Tanizaki Y, Kitani H, Okazaki M, Mifune T, Mitsunobu F, Kimura I
Department of Medicine, Okayama University Medical School, Tottori, Japan.
Int Arch Allergy Immunol. 1993;101(2):196-202. doi: 10.1159/000236519.
The proportion of inflammatory cells in bronchoalveolar lavage (BAL) fluid and the release of chemical mediators from BAL and peripheral blood cells were examined in 40 patients with steroid-dependent intractable asthma (SDIA) to clarify the effects of a long-term glucocorticoid regimen on these cells. The proportion of BAL lymphocytes was significantly reduced (p < 0.01) and the proportion of BAL neutrophils was significantly increased (p < 0.01) in SDIA patients compared with non-SDIA patients. The proportion of basophilic cells (mast cells and basophils) in BAL fluid was significantly lower in SDIA patients compared to non-SDIA patients (p < 0.02). The values of six ventilatory parameters were significantly lower in SDIA patients with a high proportion of BAL neutrophils (more than 10%) compared with the values in non-SDIA patients. The release of histamine and leukotriene C4 (LTC4) from the BAL cells of patients with atopic asthma was significantly reduced in SDIA patients compared with non-SDIA patients (p < 0.05). These results show that the changes in the proportion of BAL cells are observed in patients with SDIA, and these changes are related to suppressed ventilatory function and a reduction in the release of histamine and LTC4 from BAL cells.
为明确长期糖皮质激素治疗方案对这些细胞的影响，对40例激素依赖型难治性哮喘（SDIA）患者的支气管肺泡灌洗（BAL）液中的炎性细胞比例以及BAL和外周血细胞中化学介质的释放情况进行了检测。与非SDIA患者相比，SDIA患者BAL淋巴细胞比例显著降低（p < 0.01），BAL中性粒细胞比例显著升高（p < 0.01）。与非SDIA患者相比，SDIA患者BAL液中嗜碱性细胞（肥大细胞和嗜碱性粒细胞）比例显著降低（p < 0.02）。BAL中性粒细胞比例高（超过10%）的SDIA患者的六个通气参数值显著低于非SDIA患者。与非SDIA患者相比，SDIA患者特应性哮喘患者BAL细胞中组胺和白三烯C4（LTC4）的释放显著减少（p < 0.05）。这些结果表明，SDIA患者存在BAL细胞比例的变化，且这些变化与通气功能受抑制以及BAL细胞中组胺和LTC4释放减少有关。
