Pedersen B, Iversen M, Bundgaard Larsen B, Dahl R
Dept of Respiratory Diseases, University Hospital of Aarhus, Denmark.
Eur Respir J. 1996 Mar;9(3):524-30.
The purpose of this study was to investigate whether pig farmers had inflammation of the bronchial mucosa and activation of bronchoalveolar lavage (BAL) cells. Pig farmers are exposed to high dust levels and have a prevalence of work-related respiratory symptoms. Bronchoscopy and BAL were performed in 27 young large-scale pig farmers, who had never smoked. Fifty three lifetime nonsmoking healthy students participated as controls. All farmers and controls had normal lung function (forced expiratory volume in one second (FEV1) 109 and 105% predicted respectively. Estimation of macroscopic signs of inflammation in the bronchi (erythema, oedema, secretion and friability) showed that pig farmers had significantly increased signs of inflammation. The median score was 3 (range 0-6) compared to a median score of 0 (range 0-3) in controls. More pig farmers than controls (41 versus 25%) had a positive histamine challenge (provocative dose producing a 20% fall in FEV1 (PC20) < or = 32 mg.mL-1) but the difference was not significant. The cell concentration in BAL fluid was identical in the two groups. Pig farmers had a significantly increased percentage of lymphocytes (median 7, range 1-27 versus median 2, range 0-7) and neutrophils (median 2, range 0-30 versus median 1, range 0-4) compared to controls. Spontaneous migration (19.8 versus 5.5 microns) and chemotaxis (62.6 versus 11.2 microns) was significantly increased in pig farmers compared to controls. After stimulation with zymosan and phorbol myristrate acetate (PMA), the reactive oxygen radical generation of purified alveolar macrophages was also significantly increased in pig farmers. Lifetime nonsmoking pig farmers with normal lung function have macroscopic signs of bronchial inflammation and an increased number of neutrophils in bronchoalveolar lavage. Their alveolar macrophages showed biological signs of activation. The inflammation of pig farmers bronchi may be early signs of bronchitis.
本研究的目的是调查养猪户是否存在支气管黏膜炎症以及支气管肺泡灌洗（BAL）细胞的激活情况。养猪户暴露于高粉尘环境中，且与工作相关的呼吸道症状患病率较高。对27名从未吸烟的年轻大型养猪户进行了支气管镜检查和BAL。53名终生不吸烟的健康学生作为对照。所有农民和对照者的肺功能均正常（一秒用力呼气量（FEV1）分别为预测值的109%和105%）。对支气管炎症的宏观体征（红斑、水肿、分泌物和脆性）进行评估显示，养猪户的炎症体征明显增加。中位数评分为3（范围0 - 6），而对照组的中位数评分为0（范围0 - 3）。组胺激发试验阳性（使FEV1下降20%的激发剂量（PC20）≤32 mg/mL）的养猪户比对照组更多（41%对25%），但差异不显著。两组BAL液中的细胞浓度相同。与对照组相比，养猪户的淋巴细胞百分比（中位数7，范围1 - 27，对照组中位数2，范围0 - 7）和中性粒细胞百分比（中位数2，范围0 - 30，对照组中位数1，范围0 - 4）显著增加。与对照组相比，养猪户的自发迁移（19.8对5.5微米）和趋化性（62.6对11.2微米）显著增加。在用酵母聚糖和佛波酯肉豆蔻酸酯（PMA）刺激后，养猪户纯化肺泡巨噬细胞的活性氧自由基生成也显著增加。肺功能正常的终生不吸烟养猪户有支气管炎症的宏观体征，支气管肺泡灌洗中的中性粒细胞数量增加。他们的肺泡巨噬细胞表现出激活的生物学迹象。养猪户支气管的炎症可能是支气管炎的早期迹象。
