Hunninghake G W, Crystal R G
Am Rev Respir Dis. 1983 Nov;128(5):833-8. doi: 10.1164/arrd.1983.128.5.833.
It has been hypothesized that lung destruction in persons with emphysema associated with cigarette smoking is mediated by elastase released by neutrophils that have migrated to the alveolar structures in response to cigarette smoke. To directly evaluate this hypothesis, cell suspensions, isolated from bronchoalveolar lavage fluid and from open lung biopsies of nonsmokers and cigarette smokers with normal lung parenchyma and from open lung biopsies of nonsmokers and cigarette smokers who have sarcoidosis were evaluated for the presence of neutrophils. A significantly increased number of neutrophils was present in the cell suspensions isolated from bronchoalveolar lavage fluid and from open lung biopsies of both normal and sarcoid cigarette smokers compared with that in the nonsmokers (p less than 0.01, each comparison). Evaluation of the alveolar macrophages present in lavage fluid suggested a mechanism by which neutrophils may be attracted to the lungs of cigarette smokers: alveolar macrophages of cigarette smokers release a chemotactic factor for neutrophils, whereas alveolar macrophages of nonsmokers do not. In addition, alveolar macrophages of nonsmokers, after exposure to cigarette smoke, in vitro, are stimulated to release this chemotactic factor. These studies demonstrate that an increased number of neutrophils are present in the lungs of cigarette smokers compared with that in nonsmokers and suggest that cigarette smoke may attract neutrophils to the lung by stimulating alveolar macrophages to release a potent chemotactic factor for neutrophils.
有假说认为，与吸烟相关的肺气肿患者的肺组织破坏是由中性粒细胞释放的弹性蛋白酶介导的，这些中性粒细胞因香烟烟雾而迁移至肺泡结构。为了直接评估这一假说，对从支气管肺泡灌洗液以及肺实质正常的非吸烟者和吸烟者的开胸肺活检组织中分离出的细胞悬液，以及结节病患者（包括非吸烟者和吸烟者）的开胸肺活检组织进行了中性粒细胞检测。与非吸烟者相比，从正常吸烟者和结节病吸烟者的支气管肺泡灌洗液及开胸肺活检组织中分离出的细胞悬液中的中性粒细胞数量显著增加（每次比较，p均小于0.01）。对灌洗液中肺泡巨噬细胞的评估提示了一种中性粒细胞可能被吸引至吸烟者肺部的机制：吸烟者的肺泡巨噬细胞会释放一种吸引中性粒细胞的趋化因子，而非吸烟者的肺泡巨噬细胞则不会。此外，非吸烟者的肺泡巨噬细胞在体外接触香烟烟雾后，会被刺激释放这种趋化因子。这些研究表明，与非吸烟者相比，吸烟者肺部的中性粒细胞数量增加，并且提示香烟烟雾可能通过刺激肺泡巨噬细胞释放一种强效的中性粒细胞趋化因子，将中性粒细胞吸引至肺部。
