Boljevic S, Daniljak I G, Kogan A H
Katedra za unutrasnje bolesti br. 2, Prvog medicinskog fakulteta, Moskovske medicinske akademije I. M. Secenov.
Vojnosanit Pregl. 1993 Jan-Feb;50(1):3-18.
The controversy of data about the role of free radicals in the pathogenesis of bronchial asthma (BA) and lack of clear recommendations for the use of medicaments with antioxidant characteristics in the treatment of patients with BA has challenged us to undertake this study. The aim was to explain characteristics of generation of active forms of oxygen (AFO) by leukocytes, peroxide lipid oxidation (PLO) and antiperoxide plasma activities (APA) in patients with BA, evaluation of their pathogenetic importance and justified use of antioxidants in the complex therapy of BA. For this purpose, 92 patients with BA and 45 healthy volunteers were studied. Generation of AFO by blood leukocytes were examined by the method of luminol-dependent chemiluminiscence (CL). Basal and stimulated HL parameters have been measured. The intensity of PLO was determined according to the contents of malondialdehyde (MDA) in plasma. The APA was determined according to its resistance to the injection of free radicals oxidation of hydrogen peroxide. In patients with acute BA compared with healthy volunteers, both CL parameters were increased. In the same time the contents of plasma MDA and relationship of induced and spontaneous plasma CL were increased which suggested the decreased APA. In remission, both CL parameters of AFK generation by leukocytes and the contents of plasma MDA were decreased approximating the normal, but it was never reached. The direct proportional dependence of the degree of impairment and severity of the BA course and the intensity of free radical process were discovered as well as the reversed proportional dependence among the degree of impairment and severity of BA and plasma APA. However, the least parameters of AFK generation by leukocytes were obtained in patients with asthmatic state. In patients with steroid-dependent bronchial asthma the free radical process is more intensive, the plasma APA being lower than in patients with steroid-non-dependent bronchial asthma. Regarding the free radical process the most responsive was aspirin asthma, the mildest exercise-induced asthma. In patients with steroid-non-dependent BA and in patients with steroid-dependent BA who together with the traditional therapy received also antioxidants (aevit and glutamic acid), the decreased CL parameters of leukocyte AFK generation and the decreased contents of MDA were more manifested than in patients not taking antioxidants.
关于自由基在支气管哮喘（BA）发病机制中的作用的数据存在争议，且在BA患者治疗中缺乏关于使用具有抗氧化特性药物的明确建议，这促使我们开展这项研究。目的是解释BA患者中白细胞产生活性氧形式（AFO）、过氧化脂质氧化（PLO）和抗过氧化血浆活性（APA）的特征，评估它们在发病机制中的重要性，并证明抗氧化剂在BA综合治疗中的合理应用。为此，对92例BA患者和45名健康志愿者进行了研究。通过鲁米诺依赖性化学发光（CL）方法检测血液白细胞产生AFO的情况。测量了基础和刺激后的HL参数。根据血浆中丙二醛（MDA）的含量确定PLO的强度。根据其对注射过氧化氢自由基氧化的抗性确定APA。与健康志愿者相比，急性BA患者的两个CL参数均升高。同时，血浆MDA含量以及诱导和自发血浆CL的关系增加，这表明APA降低。在缓解期，白细胞产生AFK的两个CL参数以及血浆MDA含量均降低，接近正常水平，但从未达到正常。发现BA病程的损害程度和严重程度与自由基过程强度之间存在直接比例关系，以及BA的损害程度和严重程度与血浆APA之间存在反向比例关系。然而，哮喘状态患者白细胞产生AFK的参数最少。在依赖类固醇的支气管哮喘患者中，自由基过程更强烈，血浆APA低于非依赖类固醇的支气管哮喘患者。关于自由基过程，阿司匹林哮喘反应最明显，运动诱发哮喘最轻。在非依赖类固醇的BA患者和接受传统治疗同时还接受抗氧化剂（维生素E和谷氨酸）的依赖类固醇的BA患者中，白细胞AFK产生的CL参数降低和MDA含量降低比未服用抗氧化剂的患者更明显。
