Fujimoto K, Kubo K, Matsuzawa Y, Sekiguchi M
First Department of Internal Medicine, Shinshu University School of Medicine, Asahi, Matsumoto, Japan.
Chest. 1997 Nov 5;112(5):1241-7. doi: 10.1378/chest.112.5.1241.
Activated eosinophils play an important role in the pathogenesis of bronchial asthma. In this study, we analyzed the inflammatory leukocyte population and the concentrations of eosinophil cationic protein (ECP) and albumin in induced sputum from patients with mild to severe asthma (n=36), and assessed the findings in relation to the severity of their asthma. Both the eosinophil numbers and the concentrations of ECP in the induced sputum were significantly increased in the patients with asthma compared with those in healthy subjects (n=9). There were significant positive correlations between the ECP levels and both the eosinophil counts (r=0.45) and the albumin concentrations (r=0.53). When the asthmatics were classified as having mild (n=12), moderate (n=14), or severe (n=10) asthma as evaluated by their symptoms and peak expiratory flow rate (PEFR), the ECP levels showed significant increases in accordance with the severity of asthma. The eosinophil counts in the patients with severe asthma were significantly higher than those in the patients with mild and moderate asthma; there was no significant difference between those with mild and moderate asthma. The eosinophil counts and ECP levels were also significantly positively correlated with the mean weekly total symptom scores (r=0.52 and r=0.48, respectively) and negatively with the mean percent PEFR on waking (r=-0.50 and r=-0.65, respectively) recorded for 2 weeks prior to the sputum collection. These findings suggest that the eosinophil activation in the airway is closely linked to the symptoms and airflow obstruction of asthma, and that the ECP concentration in induced sputum could serve as useful marker for evaluating the severity of asthma and monitoring airway inflammation to achieve the optimal control of asthma.
活化的嗜酸性粒细胞在支气管哮喘的发病机制中起重要作用。在本研究中，我们分析了轻度至重度哮喘患者（n = 36）诱导痰中的炎症白细胞群体以及嗜酸性粒细胞阳离子蛋白（ECP）和白蛋白的浓度，并评估了这些结果与哮喘严重程度的关系。与健康受试者（n = 9）相比，哮喘患者诱导痰中的嗜酸性粒细胞数量和ECP浓度均显著增加。ECP水平与嗜酸性粒细胞计数（r = 0.45）和白蛋白浓度（r = 0.53）均呈显著正相关。根据症状和呼气峰值流速（PEFR）评估，将哮喘患者分为轻度（n = 12）、中度（n = 14）或重度（n = 10）哮喘时，ECP水平随哮喘严重程度显著升高。重度哮喘患者的嗜酸性粒细胞计数显著高于轻度和中度哮喘患者；轻度和中度哮喘患者之间无显著差异。嗜酸性粒细胞计数和ECP水平也与痰收集前2周记录的平均每周总症状评分显著正相关（分别为r = 0.52和r = 0.48），与醒来时的平均PEFR百分比显著负相关（分别为r = -0.50和r = -0.65）。这些发现表明，气道中的嗜酸性粒细胞活化与哮喘的症状和气流阻塞密切相关，诱导痰中的ECP浓度可作为评估哮喘严重程度和监测气道炎症以实现哮喘最佳控制的有用标志物。
