Yoshikawa T, Shoji S, Fujii T, Kanazawa H, Kudoh S, Hirata K, Yoshikawa J
First Dept of Internal Medicine, Osaka City University Medical School, Osaka, Japan.
Eur Respir J. 1998 Oct;12(4):879-84. doi: 10.1183/09031936.98.12040879.
Exercise-induced bronchoconstriction (EIB) is widely prevalent in asthmatic patients. Eosinophilic airway inflammation is considered to be a major factor in the pathogenesis of asthma. However, the effects of eosinophilic airway inflammation on EIB have been elucidated insufficiently. To examine the relationship between the severity of EIB and eosinophilic inflammation, sputum induction and exercise challenge were performed in 21 asthmatic patients. Significantly higher percentages of eosinophils and levels of eosinophil cationic protein (ECP) were found in induced sputum in EIB-positive asthmatics (median (range), eosinophils: 23.5 (11.0-61.0)%; ECP: 1,475 (74.8-17,701) ng x mL(-1)) than in EIB-negative asthmatics (eosinophils: 6.0 (1.0-41.5)% (p=0.006); ECP: 270.6 (10.8-7,700) ng x mL(-1) (p=0.049)). There was a significant correlation between the severity of EIB and the sputum eosinophil percentage (r=0.59, p=0.009) and the level of ECP (r=0.47, p=0.037). The area under the curve of the forced expiratory volume in one second for 30 min after exercise correlated with the percentage of eosinophils (r=0.60, p=0.008) and the level of ECP (r=0.45, p=0.04). There was no correlation between airway responsiveness to methacholine on the one hand and EIB, sputum eosinophils or ECP on the other. In conclusion, these results provide evidence that the severity of bronchoconstriction evoked by exercise is more closely related to eosinophilic airway inflammation than airway hyperresponsiveness to methacholine in asthmatic patients.
运动诱发的支气管收缩（EIB）在哮喘患者中广泛存在。嗜酸性气道炎症被认为是哮喘发病机制中的一个主要因素。然而，嗜酸性气道炎症对EIB的影响尚未得到充分阐明。为了研究EIB严重程度与嗜酸性炎症之间的关系，对21例哮喘患者进行了痰液诱导和运动激发试验。EIB阳性哮喘患者诱导痰中的嗜酸性粒细胞百分比和嗜酸性粒细胞阳离子蛋白（ECP）水平显著高于EIB阴性哮喘患者（中位数（范围），嗜酸性粒细胞：EIB阳性患者为23.5（11.0 - 61.0）%，EIB阴性患者为6.0（1.0 - 41.5）%（p = 0.006）；ECP：EIB阳性患者为1475（74.8 - 17701）ng x mL⁻¹，EIB阴性患者为270.6（10.8 - 7700）ng x mL⁻¹（p = 0.049））。EIB严重程度与痰液嗜酸性粒细胞百分比（r = 0.59，p = 0.009）和ECP水平（r = 0.47，p = 0.037）之间存在显著相关性。运动后30分钟一秒用力呼气量曲线下面积与嗜酸性粒细胞百分比（r = 0.60，p = 0.008）和ECP水平（r = 0.45，p = 0.04）相关。气道对乙酰甲胆碱的反应性与EIB、痰液嗜酸性粒细胞或ECP之间没有相关性。总之，这些结果表明，在哮喘患者中，运动诱发的支气管收缩严重程度与嗜酸性气道炎症的关系比与气道对乙酰甲胆碱的高反应性更为密切。
