Bousquet J, Chanez P, Lacoste J Y, Barnéon G, Ghavanian N, Enander I, Venge P, Ahlstedt S, Simony-Lafontaine J, Godard P
Clinique des Maladies Respiratoires, Hôpital l'Aiguelongue, Montpellier, France.
N Engl J Med. 1990 Oct 11;323(15):1033-9. doi: 10.1056/NEJM199010113231505.
The importance of eosinophils in the pathogenesis of bronchial asthma is not established. In an attempt to evaluate the role of eosinophilic inflammation in asthma, we compared 10 normal subjects with 43 patients with chronic asthma, 19 of whom had severe disease as assessed by a clinical scoring method described by Aas and by pulmonary-function tests. Eosinophils were counted in peripheral blood and bronchoalveolar-lavage fluid, and in biopsy specimens obtained from the patients and post mortem from 8 subjects without asthma, but not from the 10 normal controls. Eosinophil cationic protein was titrated by radioimmunoassay in the bronchoalveolar-lavage fluid from all subjects and studied by immunohistochemistry in the biopsy specimens.
There was a significant increase in the number of peripheral-blood eosinophils in the patients that was correlated with the clinical severity of asthma (P less than 0.001) and pulmonary function (P less than 0.03). Levels of eosinophils and eosinophil cationic protein were increased in the bronchoalveolar-lavage fluid from the patients and were also correlated with the severity of asthma (P less than 0.001 and P less than 0.002, respectively). Hematoxylin-eosin staining of bronchial-biopsy specimens showed that intraepithelial eosinophils were present only in patients with asthma. Immunohistochemical analysis of eosinophil cationic protein revealed that normal subjects had only a few nondegranulated eosinophils deep in the submucosa, whereas all the patients had degranulated eosinophils beneath the basement membrane and among epithelial cells. In some patients there was a relation between the presence of degranulated eosinophils and epithelial damage.
Eosinophilic inflammation of the airways is correlated with the severity of asthma. These cells are likely to play a part in the epithelial damage seen in this disease.
嗜酸性粒细胞在支气管哮喘发病机制中的重要性尚未明确。为了评估嗜酸性粒细胞炎症在哮喘中的作用，我们将10名正常受试者与43例慢性哮喘患者进行了比较，其中19例患者根据Aas描述的临床评分方法及肺功能测试评估为重度疾病。对所有受试者的外周血、支气管肺泡灌洗液中的嗜酸性粒细胞进行计数，并对患者活检标本以及8例无哮喘受试者的尸检标本（但未对10名正常对照者的标本）进行计数。通过放射免疫分析法对所有受试者支气管肺泡灌洗液中的嗜酸性粒细胞阳离子蛋白进行滴定，并在活检标本中采用免疫组织化学方法进行研究。
患者外周血嗜酸性粒细胞数量显著增加，且与哮喘临床严重程度（P<0.001）及肺功能（P<0.03）相关。患者支气管肺泡灌洗液中嗜酸性粒细胞及其阳离子蛋白水平升高，且也与哮喘严重程度相关（分别为P<0.001和P<0.002）。支气管活检标本苏木精-伊红染色显示，上皮内嗜酸性粒细胞仅见于哮喘患者。嗜酸性粒细胞阳离子蛋白的免疫组织化学分析显示，正常受试者仅在黏膜下层深处有少量未脱颗粒的嗜酸性粒细胞，而所有患者在基底膜下及上皮细胞间均有脱颗粒的嗜酸性粒细胞。部分患者中，脱颗粒嗜酸性粒细胞的存在与上皮损伤有关。
气道嗜酸性粒细胞炎症与哮喘严重程度相关。这些细胞可能在该疾病所见的上皮损伤中起作用。
