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通过磁共振成像测量的肺水肿与对过敏原激发的晚期反应相关。

Pulmonary edema measured by MRI correlates with late-phase response to allergen challenge.

作者信息

Evans Rhys L, Changani Kumar K, Hotee Sarah, Pindoria Kashmira, Campbell Simon, Nials Anthony T, Ford William R, Broadley Kenneth J, Kidd Emma J

机构信息

1Division of Pharmacology, Cardiff School of Pharmacy & Pharmaceutical Science, Cardiff University, Cardiff, United Kingdom.

出版信息

Exp Lung Res. 2015 May;41(4):189-98. doi: 10.3109/01902148.2014.985407. Epub 2015 Apr 6.

Abstract

PURPOSE

Asthma is associated with reversible airway obstruction, leucocyte infiltration, airways hyperresponsiveness (AHR), and airways remodeling. Fluid accumulation causes pulmonary edema contributing to airways obstruction. We examined the temporal relationship between the late asthmatic response (LAR) following allergen challenge of sensitized guinea-pigs and pulmonary edema measured by magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Ovalbumin (OVA) sensitized guinea-pigs received either a single OVA inhalation (acute) or nine OVA inhalations at 48 h intervals (chronic). Airways obstruction was measured as specific airways conductance (sG(aw)) by whole body plethysmography. AHR to inhaled histamine and bronchoalveolar lavage for leucocyte counts were measured 24 h after a single or the final chronic ovalbumin challenges. MRI was performed at intervals after OVA challenge and high-intensity edemic signals were quantified.

RESULTS

Ovalbumin caused early bronchoconstriction, followed at 7 h by an LAR and at 24 h AHR and leucocyte influx. The bright-intensity MRI edema signal, peaking at 7 h, was significantly (P < .05) greater after chronic (9.0 ± 0.7 × 10(3) mm(3)) than acute OVA (7.6 ± 0.2 × 10(3) mm(3)). Dexamethasone treatment before acute OVA abolished the AHR and LAR and significantly reduced eosinophils and the bright-intensity MRI edema from 9.1 ± 1.0 to 6.4 ± 0.3 × 10(3) mm(3).

CONCLUSION

We show a temporal relationship between edema and the LAR and their parallel reduction, along with eosinophils and AHR, by dexamethasone. This suggests a close causative association between pulmonary edema and impaired airways function.

摘要

目的

哮喘与可逆性气道阻塞、白细胞浸润、气道高反应性(AHR)及气道重塑相关。液体蓄积导致肺水肿,进而造成气道阻塞。我们研究了致敏豚鼠变应原激发后的迟发性哮喘反应(LAR)与通过磁共振成像(MRI)测量的肺水肿之间的时间关系。

材料与方法

用卵清蛋白(OVA)致敏豚鼠,使其接受单次OVA吸入(急性)或每隔48小时进行9次OVA吸入(慢性)。通过全身体积描记法以比气道传导率(sG(aw))来测量气道阻塞情况。在单次或最后一次慢性卵清蛋白激发后24小时,测量对吸入组胺的气道高反应性以及进行支气管肺泡灌洗以计数白细胞。在OVA激发后的不同时间间隔进行MRI检查,并对高强度水肿信号进行定量分析。

结果

卵清蛋白引起早期支气管收缩,7小时后出现迟发性哮喘反应,24小时时出现气道高反应性和白细胞流入。高强度MRI水肿信号在7小时达到峰值,慢性OVA激发后(9.0±0.7×10(3) mm(3))显著(P<.05)高于急性OVA激发后(7.6±0.2×10(3) mm(3))。急性OVA激发前用地塞米松治疗可消除气道高反应性和迟发性哮喘反应,并显著减少嗜酸性粒细胞,高强度MRI水肿从9.1±1.0降至6.4±0.3×10(3) mm(3)。

结论

我们发现水肿与迟发性哮喘反应之间存在时间关系,且它们可被地塞米松同时减轻,同时嗜酸性粒细胞和气道高反应性也随之减轻。这表明肺水肿与气道功能受损之间存在密切的因果关系。

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