Lacoste J Y, Bousquet J, Chanez P, Van Vyve T, Simony-Lafontaine J, Lequeu N, Vic P, Enander I, Godard P, Michel F B
Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, Montpellier, France.
J Allergy Clin Immunol. 1993 Oct;92(4):537-48. doi: 10.1016/0091-6749(93)90078-t.
Eosinophils but not neutrophils may play a role in the airway inflammation of asthma. In chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD), neutrophils are present in the airways. To differentiate among the pathology of asthma, CB, and COPD eosinophils and neutrophils were studied in peripheral blood, bronchial biopsy specimens, and bronchoalveolar lavage fluid (BALF).
We studied nine nonsmoking healthy subjects, 20 nonsmoking patients with asthma, 10 nonatopic smoking patients with CB (forced expiratory volume in 1 second: 98.4% +/- 11.3%) and 17 patients with COPD (forced expiratory volume in 1 second: 51.2% +/- 14.3%). Eosinophils were characterized by their enumeration in biopsy specimens (EG2 monoclonal antibody), peripheral blood, and BALF and by measurement of eosinophil cationic protein in BALF. Neutrophils were characterized by their enumeration in biopsy specimens (anti-elastase monoclonal antibody) and BALF and by measurement of neutrophil-specific myeloperoxidase in BALF.
In patients with asthma we found degranulated eosinophils in biopsy specimens and significantly increased eosinophil cationic protein levels in BALF. In patients with CB or COPD, eosinophil numbers in biopsy specimens were not significantly different from those of patients with asthma, but cells were not degranulated and eosinophil cationic protein levels in BALF were similar to those of normal subjects. In patients with CB or COPD neutrophils were not increased in the mucosa, but neutrophil numbers and myeloperoxidase levels in BALF were significantly increased.
The percentages of neutrophils in BALF were greater in patients with COPD than in those with CB, suggesting a role in the chronic airflow limitation.
嗜酸性粒细胞而非中性粒细胞可能在哮喘的气道炎症中起作用。在慢性支气管炎（CB）和慢性阻塞性肺疾病（COPD）中，气道内存在中性粒细胞。为了区分哮喘、CB和COPD的病理情况，我们对外周血、支气管活检标本和支气管肺泡灌洗（BALF）中的嗜酸性粒细胞和中性粒细胞进行了研究。
我们研究了9名不吸烟的健康受试者、20名不吸烟的哮喘患者、10名非特应性吸烟的CB患者（一秒用力呼气量：98.4%±11.3%）和17名COPD患者（一秒用力呼气量：51.2%±14.3%）。通过在活检标本（EG2单克隆抗体）、外周血和BALF中计数嗜酸性粒细胞以及测量BALF中嗜酸性粒细胞阳离子蛋白来对嗜酸性粒细胞进行特征分析。通过在活检标本（抗弹性蛋白酶单克隆抗体）和BALF中计数中性粒细胞以及测量BALF中中性粒细胞特异性髓过氧化物酶来对中性粒细胞进行特征分析。
在哮喘患者中，我们在活检标本中发现了脱颗粒的嗜酸性粒细胞，并且BALF中嗜酸性粒细胞阳离子蛋白水平显著升高。在CB或COPD患者中，活检标本中的嗜酸性粒细胞数量与哮喘患者无显著差异，但细胞未脱颗粒，且BALF中嗜酸性粒细胞阳离子蛋白水平与正常受试者相似。在CB或COPD患者中，黏膜中的中性粒细胞未增加，但BALF中的中性粒细胞数量和髓过氧化物酶水平显著升高。
COPD患者BALF中中性粒细胞的百分比高于CB患者，提示其在慢性气流受限中起作用。
