Kirchner K K, Wagener J S, Khan T Z, Copenhaver S C, Accurso F J
Department of Pediatrics, University of Colorado School of Medicine, The Children's Hospital, Denver, USA.
Am J Respir Crit Care Med. 1996 Nov;154(5):1426-9. doi: 10.1164/ajrccm.154.5.8912759.
Airway inflammation in children younger than 5 yr of age is difficult to assess, particularly in patients with cystic fibrosis (CF). Furthermore, determining responses to therapies is often subjective in infants, especially those with CF. To determine whether airway DNA levels could be used as an index of airway inflammation, we measured DNA levels in bronchoalveolar lavage fluid (BALF), using a Hoechst dye-binding assay. BALF DNA levels and neutrophils from 16 infants with CF were compared with levels obtained from seven older CF patients and nine control children who underwent bronchoalveolar lavage for evaluation of other pulmonary diseases. BALF DNA was increased in both infants (3.2 +/- 0.7 microg/ml) and older patients with CF (5.4 +/- 0.9 microg/ml) compared with the controls (0.7 +/- 0.2 microg/ml) (mean +/- SEM). BALF DNA levels were not significantly different between infants and older patients with CF. BALF neutrophil counts in CF patients were significantly higher than in controls. Furthermore, BALF DNA levels and total neutrophil counts in infants with CF correlated positively with one another. We conclude that: (1) DNA levels were easily quantifiable in BALF of young children; (2) DNA levels in BALF from CF patients were greater than in a group of children with other pulmonary diseases, and that in some infants with CF, BALF DNA levels were equivalent to those of much older patients with CF; (3) DNA levels in BALF correlate with BALF neutrophil number, an index of inflammation; and (4) some infants with CF have increased levels of DNA in BALF, which may justify a clinical trial of aerosolized rhDNase in this population.
5岁以下儿童的气道炎症难以评估，尤其是囊性纤维化（CF）患者。此外，对于婴儿，尤其是CF婴儿，确定对治疗的反应往往具有主观性。为了确定气道DNA水平是否可作为气道炎症的指标，我们使用Hoechst染料结合分析法测量了支气管肺泡灌洗液（BALF）中的DNA水平。将16例CF婴儿的BALF DNA水平和中性粒细胞与7例年龄较大的CF患者以及9例因评估其他肺部疾病而接受支气管肺泡灌洗的对照儿童所测得的水平进行比较。与对照组（0.7±0.2μg/ml）（均值±标准误）相比，CF婴儿（3.2±0.7μg/ml）和年龄较大的CF患者（5.4±0.9μg/ml）的BALF DNA均升高。CF婴儿和年龄较大的CF患者之间的BALF DNA水平无显著差异。CF患者的BALF中性粒细胞计数显著高于对照组。此外，CF婴儿的BALF DNA水平与总中性粒细胞计数呈正相关。我们得出以下结论：（1）幼儿BALF中的DNA水平易于定量；（2）CF患者BALF中的DNA水平高于患有其他肺部疾病的儿童组，并且在一些CF婴儿中，BALF DNA水平与年龄大得多的CF患者相当；（3）BALF中的DNA水平与作为炎症指标的BALF中性粒细胞数量相关；（4）一些CF婴儿的BALF中DNA水平升高，这可能为在该人群中进行雾化重组人脱氧核糖核酸酶的临床试验提供依据。
