Crestani B, Seta N, Palazzo E, Rolland C, Venembre P, Dehoux M, Boutten A, Soler P, Dombret M C, Kahn M F
Unité INSERM 408, Hôpital Bichat, Paris, France.
Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1363-7. doi: 10.1164/ajrccm.150.5.7952565.
We investigated the mechanisms and consequences of neutrophil accumulation in the airspace in 11 patients with systemic sclerosis (SSc) and interstitial lung disease. Seven normal subjects served as controls. We measured total neutrophil elastase burden, elastase activity, and alpha-1-antitrypsin (alpha 1AT) in bronchoalveolar lavage (BAL) fluid and we evaluated the in vitro interleukin-8 (IL-8, a potent chemoattractant for neutrophils) secretion by alveolar macrophages (AM). A mild neutrophil alveolitis was observed in patients when compared with control subjects. Total BAL elastase burden was higher in patients than in control subjects and correlated positively with the percentage of neutrophils in BAL. BAL elastase activity was undetectable in control subjects, but it was detected in all patients but one (mean: 257 +/- 87 mU/L). Spontaneous IL-8 secretion by AM was higher in patients with SSc than in control subjects (518 +/- 115 versus 228 +/- 65 ng/ml, p = 0.04) and positively correlated with the percentage of neutrophils in BAL (r = 0.505). We conclude that (1) the neutrophil could participate in the pathogenesis of SSC lung disease through the release of elastase; (2) the AM could contribute to the influx of neutrophils in the alveolus through the release of IL-8.
我们研究了11例系统性硬化症（SSc）合并间质性肺疾病患者肺间质中中性粒细胞积聚的机制及后果。7名正常受试者作为对照。我们检测了支气管肺泡灌洗（BAL）液中的总中性粒细胞弹性蛋白酶负荷、弹性蛋白酶活性和α-1抗胰蛋白酶（α1AT），并评估了肺泡巨噬细胞（AM）体外白细胞介素-8（IL-8，一种有效的中性粒细胞趋化因子）的分泌情况。与对照受试者相比，患者中观察到轻度中性粒细胞肺泡炎。患者BAL中的总弹性蛋白酶负荷高于对照受试者，且与BAL中中性粒细胞百分比呈正相关。对照受试者中未检测到BAL弹性蛋白酶活性，但除1例患者外，所有患者均检测到（平均值：257±87 mU/L）。SSc患者AM的自发IL-8分泌高于对照受试者（518±115对228±65 ng/ml，p = 0.04），且与BAL中中性粒细胞百分比呈正相关（r = 0.505）。我们得出结论：（1）中性粒细胞可能通过释放弹性蛋白酶参与SSc肺部疾病的发病机制；（2）AM可能通过释放IL-8促进中性粒细胞流入肺泡。
