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诱导痰中的炎症介质与咳嗽变异性哮喘气道高反应性在长期吸入皮质激素治疗中的相关性。

Inflammatory mediators in induced sputum and airway hyperresponsiveness in cough variant asthma during long-term inhaled corticosteroid treatment.

机构信息

Department of Respiratory Disease, Huashan Hospital, Fudan University, Shanghai 200040, China.

出版信息

Mediators Inflamm. 2012;2012:403868. doi: 10.1155/2012/403868. Epub 2012 Aug 8.

DOI:10.1155/2012/403868
PMID:22927709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3423943/
Abstract

OBJECTIVE

This study aimed to investigate improvements in inflammatory mediator levels in induced sputum and airway hyperresponsiveness (AHR) in cough variant asthma (CVA) during long-term inhaled corticosteroid (ICS) treatment.

PATIENTS AND METHODS

Patients with CVA (N = 35) and classic asthma (N = 26) and healthy subjects (N = 24) were recruited into this study. All patients were treated with budesonide (400 μg/day). Measurement of inflammatory mediators in induced sputum and PD20-FEV(1) (the accumulated provocative dose resulting in a 20% decrease in FEV(1)) in histamine-challenged subjects was performed every three months after the start of medication. Interleukin- (IL-) 5 and IL-10 were assayed by ELISA, and the percentage of eosinophils was detected with Giemsa stain. Trends during the follow-up period were analyzed using a general linear model.

RESULTS

Inflammatory mediator levels in induced sputum and PD20-FEV(1) in patients with CVA and classic asthma differed from those in the control group, although no differences were found in the two asthmatic groups. PD20-FEV(1) significantly increased in CVA patients after ICS treatment for 3 months, while classic asthma patients exhibited a delayed change in AHR. After ICS treatment, levels of IL-5 and IL-10 as well as the percentage of eosinophils in the CVA group were altered at 3 months and 6 months, respectively. Accordingly, the level of inflammatory mediators in classic asthma changed more slowly.

CONCLUSION

CVA has a greater improvement in airway inflammation and airway hyperresponsiveness (AHR) than classic asthma with respect to inhaled corticosteroid (ICS). Short-term ICS considerably reduces AHR although longer treatment is required for complete control of airway inflammation.

摘要

目的

本研究旨在探讨长期吸入皮质类固醇（ICS）治疗对咳嗽变异性哮喘（CVA）患者诱导痰中炎症介质水平和气道高反应性（AHR）的改善作用。

方法

本研究纳入了 35 例 CVA 患者、26 例典型哮喘患者和 24 例健康对照者。所有患者均接受布地奈德（400μg/天）治疗。在开始用药后每 3 个月，对所有患者进行诱导痰中炎症介质测量和组胺激发后 PD20-FEV1（导致 FEV1 下降 20%的累积激发剂量）测量。采用 ELISA 法检测白细胞介素-（IL-）5 和 IL-10，吉姆萨染色法检测嗜酸性粒细胞百分比。采用一般线性模型分析随访期间的趋势。

结果

尽管在两组哮喘患者之间未发现差异，但 CVA 和典型哮喘患者诱导痰中的炎症介质水平和 PD20-FEV1 与对照组不同。ICS 治疗 3 个月后，CVA 患者的 PD20-FEV1 显著增加，而典型哮喘患者的 AHR 变化则延迟。ICS 治疗后，CVA 组的 IL-5 和 IL-10 水平以及嗜酸性粒细胞百分比分别在 3 个月和 6 个月时发生变化。相应地，典型哮喘患者的炎症介质水平变化较慢。

结论

与典型哮喘相比，ICS 治疗后 CVA 患者气道炎症和 AHR 的改善更为显著。尽管短期 ICS 治疗可显著降低 AHR，但需要更长时间的治疗才能完全控制气道炎症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/53c797371a74/MI2012-403868.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/62f01e232155/MI2012-403868.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/7f792978fe3f/MI2012-403868.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/0cf2dd66d4f5/MI2012-403868.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/53c797371a74/MI2012-403868.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/62f01e232155/MI2012-403868.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/7f792978fe3f/MI2012-403868.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/0cf2dd66d4f5/MI2012-403868.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a324/3423943/53c797371a74/MI2012-403868.004.jpg

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