Laboratory of Cellular Immunology, Pathology, Faculty of Medicine, Campus Darcy Ribeiro, Asa Norte, University of Brasilia, Brasilia, DF 70,910-900, Brazil.
Clin Transl Allergy. 2013 Aug 30;3(1):28. doi: 10.1186/2045-7022-3-28.
Corticosteroids are the first-line therapy for asthma; however, the effect of corticosteroids on the innate immune system remains unclear. This study's objective was to evaluate the effect of inhaled corticosteroid therapy (ICT) on phagocytic functions.
To evaluate the impact of ICT, the phagocytosis of Saccharomyces cerevisiae by blood monocytes and neutrophils and the production of superoxide anions were assessed before and after three and six months of ICT treatment in 58 children with persistent asthma and 21 healthy controls.
We showed that the phagocytic capacity of monocytes and neutrophils that occurred via pattern recognition receptors or was mediated by complement and immunoglobulin receptors in asthmatic children before treatment was significantly lower than in healthy controls (p<0.05, Mann-Whitney test) and was not influenced by the severity of the clinical form of the disease. Although there was clinical improvement with treatment, ICT for 6 months was not sufficient to normalize phagocytosis by the phagocytes. Superoxide anion production was also decreased in the asthmatic children before treatment, and ICT normalized the O- production only for children with mild persistent asthma when assessed at baseline but caused this function to decrease after stimulation (p<0.05, Kruskal-Wallis test).
Our data suggest that an immunodeficiency in phagocytes remained even after treatment. However, this immunodeficiency does not appear to correspond with the clinical evolution of asthma because an improvement in clinical parameters occurred.
皮质类固醇是哮喘的一线治疗药物；然而，皮质类固醇对固有免疫系统的影响尚不清楚。本研究的目的是评估吸入皮质类固醇治疗（ICT）对吞噬功能的影响。
为了评估 ICT 的影响，我们评估了 58 例持续性哮喘儿童和 21 例健康对照者在 ICT 治疗前、治疗后 3 个月和 6 个月时血单核细胞和中性粒细胞吞噬酿酒酵母和产生超氧阴离子的能力。
我们表明，与健康对照组相比，治疗前哮喘儿童通过模式识别受体或补体和免疫球蛋白受体介导的单核细胞和中性粒细胞吞噬能力明显降低（p<0.05，Mann-Whitney 检验），且不受疾病临床表型严重程度的影响。尽管治疗后临床有所改善，但 ICT 治疗 6 个月不足以使吞噬细胞的吞噬作用正常化。在治疗前，哮喘儿童的超氧阴离子产生也减少，并且仅在基线评估时，ICT 使轻度持续性哮喘儿童的 O-产生正常化，但在刺激后使该功能下降（p<0.05，Kruskal-Wallis 检验）。
我们的数据表明，即使在治疗后，吞噬细胞的免疫缺陷仍然存在。然而，这种免疫缺陷似乎与哮喘的临床演变不一致，因为临床参数有所改善。
