Villar Ana, Muñoz Xavier, Sanchez-Vidaurre Sara, Gómez-Ollés Susana, Morell Ferran, Cruz María-Jesús
Department of Medicine, Pulmonology Unit, Vall d'Hebron University Hospital, Barcelona, Spain; Network for Biomedical Research in Respiratory Disease (CIBER Enfermedades Respiratorias or CIBERES), Salud Carlos III Health Institute, Barcelona, Spain.
Respirology. 2014 Aug;19(6):891-9. doi: 10.1111/resp.12323. Epub 2014 May 29.
The aim of this study is to compare the inflammatory profile before and after specific inhalation challenge (SIC) in induced sputum from patients with hypersensitivity pneumonitis (HP) and to investigate whether different causal antigens define the resulting profile.
A prospective study was conducted in 27 patients with HP: 15 patients due to exposure to birds (BHP) and 12 due to exposure to fungi (FHP), confirmed by SIC. Induced sputum was obtained before and/or 24 h after SIC. Cell types were determined by differential cell count using optical microscopy. Interferon-γ, interleukin (IL)-12p70, IL-2, IL-10, IL-8, IL-6, IL-4, IL-5, IL-1β, tumour necrosis factor (TNF)-α and TNF-β levels were measured in the supernatants.
Following SIC, higher sputum neutrophilia levels (P = 0.048) and an increase in IL-8 levels (P = 0.017) were found in patients with FHP than in those with BHP. FHP patients also showed increased IL-1β, IL12-p70 and IL5 levels (P = 0.011, P = 0.036 and P = 0.018, respectively) after SIC. In BHP, a trend towards increases in sputum eosinophils and TH2 cytokines (IL4, IL5) was seen following SIC (P = 0.059, P = 0.068 and P = 0.075 respectively).
This study shows that bronchial inflammation is present in patients with HP evidenced by increases in sputum neutrophils and eosinophils following exposure to the offending antigen during SIC.
本研究旨在比较过敏性肺炎（HP）患者诱导痰中特异性吸入激发试验（SIC）前后的炎症特征，并探讨不同的致病抗原是否决定了最终的炎症特征。
对27例HP患者进行了一项前瞻性研究：15例因接触鸟类致病（鸟类过敏性肺炎，BHP），12例因接触真菌致病（真菌过敏性肺炎，FHP），均经SIC确诊。在SIC前和/或SIC后24小时获取诱导痰。使用光学显微镜通过细胞分类计数确定细胞类型。检测上清液中干扰素-γ、白细胞介素（IL）-12p70、IL-2、IL-10、IL-8、IL-6、IL-4、IL-5、IL-1β、肿瘤坏死因子（TNF）-α和TNF-β的水平。
SIC后，FHP患者的痰液中性粒细胞水平高于BHP患者（P = 0.048），IL-8水平升高（P = 0.017）。FHP患者在SIC后还显示IL-1β、IL12-p70和IL5水平升高（分别为P = 0.011、P = 0.036和P = 0.018）。在BHP患者中，SIC后痰液嗜酸性粒细胞和TH2细胞因子（IL4、IL5）有增加趋势（分别为P = 0.059、P = 0.068和P = 0.075）。
本研究表明，HP患者存在支气管炎症，证据是在SIC期间接触致病抗原后痰液中性粒细胞和嗜酸性粒细胞增加。
