The Immunopharmacology Research Group, Medical School, University of Tampere, Finland.
Respir Med. 2010 Jul;104(7):1042-9. doi: 10.1016/j.rmed.2010.01.019. Epub 2010 Feb 16.
Many asbestos-exposed subjects have minor parenchymal changes on high resolution computed tomography (HRCT) that do not fulfil the diagnostic criteria for pulmonary fibrosis and asbestosis. We investigated if these borderline parenchymal changes in asbestos-exposed subjects are related to pulmonary inflammatory activity. Exhaled nitric oxide was measured, exhaled breath condensate collected and HRCT scanned in 104 subjects with moderate to high occupational asbestos exposure. Forty-one healthy unexposed subjects served as a comparison group. After excluding other pulmonary diseases, 35 asbestos-exposed subjects had normal parenchymal findings and 31 subjects had borderline parenchymal changes on HRCT. Lung function was poorer in the latter group, but there was no difference in the degree of asbestos exposure between these groups. As compared with the unexposed comparison group, asbestos-exposed subjects with borderline parenchymal changes had increased alveolar NO concentration (3.0 + or - 0.2 vs. 2.3 + or - 0.1 ppb, p = 0.008) and increased levels of leukotriene B(4) (12.2 + or - 1.1 vs. 3.3 + or - 0.8 pg/ml, p < 0.001) and 8-isoprostane (9.4 + or - 0.7 vs. 7.3 + or - 0.6 pg/ml, p = 0.021) in breath condensate. Asbestos-exposed subjects with normal parenchymal findings had only increased breath condensate levels of leukotriene B(4) (11.4 + or - 0.9, p < 0.001). Borderline parenchymal changes on HRCT in asbestos-exposed subjects are associated with increased markers of pulmonary inflammation. Such borderline parenchymal changes are likely a mild or early form of the same pathological process that leads to asbestosis.
许多接触石棉的人在高分辨率计算机断层扫描（HRCT）上有轻微的实质变化，但不符合肺纤维化和石棉肺的诊断标准。我们研究了这些接触石棉的人在 HRCT 上的边界实质变化是否与肺部炎症活动有关。在 104 名有中度至高度职业性石棉暴露的患者中，测量了呼出气一氧化氮，收集了呼出气冷凝液，并进行了 HRCT 扫描。41 名健康的未暴露者作为对照组。排除其他肺部疾病后，35 名接触石棉的患者 HRCT 上有正常的实质发现，31 名患者有边界实质变化。后一组的肺功能较差，但两组之间的石棉暴露程度没有差异。与未暴露的对照组相比，HRCT 上有边界实质变化的接触石棉者肺泡一氧化氮浓度升高（3.0 + or - 0.2 与 2.3 + or - 0.1 ppb，p = 0.008），呼出气冷凝液中的白三烯 B4 水平升高（12.2 + or - 1.1 与 3.3 + or - 0.8 pg/ml，p < 0.001）和 8-异前列腺素（9.4 + or - 0.7 与 7.3 + or - 0.6 pg/ml，p = 0.021）。HRCT 上有正常实质表现的接触石棉者仅呼出气冷凝液中的白三烯 B4 水平升高（11.4 + or - 0.9，p < 0.001）。接触石棉者 HRCT 上的边界实质变化与肺部炎症标志物的增加有关。这种边界实质变化可能是导致石棉肺的同一病理过程的轻度或早期形式。
