Zehr B B, Casale T B, Wood D, Floerchinger C, Richerson H B, Hunninghake G W
Department of Medicine, Veterans Administration, Iowa City.
Chest. 1989 May;95(5):1059-63. doi: 10.1378/chest.95.5.1059.
Studies have demonstrated that increased amounts of histamine in the airways of asthmatic patients are associated with increased airway reactivity. However, using routine bronchoalveolar lavage (BAL), histamine can be detected in only a portion of asthmatic subjects and a minority of control populations. To obtain relevant mediators from the airways in higher concentrations by avoiding the dilution inherent with a standard BAL, a technique was developed to lavage isolated airway segments of the human lung that employed a double-lumen bronchoscope and a balloon-tipped catheter. Lavage fluid obtained by this method yielded significantly higher concentrations of histamine than that obtained with routine BAL (asthmatic subjects, 2,403 +/- 633 pg/ml vs 188 +/- 42 pg/ml; rhinitis subjects, 533 +/- 187 pg/ml vs 113 +/- 53 pg/ml; normal subjects, 174 +/- 63 pg/ml vs 11 +/- 11 pg/ml). Similar findings were also noted for prostaglandin D2 (PGD2). Segmental airway lavage also resulted in higher lavage fluid concentrations of LTB, than routine BAL. Segmental airway lavage should help in studying the relationship of mast cell degranulation to airways reactivity in both asthmatic and other study populations.
研究表明，哮喘患者气道中组胺量的增加与气道反应性增强有关。然而，使用常规支气管肺泡灌洗（BAL），仅能在一部分哮喘受试者和少数对照人群中检测到组胺。为了通过避免标准BAL固有的稀释作用，从气道中获得更高浓度的相关介质，开发了一种技术，用于灌洗人肺的分离气道段，该技术采用双腔支气管镜和带气囊导管。通过这种方法获得的灌洗液中组胺浓度明显高于常规BAL获得的浓度（哮喘受试者，2403±633 pg/ml对188±42 pg/ml；鼻炎受试者，533±187 pg/ml对113±53 pg/ml；正常受试者，174±63 pg/ml对11±11 pg/ml）。前列腺素D2（PGD2）也有类似发现。节段性气道灌洗还导致灌洗液中白三烯B4（LTB4）的浓度高于常规BAL。节段性气道灌洗应有助于研究哮喘和其他研究人群中肥大细胞脱颗粒与气道反应性的关系。
