Katsuki M
Department of Medicine, Kurume University School of Medicine, Japan.
Kurume Med J. 1996;43(4):279-87. doi: 10.2739/kurumemedj.43.279.
The present study was aimed at elucidating the role of inflammatory cells in the pathogenesis of the chronic inflammatory changes in the bronchioles of patients with diffuse panbronchiolitis (DPB) and at determining the mechanism for the clinical efficacy of erythromycin (EM) therapy for these patients. For this purpose, neutrophil percentages, neutrophil chemotactic activity (NCA), IL-8 and TNF-alpha in the bronchoalveolar lavage fluid (BALF) were measured in 9 patients with DPB. Significantly higher neutrophil percentages, NCA and IL-8 concentrations were demonstrated in the BALF from DPB patients than from chronic bronchitis (CB) patients or healthy control subjects. The levels of these indicators of chronic inflammation in the BALF from DPB patients were significantly decreased after EM therapy. TNF-alpha was elevated in the BALF from both DPB- and CB-patients and was not decreased by treatment of the DPB patients with EM. From the above results, it can be concluded that IL-8, not TNF-alpha, is the major chemoattractant for neutrophils and that the inhibition of IL-8 production by EM induces the subsequent depression of neutrophil accumulation in the peripheral airways, and consequently, prevents the peripheral airway tissue damage due to accumulated and activated neutrophils.
本研究旨在阐明炎症细胞在弥漫性泛细支气管炎（DPB）患者细支气管慢性炎症改变发病机制中的作用，并确定红霉素（EM）治疗这些患者临床疗效的机制。为此，对9例DPB患者的支气管肺泡灌洗液（BALF）中的中性粒细胞百分比、中性粒细胞趋化活性（NCA）、白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）进行了检测。结果显示，DPB患者BALF中的中性粒细胞百分比、NCA和IL-8浓度显著高于慢性支气管炎（CB）患者或健康对照者。EM治疗后，DPB患者BALF中这些慢性炎症指标水平显著降低。DPB患者和CB患者BALF中的TNF-α均升高，EM治疗DPB患者后TNF-α未降低。根据上述结果，可以得出结论，IL-8而非TNF-α是中性粒细胞的主要趋化因子，EM抑制IL-8产生可导致外周气道中性粒细胞聚集随后减少，从而防止外周气道组织因聚集和活化的中性粒细胞而受损。
