慢性支气管炎急性加重期支气管肺泡粒细胞及粒细胞/巨噬细胞集落刺激因子增加。
Increased bronchoalveolar granulocytes and granulocyte/macrophage colony-stimulating factor during exacerbations of chronic bronchitis.
作者信息
Balbi B, Bason C, Balleari E, Fiasella F, Pesci A, Ghio R, Fabiano F
机构信息
Salvatore Maugeri Foundation, IRCCS, Rehabilitation Institute of Veruno, Section of Varallo Sesia, Italy.
出版信息
Eur Respir J. 1997 Apr;10(4):846-50.
Although inflammatory changes are found throughout the airways of patients with chronic bronchitis, the mechanisms of the pathogenesis of chronic bronchitis are still unclear. The aim of this study was to investigate airways inflammation in patients with and without an exacerbation of bronchitis. Thirteen chronic bronchitic patients and nine normal subjects were studied. Eight of the patients were studied under baseline conditions (B), and five during an exacerbation of bronchitis (E). Bronchoscopy and bronchoalveolar lavage (BAL) with cytological analysis were performed, and the levels of granulocyte/macrophage colony-stimulating factor (GM-CSF) were determined in sera and in BAL supernatants by a solid phase enzyme immunoassay. Compared with patients under baseline conditions, chronic bronchitic patients with an exacerbation had increased numbers of BAL neutrophils (10+/-3 and 83+/-18x10(3) cells x mL(-1), respectively; p<0.0001) and of BAL eosinophils (1.9+/-0.5 and 6.7/-1.9x10(3) cells x mL(-1), respectively; p=0.014). Patients with chronic bronchitis, as a whole, had significantly increased levels of BAL GM-CSF compared to control subjects (36+/-5 and 19+/-4 pg x mL(-1), respectively; p=0.035), and similar levels of serum GM-CSF. Serum levels of GM-CSF were markedly increased in chronic bronchitic patients with an exacerbation, as compared with patients under baseline conditions (1.4+/-0.4 and 13+/-1 pg x mL(-1), respectively; p <0.0001). BAL levels of GM-CSF were also increased in chronic bronchitic patients with an exacerbation (25+/-5 and 54+/-8 pg x mL(-1), respectively; p=0.009). During exacerbations of chronic bronchitis there are changes in the cell populations in bronchoalveolar lavage of patients consistent with a recruitment of polymorphonuclear leucocytes in the airway lumen. The increased levels of granulocyte/macrophage colony-stimulating factor might suggest a role for this cytokine in the inflammatory processes of chronic bronchitis.
虽然在慢性支气管炎患者的整个气道中都发现了炎症变化，但慢性支气管炎的发病机制仍不清楚。本研究的目的是调查支气管炎加重期和非加重期患者的气道炎症。对13例慢性支气管炎患者和9名正常受试者进行了研究。其中8例患者在基线条件下（B）进行研究，5例在支气管炎加重期（E）进行研究。进行了支气管镜检查和支气管肺泡灌洗（BAL）及细胞学分析，并通过固相酶免疫测定法测定血清和BAL上清液中粒细胞/巨噬细胞集落刺激因子（GM-CSF）的水平。与基线条件下的患者相比，加重期的慢性支气管炎患者BAL中性粒细胞数量增加（分别为10±3和83±18×10³细胞×mL⁻¹；p<0.0001），BAL嗜酸性粒细胞数量也增加（分别为1.9±0.5和6.7±1.9×10³细胞×mL⁻¹；p=0.014）。总体而言，慢性支气管炎患者BAL中GM-CSF水平显著高于对照组（分别为36±5和19±4 pg×mL⁻¹；p=0.035），血清GM-CSF水平相似。与基线条件下的患者相比，加重期的慢性支气管炎患者血清GM-CSF水平显著升高（分别为1.4±0.4和13±1 pg×mL⁻¹；p<0.0001）。加重期的慢性支气管炎患者BAL中GM-CSF水平也升高（分别为25±5和54±8 pg×mL⁻¹；p=0.009）。在慢性支气管炎加重期，患者支气管肺泡灌洗中的细胞群发生变化，这与气道腔内多形核白细胞的募集一致。粒细胞/巨噬细胞集落刺激因子水平的升高可能表明该细胞因子在慢性支气管炎的炎症过程中起作用。
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