Metzger W J, Richerson H B, Wasserman S I
J Allergy Clin Immunol. 1986 Aug;78(2):282-90. doi: 10.1016/s0091-6749(86)80077-x.
Asthma has been recognized to consist of hyperresponsive airways and cellular inflammation. Allergen bronchoprovocation (BPC) may define the early (EAR) and late-phase asthmatic response (LAR). The LAR has now been associated with increased nonspecific airway hyperresponsiveness and cellular inflammation consisting of neutrophils and eosinophils. We used BPC to demonstrate EAR and LAR in 12 subjects with seasonal allergic asthma. One normal subject and one subject with asthma who had been treated with allergy immunotherapy were challenged but did not respond. Plasma was sampled at frequent intervals during these aeroallergen challenges and assayed for eosinophil chemotactic activity (ECA) and neutrophil chemotactic activity (NCA). Of the 12 subjects with asthma who were challenged, nine had dual responses (both EAR and LAR), and three subjects demonstrated only an LAR. Those subjects who had dual airway responses had biphasic rises in both ECA (early = 267 +/- 28%; late = 286 +/- 28%) and NCA (early = 279 +/- 24%; late = 215 +/- 15%) in their plasma, whereas those subjects who demonstrated only an LAR had only a late rise in ECA (218 +/- 61%) and NCA (188 +/- 31%). The two individuals who did not respond to aeroallergen challenge demonstrated no change in their plasma chemotactic activity toward either eosinophils or neutrophils. Those individuals with the most severe LAR (greater than or equal to 1,000 mm2) had combined ECA plus NCA peak values of greater than 500%.(ABSTRACT TRUNCATED AT 250 WORDS)
哮喘已被认为是由气道高反应性和细胞炎症组成。变应原支气管激发试验(BPC)可确定早期(EAR)和迟发性哮喘反应(LAR)。现在已发现LAR与非特异性气道高反应性增加以及由中性粒细胞和嗜酸性粒细胞组成的细胞炎症有关。我们使用BPC在12名季节性过敏性哮喘患者中证实了EAR和LAR。一名正常受试者和一名接受过变应原免疫治疗的哮喘患者接受了激发试验,但没有反应。在这些气传变应原激发试验期间,频繁采集血浆样本,检测嗜酸性粒细胞趋化活性(ECA)和中性粒细胞趋化活性(NCA)。在接受激发试验的12名哮喘患者中,9名有双重反应(EAR和LAR),3名患者仅表现出LAR。那些有双重气道反应的患者血浆中ECA(早期=267±28%;晚期=286±28%)和NCA(早期=279±24%;晚期=215±15%)均呈双相升高,而那些仅表现出LAR的患者血浆中ECA(218±61%)和NCA(188±31%)仅在晚期升高。两名对气传变应原激发试验无反应的个体,其血浆对嗜酸性粒细胞或中性粒细胞的趋化活性无变化。那些LAR最严重(大于或等于1000 mm2)的个体,其ECA加NCA峰值之和大于500%。(摘要截短于250字)