Clalit Medical Services, Tel Aviv District, Tel Aviv, Israel 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2022 Dec 1;25(12):853-854.
The exposure to ambient particulate matter (PM) is associated with increased morbidity and mortality from respiratory, cardiovascular, and other causes. A major contribution to this adverse effect is attributed to particles at the nanoscale range (ultrafine particles [UFP] particles < 100 nm). Most of the information about human exposure to PM has been collected by environmental monitoring of inhaled particles.
To evaluate the use of direct measuring of UFP in the sputum as a biomarker for lung inflammation and functional impairment.
The study population included 121 patients who underwent an induced sputum (IS) test as a part of a clinical evaluation for respiratory symptoms. Cell differential count was performed, and the UFP content was measured in each IS sample. The UFP content in the sputum was compared among patients with different inflammatory phenotypes based on IS granulocytes levels: eosinophilic inflammation (EI) IS eosinophils > 2.7%, neutrophilic inflammation (NI) IS neutrophils > 65%, and mixed granulocytic inflammation (MGI) including both IS eosinophils > 2.7% and IS neutrophils > 65%. The association between the IS-UFP content and pulmonary function test (PFT) parameters was also tested.
Patients with MGI had a distinct profile of particles in IS, which was characterized by the highest percentage of UFP (relative to larger particles) compared to patients with EI, NI, or normal IS cell count. Furthermore, EI and NI were found to have an interaction effect regarding the IS-UFP profile, as demonstrated by the significantly different IS-UFP profile of patients with MGI compared to the profile associated with EI and NI independently. Last, the profile of UFP in the IS samples was also correlated with patient PFT. Reduced forced mid-expiratory flow (FEF) 25-75 or FEV1 were correlated with a higher IS-UFP mean size. Reduced FEF25-75 was correlated with a lower IS-UFP concentration and percentage relative to larger particles.
To the best of my knowledge, this study is the first to report a distinct IS-UFP profile in patients with MGI, which suggest an interaction effect of EI and NI on the IS-UFP content. This finding may further support the consideration of MGI as a distinct inflammatory phenotype, beyond the simple combination of EI and NI independently. In addition, reduced PFT parameters were associated with a specific change in the IS-UFP profile. The results of this study may shed light on the use of IS-UFP content as a biomarker for lungs inflammation and functional impairment. Further prospective studies are needed to establish a cause and effect relationship between lungs inflammation and functional impairment to the IS-UFP content.
环境中颗粒物（PM）的暴露与呼吸道、心血管和其他原因导致的发病率和死亡率增加有关。这种不利影响的一个主要原因是归因于纳米级范围的颗粒（超细微粒[UFP]颗粒<100nm）。大多数关于人类接触 PM 的信息都是通过对吸入颗粒的环境监测收集的。
评估直接测量痰液中的 UFP 作为肺部炎症和功能障碍的生物标志物的用途。
研究人群包括 121 名接受诱导痰（IS）测试的患者，该测试是呼吸系统症状临床评估的一部分。进行细胞差异计数，并测量每个 IS 样本中的 UFP 含量。根据 IS 嗜酸性粒细胞水平，将 UFP 含量在具有不同炎症表型的患者之间进行比较：嗜酸性粒细胞炎症（EI）IS 嗜酸性粒细胞>2.7%，中性粒细胞炎症（NI）IS 中性粒细胞>65%，以及包括 IS 嗜酸性粒细胞>2.7%和 IS 中性粒细胞>65%的混合粒细胞炎症（MGI）。还测试了 IS-UFP 含量与肺功能测试（PFT）参数之间的关联。
MGI 患者的 IS 中有明显的颗粒特征，与 EI、NI 或正常 IS 细胞计数的患者相比，UFP（相对于较大颗粒）的百分比最高。此外，EI 和 NI 之间存在 IS-UFP 特征的相互作用效应，这表现为与 EI 和 NI 独立相关的 IS-UFP 特征相比，MGI 患者的 IS-UFP 特征明显不同。最后，IS 样本中的 UFP 特征也与患者的 PFT 相关。中速呼气中期流量（FEF）25-75 或 FEV1 的降低与较高的 IS-UFP 平均大小相关。FEF25-75 的降低与 IS-UFP 浓度和相对于较大颗粒的百分比降低相关。
据我所知，这项研究首次报道了 MGI 患者中存在明显的 IS-UFP 特征，这表明 EI 和 NI 对 IS-UFP 含量存在相互作用效应。这一发现可能进一步支持将 MGI 视为一种独特的炎症表型，而不仅仅是简单地将 EI 和 NI 独立组合。此外，降低的 PFT 参数与 IS-UFP 特征的特定变化相关。这项研究的结果可能为使用 IS-UFP 含量作为肺部炎症和功能障碍的生物标志物提供启示。需要进一步的前瞻性研究来建立肺部炎症和功能障碍与 IS-UFP 含量之间的因果关系。
