Freed A N, Omori C, Schofield B H, Mitzner W
Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland 21205.
Am J Respir Cell Mol Biol. 1994 Dec;11(6):724-32. doi: 10.1165/ajrcmb.11.6.7946400.
The purpose of this study was to examine the relationship between hyperpnea-induced mucosal injury, bronchovascular hyperpermeability, and airway reactivity. Hyperpnea-induced bronchoconstriction was assessed by measuring peripheral airway resistance (Rp) in anesthetized mechanically ventilated male mongrel dogs. Either colloidal carbon or monastral blue was used to localize bronchovascular leakage after a 5-min exposure to either a 1000 ml/min dry, 2000 ml/min wet, or 2000 ml/min dry air challenge. Morphometric analyses of cross-sectioned bronchi revealed that hyperpnea with dry air stimulated goblet cell degranulation, damaged the bronchial mucosa, and increased bronchovascular permeability. Exposure to only a 2000 ml/min dry air challenge produced marked mucosal injury when compared with control. Regardless of treatment, bronchial vessels lying below normal mucosa characterized by goblet/ciliated cell (G/C) ratios > or = 0.3 did not leak. A G/C transition zone between 0 and 0.3 separated normal from damaged mucosa. Within this zone, vascular permeability was inversely correlated with G/C ratio. In addition, airflow-induced changes in Rp were inversely related to G/C ratio and positively correlated with bronchovascular leakage. Although these correlations are consistent with the speculation that bronchovascular leakage and edema formation are responsible for the dry air-induced changes in Rp, it is equally plausible that bronchovascular leakage is not the cause of but occurs in concert with airway narrowing to protect cells in the bronchial mucosa from excessive losses of heat and water.
本研究的目的是探讨通气过度引起的黏膜损伤、支气管血管通透性增加与气道反应性之间的关系。通过测量麻醉状态下机械通气的雄性杂种犬的外周气道阻力(Rp)来评估通气过度引起的支气管收缩。在分别暴露于1000 ml/min干燥空气、2000 ml/min湿空气或2000 ml/min干燥空气5分钟后,使用胶体碳或苯胺蓝对支气管血管渗漏进行定位。对横切支气管的形态学分析显示,干燥空气通气过度刺激杯状细胞脱颗粒,损伤支气管黏膜,并增加支气管血管通透性。与对照组相比,仅暴露于2000 ml/min干燥空气时就会产生明显的黏膜损伤。无论采用何种处理方法,杯状/纤毛细胞(G/C)比率≥0.3的正常黏膜下方的支气管血管均无渗漏。G/C比率在0至0.3之间的区域将正常黏膜与受损黏膜分隔开来。在该区域内,血管通透性与G/C比率呈负相关。此外,气流引起的Rp变化与G/C比率呈负相关,与支气管血管渗漏呈正相关。尽管这些相关性与支气管血管渗漏和水肿形成是干燥空气引起Rp变化的原因这一推测一致,但支气管血管渗漏不是气道狭窄的原因,而是与气道狭窄同时发生以保护支气管黏膜细胞免于过多的热量和水分流失,这一观点同样合理。