Laboratory of Cellular Immunology, Pathology Area, Faculty of Medicine, University of Brasilia, Brasilia, Brazil.
Allergy. 2013 Jul;68(7):911-20. doi: 10.1111/all.12176. Epub 2013 Jun 7.
Early identification of the severity of asthma exacerbation would be helpful for the management of patients. We aimed to evaluate the correlation of morphological change in activated eosinophils and the severity of an asthma exacerbation.
Blood was collected from 55 asthmatic children: 40 of whom were having an exacerbation, 15 symptom-free, and 15 healthy controls. The percentage of eosinophils with morphological changes (emission of single or multiple pseudopods, presence of cytoplasmic vacuoles, releasing a small, moderate, or large quantity of granules, spreading, eosinophil death, and presence of cluster of free eosinophil granules) was quantified after the adherence to a slide and compared using the Mann-Whitney test. The correlation between the severity of the asthma exacerbation and the percentage changed eosinophils was tested with Spearman's correlation.
The proportion of activated eosinophils was higher in asthmatic symptom-free children than in the control group, and acute asthma exacerbation produced an additional increase in eosinophil activation (P < 0.01). More significantly increased morphological changes were emissions of multiple pseudopods, presence of cytoplasmic vacuoles, spreading, and presence of a cluster of free eosinophil granules (P < 0.001). The following were correlated with the severity of an asthma exacerbation: ≥14% of eosinophils emitting single pseudopod, 8% emitting multiple pseudopods, 17% with vacuoles, 28% eosinophils releasing a large quantity of granules, and 66% of spread eosinophils.
Quantifying the morphological changes in eosinophils is a feasible, easy, and reliable manner to identify the severity of an asthma exacerbation and therefore might improve the clinical management of asthmatic children.
早期识别哮喘恶化的严重程度将有助于患者的管理。我们旨在评估活化嗜酸性粒细胞形态变化与哮喘恶化严重程度的相关性。
采集 55 例哮喘儿童的血液：40 例处于哮喘发作期，15 例无症状，15 例健康对照。在粘附到载玻片后，量化具有形态变化（发出单个或多个伪足、存在细胞质空泡、释放少量、中等量或大量颗粒、扩散、嗜酸性粒细胞死亡和存在游离嗜酸性粒细胞颗粒簇）的嗜酸性粒细胞的百分比，并使用 Mann-Whitney 检验进行比较。使用 Spearman 相关性检验测试哮喘恶化严重程度与改变的嗜酸性粒细胞百分比之间的相关性。
无症状哮喘儿童的活化嗜酸性粒细胞比例高于对照组，急性哮喘恶化进一步增加了嗜酸性粒细胞的激活（P<0.01）。更显著的形态变化增加是发出多个伪足、存在细胞质空泡、扩散和存在游离嗜酸性粒细胞颗粒簇（P<0.001）。以下与哮喘恶化严重程度相关：发出单个伪足的嗜酸性粒细胞中≥14%、发出多个伪足的嗜酸性粒细胞中 8%、有空泡的嗜酸性粒细胞中 17%、释放大量颗粒的嗜酸性粒细胞中 28%和扩散的嗜酸性粒细胞中 66%。
量化嗜酸性粒细胞的形态变化是识别哮喘恶化严重程度的一种可行、简便、可靠的方法，可能改善哮喘儿童的临床管理。
