Ge Y M, Zhu Y J, Luo W C, Gong Y H, Zhang X Q
Peking Union Medical College Hospital, Beijing.
Chin Med J (Engl). 1990 Jul;103(7):588-94.
The immunolocalization of human neutrophil elastase (HNE) in the alveolar interstitium of 6 patients with emphysema was investigated by immunochemical electron microscopy. The results showed that HNE is localized in the azurophil granules of neutrophils, and extracellularly on the elastic fibers of alveolar interstitium and basement membranes of epithelium and endothelium. The damage of elastic fibers and basement membranes could be observed. The HNE level of the alveolar interstitium was obviously elevated and closely related to the severity of emphysematous lesions as shown by measuring the mean linear intercept (MLI) in 4 emphysematous lungs with chronic bronchitis (r = 0.84). This suggests that HNE might play an important role in the pathogenesis of emphysema. Although enlarged airspace and increased MLI data were observed in 2 patients, one with asthma and the other, an elderly patient, without lung diseases, the HNE level of alveolar interstitium is much less than that of the other 4 chronic obstructive pulmonary disease patients. This implies that the mechanism of the the airspace enlargement occurring in the 2 patients may be different from that of others. These findings support the hypothesis of elastase-antielastase imbalance on the pathogenesis of pulmonary emphysema.
采用免疫化学电子显微镜技术，对6例肺气肿患者肺泡间质中人中性粒细胞弹性蛋白酶（HNE）进行免疫定位研究。结果显示，HNE定位于中性粒细胞的嗜天青颗粒中，且在细胞外定位于肺泡间质的弹性纤维以及上皮和内皮的基底膜上。可见弹性纤维和基底膜受损。通过测量4例合并慢性支气管炎的肺气肿患者的平均线性截距（MLI）发现，肺泡间质中HNE水平明显升高，且与肺气肿病变严重程度密切相关（r = 0.84）。这表明HNE可能在肺气肿发病机制中起重要作用。尽管在2例患者中观察到气腔扩大和MLI数据增加，其中1例患有哮喘，另1例为无肺部疾病的老年患者，但这2例患者肺泡间质中的HNE水平远低于其他4例慢性阻塞性肺疾病患者。这意味着这2例患者气腔扩大的机制可能与其他患者不同。这些发现支持了弹性蛋白酶 - 抗弹性蛋白酶失衡在肺气肿发病机制中的假说。
