Maestrelli P, Saetta M, Di Stefano A, Calcagni P G, Turato G, Ruggieri M P, Roggeri A, Mapp C E, Fabbri L M
Institute of Occupational Medicine, University of Padova, Italy.
Am J Respir Crit Care Med. 1995 Dec;152(6 Pt 1):1926-31. doi: 10.1164/ajrccm.152.6.8520757.
To determine the relationship between inflammatory cells in sputum, bronchoalveolar lavage (BAL), and bronchial mucosa, we counted the number of leukocytes in sputum, BAL, and bronchial biopsies obtained from subjects with asthma and with chronic bronchitis in stable condition or during exacerbations. Sputum was induced by inhalation of hypertonic saline in the asthma group. Spontaneous sputum was collected in the chronic bronchitis groups. Differential counts of leukocytes were performed on cytospin preparations of sputum and BAL. Eosinophils, macrophages, neutrophils, and lymphocytes were quantified in the submucosa of the bronchial biopsies. In asthma and in stable chronic bronchitis, the percentages of neutrophils were significantly higher in sputum than in BAL, whereas the opposite was true of the percentages of macrophages and lymphocytes. The lymphocyte was the predominant cell infiltrating the bronchial submucosa in all groups. BAL eosinophils correlated with submucosal and sputum eosinophils in the asthma and exacerbated chronic bronchitis groups. A similar trend was observed between submucosal and sputum eosinophils. In conclusion, the relative proportion of inflammatory cells was different in sputum, BAL, and bronchial mucosa. However, there was a fairly good agreement between the number of eosinophils counted with the three techniques in asthmatics and in exacerbated chronic bronchitics, suggesting that sputum cell analysis may be used for a noninvasive assessment of airway eosinophilia.
为了确定痰液、支气管肺泡灌洗（BAL）液和支气管黏膜中炎症细胞之间的关系，我们对哮喘患者以及病情稳定或加重期的慢性支气管炎患者的痰液、BAL液和支气管活检组织中的白细胞进行了计数。哮喘组通过吸入高渗盐水诱导痰液生成。慢性支气管炎组收集自然咳出的痰液。对痰液和BAL液的细胞离心涂片进行白细胞分类计数。对支气管活检组织黏膜下层的嗜酸性粒细胞、巨噬细胞、中性粒细胞和淋巴细胞进行定量分析。在哮喘和稳定期慢性支气管炎患者中，痰液中中性粒细胞的百分比显著高于BAL液，而巨噬细胞和淋巴细胞的百分比情况则相反。在所有组中，淋巴细胞都是浸润支气管黏膜下层的主要细胞。在哮喘和加重期慢性支气管炎组中，BAL液嗜酸性粒细胞与黏膜下层及痰液嗜酸性粒细胞相关。在黏膜下层嗜酸性粒细胞和痰液嗜酸性粒细胞之间也观察到类似趋势。总之，痰液、BAL液和支气管黏膜中炎症细胞的相对比例有所不同。然而，在哮喘患者和加重期慢性支气管炎患者中，三种技术所计数的嗜酸性粒细胞数量之间存在相当好的一致性，这表明痰液细胞分析可用于气道嗜酸性粒细胞增多的无创评估。
