Wallaert B, Janin A, Lassalle P, Copin M C, Devisme L, Gosset P, Gosselin B, Tonnel A B
Service de Pneumologie et Immunoallergologie, Hôpital A. Calmette, C.H.R.U. de Lille, France.
Am J Respir Crit Care Med. 1994 Sep;150(3):802-9. doi: 10.1164/ajrccm.150.3.8087355.
T-lymphocytes are important components of the inflammatory cell infiltrate in bronchial mucosa in asthma. Because activated lymphocytes migrate through the thoracic duct and the general circulation to remote glandular and mucosal sites, we initiated this study to evaluate the histologic abnormalities of a minor salivary gland (MSG) associated with bronchial asthma. Fifty-eight asthmatic patients were prospectively studied (37 women, 21 men; mean age, 54 +/- 6 yr). Twenty-nine patients had allergic asthma (AA) and 29 had nonallergic asthma (NAA). Results were compared with those obtained from 15 healthy control subjects and 15 nonasthmatic patients with chronic obstructive pulmonary disease (COPD). MSG was normal in 14 of 15 patients with COPD and in 14 of 15 control subjects. Forty-three of 58 (74%) asthmatic patients presented MSG abnormalities. These were significantly more frequent in asthmatics (74%) than in patients with COPD and healthy control subjects (6%, p < 0.001 versus asthmatics) and in NAA (97%) than in AA (52%, p < 0.01). The main pathologic features of MSG in asthma were T-lymphocyte infiltration (57%: AA nine of 29; NAA 24 of 29), partly degranulated mast cells (64%: AA, 11 of 29; NAA, 26 of 29), basement membrane thickening (64%: AA, 11 of 29; NAA, 26 of 29), and endothelial cell changes (26%: AA, one of 29; NAA, 14 of 29). Eosinophils were found only in two cases. Expression of ICAM-1 was demonstrated in nine of 16 patients with NAA, whereas VCAM-1 and E-selectin were negative in all of them.(ABSTRACT TRUNCATED AT 250 WORDS)
T淋巴细胞是哮喘患者支气管黏膜炎症细胞浸润的重要组成部分。由于活化的淋巴细胞通过胸导管和体循环迁移至远处的腺体和黏膜部位,我们开展了这项研究,以评估与支气管哮喘相关的小唾液腺(MSG)的组织学异常。对58例哮喘患者进行了前瞻性研究(37例女性,21例男性;平均年龄54±6岁)。29例患者为过敏性哮喘(AA),29例为非过敏性哮喘(NAA)。将结果与15名健康对照者和15例患有慢性阻塞性肺疾病(COPD)的非哮喘患者的结果进行比较。15例COPD患者中有14例MSG正常,15名对照者中有14例MSG正常。58例(74%)哮喘患者存在MSG异常。这些异常在哮喘患者(74%)中比在COPD患者和健康对照者(6%,与哮喘患者相比p<0.001)中更常见,在NAA(97%)中比在AA(52%,p<0.01)中更常见。哮喘患者MSG的主要病理特征为T淋巴细胞浸润(57%:AA组29例中有9例;NAA组29例中有24例)、部分脱颗粒的肥大细胞(64%:AA组29例中有11例;NAA组29例中有26例)、基底膜增厚(64%:AA组29例中有11例;NAA组29例中有26例)以及内皮细胞改变(26%:AA组29例中有1例;NAA组29例中有14例)。仅在2例中发现嗜酸性粒细胞。16例NAA患者中有9例显示细胞间黏附分子-1(ICAM-1)表达,而所有患者血管细胞黏附分子-1(VCAM-1)和E选择素均为阴性。(摘要截断于250字)