Carpi S, Marini M, Vittori E, Vassalli G, Mattoli S
Diagnostic Center for Respiratory and Allergic Diseases, Institute of Experimental Medicine, University of Milan, Italy.
Chest. 1993 Nov;104(5):1346-51. doi: 10.1378/chest.104.5.1346.
Twenty-two asthmatic patients with a range of airway hyperresponsiveness to methacholine underwent a bronchial challenge with ultrasonically nebulized distilled water (UNDW). The presence of positive responses to this stimulus was related to the extent of airway inflammation, as assessed by histochemical and immunohistochemical evaluation of bronchial biopsy specimens. Twelve patients had airflow obstruction during distilled water inhalation and they showed more severe disease than subjects with no response, as demonstrated by the higher degree of nonspecific bronchial hyperresponsiveness (p < 0.01), higher variability of peak expiratory flow rates (p < 0.01), symptom scores (p < 0.01), and daily use of bronchodilators (p < 0.01). Those patients also had increased numbers of mast cells and eosinophils (p < 0.01) and increased percentage of bronchial epithelial cells expressing endothelin 1 immunoreactivity (p < 0.01). Thus, positive responses to inhaled UNDW reflect the bronchial hyperresponsiveness consistent with moderate to severe asthma and may be due to the release of mediators with bronchoconstrictive properties from inflammatory cells or activated resident cells or both.
22名对乙酰甲胆碱有不同程度气道高反应性的哮喘患者接受了超声雾化蒸馏水（UNDW）的支气管激发试验。对该刺激的阳性反应与气道炎症程度相关，这是通过支气管活检标本的组织化学和免疫组织化学评估来确定的。12名患者在吸入蒸馏水期间出现气流阻塞，与无反应的受试者相比，他们表现出更严重的疾病，表现为更高程度的非特异性支气管高反应性（p<0.01）、更高的呼气峰值流速变异性（p<0.01）、症状评分（p<0.01）以及更高的支气管扩张剂每日使用量（p<0.01）。这些患者的肥大细胞和嗜酸性粒细胞数量也增加（p<0.01），表达内皮素1免疫反应性的支气管上皮细胞百分比增加（p<0.01）。因此，对吸入UNDW的阳性反应反映了与中度至重度哮喘一致的支气管高反应性，可能是由于炎症细胞或活化的驻留细胞或两者释放具有支气管收缩特性的介质所致。
