Mallol J, Aguirre V, Espinosa V
Department of Paediatric Respiratory Medicine, Hospital CRS El Pino, University of Santiago de Chile (USACH).
Allergol Immunopathol (Madr). 2011 Sep-Oct;39(5):253-8. doi: 10.1016/j.aller.2010.09.003. Epub 2011 Jan 3.
There is increasing evidence that oxidative stress is involved in the development and severity of bronchiolitis obliterans occurring in post-transplant patients. In developing countries, the most common form of bronchiolitis obliterans occurs after severe lung infection, mainly caused by adenovirus. However, the oxidative status in the lungs of children with post infectious bronchiolitis obliterans is unknown.
The aim of this study was to measure the oxidant (8-isoprostane and protein carbonyls) and antioxidant (catalase and glutathione peroxidase) activity in the bronchoalveolar lavage fluid of 21 children with post-infectious bronchiolitis obliterans, and to correlate oxidant/antioxidant level with lung function. Lung function was assessed by spirometry and plethysmography, one week prior to fiberbronchoscopy.
There was a markedly increased oxidative stress (lipid and protein oxidation) in the bronchoalveolar lavage fluid, and a notorious impairment of lung function demonstrating moderate-severe distal airway narrowing. There was not a significant correlation between the level of oxidants or antioxidants and lung function. There was a consistent antioxidants/oxidants pattern characterised by markedly increased 8-isoprostane and carbonyls, increased GPx and normal catalase activity.
The present study shows for the first time that children with post-infectious bronchiolitis obliterans have a markedly increased oxidative stress in their lungs.
越来越多的证据表明，氧化应激参与了移植后患者闭塞性细支气管炎的发生和严重程度。在发展中国家，闭塞性细支气管炎最常见的形式发生在严重肺部感染后，主要由腺病毒引起。然而，感染后闭塞性细支气管炎患儿肺部的氧化状态尚不清楚。
本研究的目的是测量21例感染后闭塞性细支气管炎患儿支气管肺泡灌洗液中的氧化剂（8-异前列腺素和蛋白质羰基）和抗氧化剂（过氧化氢酶和谷胱甘肽过氧化物酶）活性，并将氧化剂/抗氧化剂水平与肺功能相关联。在纤维支气管镜检查前一周，通过肺活量测定法和体积描记法评估肺功能。
支气管肺泡灌洗液中的氧化应激（脂质和蛋白质氧化）明显增加，肺功能明显受损，表现为中度至重度远端气道狭窄。氧化剂或抗氧化剂水平与肺功能之间无显著相关性。存在一种一致的抗氧化剂/氧化剂模式，其特征为8-异前列腺素和羰基明显增加，谷胱甘肽过氧化物酶增加而过氧化氢酶活性正常。
本研究首次表明，感染后闭塞性细支气管炎患儿肺部的氧化应激明显增加。
