Quebec Heart and Lung Institute, Université Laval , Quebec, QC , Canada.
School of Mathematical Sciences, The University of Nottingham , Nottingham , United Kingdom.
J Appl Physiol (1985). 2018 Jun 1;124(6):1483-1490. doi: 10.1152/japplphysiol.01073.2017. Epub 2018 Feb 22.
It is suggested that the frequent strain the airways undergo in asthma because of repeated airway smooth muscle (ASM)-mediated constrictions contributes to airway wall remodeling. However, the effects of repeated constrictions on airway remodeling, as well as the ensuing impact of this presumptive remodeling on respiratory mechanics, have never been investigated in subjects without asthma. In this study, we set out to determine whether repeated constrictions lead to features that are reminiscent of asthma in mice without asthma. BALB/c mice were subjected to a 30-min constriction elicited by aerosolized methacholine every other day over 6 wk. Forty-eight hours after the last constriction, the mechanics of the respiratory system was evaluated at baseline and in response to incremental doses of nebulized methacholine with the flexiVent. The whole-lung lavages, the tracheas, and the lungs were also collected to evaluate inflammation, the contractile capacity of ASM, and the structural components of the airway wall, respectively. The resistance and the compliance of the respiratory system, as well as the Newtonian resistance and the resistive and elastic properties of the lung tissue, were not affected by repeated constrictions, both at baseline and in response to methacholine. All the other examined features also remained unaltered, except the number of goblet cells in the epithelium and the number of macrophages in the whole-lung lavages, which both increased with repeated constrictions. This study demonstrates that, despite causing goblet cell hyperplasia and a mild macrophagic inflammation, repeated constrictions with methacholine do not lead to structural changes that adversely impact the physiology. NEW & NOTEWORTHY Repeated airway constrictions led to signs of remodeling that are typically observed in asthma, which neither altered respiratory mechanics nor the contractile capacity of airway smooth muscle. These findings shed light on a debate between those claiming that constrictions induce remodeling and those convinced that methacholine challenges are harmless. Insofar as our results with mice relate to humans, the findings indicate that repeated challenges with methacholine can be performed safely.
有人提出,哮喘患者气道反复发生平滑肌介导的收缩,这使得气道频繁受到牵拉,从而导致气道壁重塑。然而,反复收缩对气道重塑的影响,以及这种假定的重塑对呼吸力学的后续影响,在非哮喘患者中从未被研究过。在这项研究中,我们旨在确定反复收缩是否会导致非哮喘小鼠出现类似于哮喘的特征。BALB/c 小鼠每隔一天接受 30 分钟雾化的乙酰甲胆碱引发的收缩,持续 6 周。最后一次收缩后 48 小时,用 FlexiVent 评估基础状态和递增剂量雾化乙酰甲胆碱时呼吸系统的力学特性。还收集全肺灌洗液、气管和肺,分别评估炎症、气道平滑肌的收缩能力和气道壁的结构成分。反复收缩既没有影响呼吸系统的阻力和顺应性,也没有影响基础状态和乙酰甲胆碱反应时的呼吸系统的牛顿阻力和肺组织的阻力和弹性特性。除了上皮中的杯状细胞数量和全肺灌洗液中的巨噬细胞数量增加外,所有其他检查的特征也保持不变。这项研究表明,尽管反复的乙酰甲胆碱收缩导致了杯状细胞增生和轻度的巨噬细胞炎症,但并没有导致结构改变,从而对生理学产生不利影响。新的和值得注意的是,反复的气道收缩导致了通常在哮喘中观察到的重塑迹象,但这并没有改变呼吸力学或气道平滑肌的收缩能力。这些发现为那些认为收缩会引起重塑的人和那些确信乙酰甲胆碱挑战是无害的人之间的争论提供了新的认识。就我们用小鼠得出的结果与人类有关而言,这些发现表明,反复用乙酰甲胆碱挑战是安全的。