Kraft M, Bettinger C M, Wenzel S E, Irvin C G, Ackerman S J, Martin R J
Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206, USA.
Eur Respir J. 1995 Nov;8(11):1966-71. doi: 10.1183/09031936.95.08111966.
Methacholine (MCh) challenge testing is often incorporated into clinical studies prior to performing bronchoscopy as a measure of bronchial hyperresponsiveness (BHR). However, the effect of methacholine on many aspects of bronchoalveolar lavage (BAL) fluid cell count and function have not been fully evaluated. Ten patients with asthma, maintained on inhaled beta 2-agonists, were studied. Each subject underwent two bronchoscopies in a random order, one preceded by methacholine challenge within 30 min of the BAL. The investigators were blinded to the regimen. Several markers of BAL fluid cell number and function were studied: cell count and differential histamine, eosinophil products, including eosinophil cationic protein and Charcot-Leyden crystal protein, macrophage production of thromboxane B2 and leukotriene B4, neutrophil lysozyme and lactoferrin, and lymphocyte typing and activation markers measured via flow cytometry. No significant differences were noted in any of these markers of cell number or function which could be ascribed to methacholine challenge. Thus, methacholine challenge does not appear to affect these markers of cell number and function. These findings indicate that a methacholine challenge can be used as a measure of bronchial hyperresponsiveness within 30 min prior to bronchoscopy without altering bronchoalveolar lavage fluid characteristics.
在进行支气管镜检查之前，乙酰甲胆碱（MCh）激发试验常被纳入临床研究，作为支气管高反应性（BHR）的一项检测指标。然而，乙酰甲胆碱对支气管肺泡灌洗（BAL）液细胞计数及功能诸多方面的影响尚未得到充分评估。本研究纳入了10名使用吸入性β2受体激动剂治疗的哮喘患者。每位受试者随机接受两次支气管镜检查，其中一次在BAL前30分钟内先进行乙酰甲胆碱激发试验。研究人员对试验方案不知情。对BAL液细胞数量及功能的多个标志物进行了研究：细胞计数及分类、组胺、嗜酸性粒细胞产物，包括嗜酸性粒细胞阳离子蛋白和夏科-莱登结晶蛋白、巨噬细胞产生的血栓素B2和白三烯B4、中性粒细胞溶菌酶和乳铁蛋白，以及通过流式细胞术检测的淋巴细胞分型和活化标志物。在这些细胞数量或功能的标志物中，未发现任何可归因于乙酰甲胆碱激发试验的显著差异。因此，乙酰甲胆碱激发试验似乎不会影响这些细胞数量和功能的标志物。这些发现表明，在支气管镜检查前30分钟内，乙酰甲胆碱激发试验可作为支气管高反应性的一项检测指标，且不会改变支气管肺泡灌洗液的特征。
