Nowak D, Grimminger F, Jörres R, Oldigs M, Rabe K F, Seeger W, Magnussen H
Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Grosshansdorf, Germany.
Eur Respir J. 1993 Mar;6(3):405-12.
The bronchoconstrictor potency of inhaled methacholine is widely used to assess airway responsiveness. However, evidence has accumulated that methacholine inhalation challenge may lead to an inflammatory response in the lower respiratory tract. We therefore compared cellular, leukotriene and prostanoid profiles in bronchoalveolar lavages (BAL) obtained five hours after methacholine challenge to control lavages without prior challenge. Eight subjects with asymptomatic to mild bronchial asthma and nine nonatopic healthy controls were enrolled in the study. Without prior challenge, the percentage of BAL eosinophils was higher in the asthmatic subjects ((mean +/- SD), 1.1 +/- 0.9%) than in the control subjects (0.1 +/- 0.1%. Leukotriene B4 (LTB4), and its omega-oxidation products (20-OH-LTB4 and 20-COOH-LTB4) were the only leukotrienes detectable in the baseline BAL fluids in five of the eight asthmatic patients. After methacholine challenge, no change in BAL cell profile occurred, but in the asthmatic patients, the total amounts of LTB4 and its omega-oxidation products rose from 0.52 +/- 0.50 ng.ml-1 (pre-challenge) to 1.55 +/- 1.32 ng.ml-1 (post-challenge), and prostaglandin D2 (PGD2) rose from 49.1 +/- 15.7 (pre-challenge) to 94.4 +/- 25.4 pg.ml-1 (post-challenge), with no change in 6-keto-PGF1 alpha, thromboxane B2 (TXB2), and prostaglandins F2 alpha and E2 (PGF2 alpha and PGE2). In the healthy controls, no consistent change in BAL cell profile and mediators occurred after methacholine provocation. We conclude that inhaled methacholine stimulates LTB4 and PGD2 release in asthmatics, but not in healthy controls, without affecting the number of inflammatory cells in BAL fluid.
吸入性乙酰甲胆碱的支气管收缩效能被广泛用于评估气道反应性。然而，越来越多的证据表明，乙酰甲胆碱吸入激发试验可能会导致下呼吸道炎症反应。因此，我们比较了乙酰甲胆碱激发试验后5小时获得的支气管肺泡灌洗（BAL）液中的细胞、白三烯和前列腺素谱与未进行预先激发试验的对照灌洗液。本研究纳入了8名无症状至轻度支气管哮喘患者和9名非特应性健康对照者。在未进行预先激发试验的情况下，哮喘患者BAL液中嗜酸性粒细胞的百分比（平均值±标准差）为1.1±0.9%，高于对照者（0.1±0.1%）。在8名哮喘患者中的5名患者的基线BAL液中，仅可检测到白三烯B4（LTB4）及其ω-氧化产物（20-OH-LTB4和20-COOH-LTB4）。乙酰甲胆碱激发试验后，BAL液中的细胞谱没有变化，但在哮喘患者中，LTB4及其ω-氧化产物的总量从0.52±0.50 ng/ml（激发试验前）升至1.55±1.32 ng/ml（激发试验后），前列腺素D2（PGD2）从49.1±15.7（激发试验前）升至94.4±25.4 pg/ml（激发试验后），而6-酮-前列腺素F1α、血栓素B2（TXB2）以及前列腺素F2α和E2（PGF2α和PGE2）没有变化。在健康对照者中，乙酰甲胆碱激发试验后BAL液中的细胞谱和介质没有一致的变化。我们得出结论，吸入性乙酰甲胆碱可刺激哮喘患者释放LTB4和PGD2，但对健康对照者无此作用，且不影响BAL液中炎症细胞的数量。
