

出版信息

Pediatr Pulmonol. 2008 Oct;43(10):982-6. doi: 10.1002/ppul.20889.

DOI:10.1002/ppul.20889

PMID:18781641

Abstract

BACKGROUND

The infiltrate in pneumonia is characterized by a large number of activated neutrophils, for which leukotriene B4 (LTB4) is a strong chemotactic agent. Exhaled breath condensate (EBC) is a non-invasive technique for studying the lower airways. The present study was conducted to measure EBC LTB4 as a potential non-invasive marker of inflammatory response in community acquired pneumonia (CAP).

METHODS

Eighteen children with CAP and 17 healthy children were recruited (age 5-13). The CAP children underwent physical examination, chest X-ray, leukocyte count and C-reactive protein measurement. The CAP and the control children performed spirometry, exhaled nitric oxide measurement (FE(NO)) and EBC collection for LTB4 assessment. In the CAP children spirometry, FE(NO) and EBC collection were repeated twice over a 1-month follow-up.

RESULTS

LTB4 EBC concentrations were higher in children with CAP than in healthy controls (10 pg/ml [7.0-15.3] vs. 3 pg/ml [3.0-6.9], P = 0.001) and decreased after 1 week (3 pg/ml [3.0-7.2], P < 0.01) with no further change a month later. In the acute phase spirometry demonstrated a restrictive pattern that gradually improved later. No difference in FE(NO) levels was found between children with CAP and healthy controls.

CONCLUSION

Exhaled LTB4 levels increase in CAP and return to normal after 1 week. EBC collection is feasible in children with CAP and may represent a new way to non-invasively monitor the lung's biological response to infections.

摘要

背景

肺炎中的浸润以大量活化的中性粒细胞为特征，白三烯B4（LTB4）是一种强效趋化剂。呼出气冷凝物（EBC）是一种用于研究下呼吸道的非侵入性技术。本研究旨在测量EBC中的LTB4，作为社区获得性肺炎（CAP）炎症反应的潜在非侵入性标志物。

方法

招募了18名CAP患儿和17名健康儿童（年龄5 - 13岁）。对CAP患儿进行体格检查、胸部X线检查、白细胞计数和C反应蛋白测量。CAP患儿和对照儿童进行肺活量测定、呼出气一氧化氮测量（FE(NO)）以及收集EBC用于LTB4评估。在CAP患儿中，在1个月的随访期间重复进行肺活量测定、FE(NO)和EBC收集两次。

结果

CAP患儿的EBC中LTB4浓度高于健康对照组（10 pg/ml [7.0 - 15.3] 对比 3 pg/ml [3.0 - 6.9]，P = 0.001），1周后降低（3 pg/ml [3.0 - 7.2]，P < 0.01），1个月后无进一步变化。急性期肺活量测定显示为限制性模式，随后逐渐改善。CAP患儿和健康对照组之间的FE(NO)水平无差异。