Vignola A M, Bonanno A, Mirabella A, Riccobono L, Mirabella F, Profita M, Bellia V, Bousquet J, Bonsignore G
Istituto di Fisiopatologia Respiratoria, Consiglio Nazionale delle Ricerche and Istituto di Medicina Generale e Pneumologia, Università di Palermo, Italy.
Am J Respir Crit Care Med. 1998 Feb;157(2):505-11. doi: 10.1164/ajrccm.157.2.9703070.
Asthma and chronic bronchitis are inflammatory diseases associated with remodeling of the extracellular matrix (ECM). Elastin, a major component of the ECM in the airways, has been previously found to be disrupted in asthma and chronic bronchitis. This study was aimed at evaluating whether elastin disruption might be associated with an imbalance between elastase (active and total) and alpha1-proteinase inhibitor (alpha1-PI), the main inhibitor of elastase. We measured elastase and alpha1-PI in induced sputum obtained from 16 control subjects, 10 healthy smokers, 19 asthmatic patients, and 10 chronic bronchitis patients. We also assessed the possible origin of elastase, evaluating its levels in sputum with reference to differential cell counts. We found that in induced sputum obtained from asthmatic and chronic bronchitis patients, the levels of both total and active elastase were significantly increased as compared with those of control subjects and healthy smokers and were significantly correlated with the percentage of neutrophils. In addition, in asthma and chronic bronchitis patients, the levels of active and total elastase were inversely correlated with the degree of airway obstruction as assessed from FEV1 values. This study shows that airway inflammation in asthma and chronic bronchitis is associated with high levels of active elastase, which may play a role in the pathogenesis of airway remodeling.
哮喘和慢性支气管炎是与细胞外基质(ECM)重塑相关的炎症性疾病。弹性蛋白是气道中细胞外基质的主要成分,此前已发现其在哮喘和慢性支气管炎中遭到破坏。本研究旨在评估弹性蛋白破坏是否可能与弹性蛋白酶(活性和总量)和α1-蛋白酶抑制剂(α1-PI,弹性蛋白酶的主要抑制剂)之间的失衡有关。我们测定了16名对照受试者、10名健康吸烟者、19名哮喘患者和10名慢性支气管炎患者诱导痰中的弹性蛋白酶和α1-PI。我们还评估了弹性蛋白酶的可能来源,参照不同细胞计数评估其在痰液中的水平。我们发现,与对照受试者和健康吸烟者相比,哮喘和慢性支气管炎患者诱导痰中弹性蛋白酶总量和活性水平均显著升高,且与中性粒细胞百分比显著相关。此外,在哮喘和慢性支气管炎患者中,根据第一秒用力呼气容积(FEV1)值评估,活性和总弹性蛋白酶水平与气道阻塞程度呈负相关。本研究表明,哮喘和慢性支气管炎中的气道炎症与高水平的活性弹性蛋白酶有关,活性弹性蛋白酶可能在气道重塑的发病机制中起作用。