Koh Y Y, Kim Y W, Park J D, Oh J W
Department of Pediatrics, Seoul National University Children's Hospital, Korea.
Clin Exp Allergy. 1996 Oct;26(10):1202-9.
Bronchial asthma is characterized by airway inflammation, which underlies the phenomenon of bronchial hyperresponsiveness. The concentration of serum haptoglobin (Hp), one of the acute phase reactant proteins, has been reported to correlate with bronchial hyperresponsiveness. The extent to which bronchoconstriction or airway inflammation contributes to airflow obstruction of exacerbation is presumed to determine the responsiveness to the initial bronchodilator therapy.
To see whether the Hp levels vary with the disease status of asthma, and also to test whether the Hp level at an acute exacerbation (AE) is correlated with the degree of response to initial bronchodilator therapy.
We measured serum Hp levels in 50 children with asthma at the times of an AE and a clinical remission(CR), and analysed the data according to the response to the initial bronchodilator therapy at AE.
The serum concentration of Hp at AE (228.5 +/- 80.8 mg/dl, mean +/- SD) was significantly (P < 0.01) higher than that at CR (152.3 +/- 49.8 mg/dl) in the total study population. The difference of Hp levels between AE and CR was more marked (101.7 +/- 82.2 mg/dl) in the subjects (n = 19) who responded poorly (post-bronchodilator FEV1 < 75% predicted) to the initial bronchodilator therapy at AE than that (61.0 +/- 56.5 mg/dl) of those (n = 31) who responded well (post-bronchodilator FEV1 > or = 75% predicted). The Hp level at AE correlated with the degree of response to initial bronchodilator therapy (r = (-)0.36, P < 0.05), whereas it had no relationship with the severity of exacerbation (r = 0.04, P = 0.79).
Our results showed that Hp levels may be increased at the time of exacerbation in a given asthma patient. The finding that the elevation of Hp level at AE is more marked in the cases with poor response to initial bronchodilator therapy at AE suggests that the increased Hp level at AE in asthma might reflect the degree of airway inflammation.
支气管哮喘的特征是气道炎症，这是支气管高反应性现象的基础。据报道，急性期反应蛋白之一的血清触珠蛋白（Hp）浓度与支气管高反应性相关。推测支气管收缩或气道炎症导致急性加重期气流受限的程度决定了对初始支气管扩张剂治疗的反应性。
观察Hp水平是否随哮喘疾病状态而变化，并检测急性加重期（AE）的Hp水平是否与初始支气管扩张剂治疗的反应程度相关。
我们测量了50例哮喘患儿在急性加重期和临床缓解期（CR）的血清Hp水平，并根据急性加重期对初始支气管扩张剂治疗的反应分析数据。
在整个研究人群中，急性加重期的血清Hp浓度（228.5±80.8mg/dl，平均值±标准差）显著高于临床缓解期（152.3±49.8mg/dl）（P<0.01）。在急性加重期对初始支气管扩张剂治疗反应不佳（支气管扩张剂后第一秒用力呼气容积<预测值的75%）的受试者（n=19）中，急性加重期与临床缓解期的Hp水平差异更为明显（101.7±82.2mg/dl），而在反应良好（支气管扩张剂后第一秒用力呼气容积≥预测值的75%）的受试者（n=31）中，该差异为（61.0±56.5mg/dl）。急性加重期的Hp水平与初始支气管扩张剂治疗的反应程度相关（r=(-)0.36，P<0.05），而与加重的严重程度无关（r=0.04，P=0.79）。
我们的结果表明，在特定哮喘患者的急性加重期，Hp水平可能会升高。急性加重期对初始支气管扩张剂治疗反应不佳的病例中，急性加重期Hp水平升高更为明显，这一发现表明哮喘急性加重期Hp水平升高可能反映气道炎症程度。
