Sun Y, Luo W
Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing.
Chin Med J (Engl). 1996 Jul;109(7):527-32.
To investigate whether persistent T lymphocyte activation is a feature of steroid-resistant (SR) asthma and to study the inhibitory effects of dexamethasone and other immuno-inhibiting agents on PHA-induced proliferation of peripheral blood T lymphocytes from SR and steroid-sensitive (SS) asthmatics.
15 SR and 15 SS asthmatics were studied. Serum levels of soluble interleukin-2 receptor (sIL-2R) were measured before and after prednisone therapy by an enzyme-linked immunosorbent assay. PHA-driven proliferative assay was performed to evaluate inhibition of T lymphocyte proliferation.
Serum levels of sIL-2R were elevated in both patients with SR and SS asthma as compared with normal controls (P < 0.001). After a 7-day course of prednisone (20 mg/day), serum levels of sIL-2R decreased significantly in SS asthmatics (P < 0.001) but not in SR asthmatics (P > 0.1). Proliferation of T lymphocytes from the sensitive but not the resistant asthmatics was significantly (P < 0.002) inhibited by dexamethasone (10 mol/L), reflecting a shift of the dose-response curve. In contrast, oxymatrine and thymus-derived immunosuppressors inhibited proliferation of T lymphocytes to a similar degree between SR and SS asthmatics.
The results suggest that persistent T lymphocyte activation due to a relative insensitivity of the cells to glucocorticoids is a feature of SR asthma. Immuno-inhibiting agents other than glucocorticoids may be of therapeutic benefit in patients with SR asthma.
研究持续性T淋巴细胞活化是否为激素抵抗（SR）哮喘的一个特征，并研究地塞米松和其他免疫抑制剂对SR哮喘患者及激素敏感（SS）哮喘患者外周血T淋巴细胞由PHA诱导的增殖的抑制作用。
对15例SR哮喘患者和15例SS哮喘患者进行研究。采用酶联免疫吸附测定法检测泼尼松治疗前后血清可溶性白细胞介素-2受体（sIL-2R）水平。进行PHA驱动的增殖试验以评估T淋巴细胞增殖的抑制情况。
与正常对照组相比，SR哮喘患者和SS哮喘患者血清sIL-2R水平均升高（P < 0.001）。经过7天的泼尼松（20 mg/天）疗程后, SS哮喘患者血清sIL-2R水平显著下降（P < 0.001），而SR哮喘患者则无明显下降（P > 0.1）。地塞米松（10 μmol/L）可显著抑制敏感哮喘患者而非抵抗哮喘患者的T淋巴细胞增殖（P < 0.002），这反映了剂量反应曲线的偏移。相比之下，氧化苦参碱和胸腺来源的免疫抑制剂对SR哮喘患者和SS哮喘患者T淋巴细胞增殖的抑制程度相似。
结果表明，由于细胞对糖皮质激素相对不敏感导致的持续性T淋巴细胞活化是SR哮喘的一个特征。糖皮质激素以外的免疫抑制剂可能对SR哮喘患者有治疗益处。
