孟鲁司特和地塞米松对哮喘炎症的作用  

Effect of montelukast and dexamethasone on inflammation of asthma

作　　者：林闽加[1] 白建文[1] 张斗霞[1] 李锦师[1] 

机构地区：[1]同济大学东方医院急诊医学部,上海200120

出　　处：《上海交通大学学报（医学版）》2008年第1期61-65,共5页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨孟鲁司特(MK)和地塞米松(Dex)对哮喘炎症的影响。方法建立哮喘动物模型,并分别给予MK和Dex治疗。检测肺泡灌洗液(BALF)和肺组织病理学改变;采用原位杂交法检测肺和骨髓细胞IL-5mRNA的表达;免疫组化法检测骨髓IL-5免疫反应阳性细胞;流式细胞仪检测骨髓CD34+和CD3+细胞。结果MK和Dex治疗组BALF细胞总数、嗜酸粒细胞数均较哮喘组减少(P<0.01),并且两治疗组比较也有显著性差异(P<0.05);病理结果显示,哮喘组肺组织气道痉挛、炎性细胞浸润明显,两治疗组肺组织炎症明显改善。MK组和Dex组肺组织和骨髓细胞IL-5mRNA表达显著低于哮喘组(P<0.05,P<0.01),两治疗组比较有显著性差异(P<0.05);两治疗组骨髓IL-5免疫反应细胞和CD34+、CD3+细胞亦较哮喘组显著减少(P<0.01,P<0.05),但两治疗组比较无统计学差异(P>0.05)。结论MK和Dex均可显著抑制气道炎症和肺、骨髓细胞表达IL-5 mRNA,尽管MK某些方面逊色于Dex,但提示皮质激素与白三烯受体拮抗剂的联合应用可能是治疗哮喘的新方向。Objective To study the effect of montelukast （MK）and dexamethasone（Dex） on inflammation of asthma. Methods Asthma model was established and treated with MK or Dex. Bronchoalveolar lavage fluid （BALF） and histopathologic change were observed, IL-5mRNA of lung and bone marrow cells were detected by in situ hybridization, IL-5 immunoreactive cells by immunohistochemistry, and CD34^＋ and CD3^＋ of bone marrow cells by flow cytometry. Results Compared with asthma group, the number of total cells and eosinophils in BALF of MK group and Dex group were significantly decreased （ P 〈 0. 01 ）, and there also existed significant differences between the two treatment groups （ P 〈 0. 05）. It was revealed by pathological examination that there was an extensive airway inflammation in the lung of asthma group accompanied by airway spasm, however, the inflammation of the two treament groups were significantly improved. Data of in situ hybridization suggested that the expression of IL-5mRNA in lung tissue and bone marrow cells of the two treatment groups were significantly decreased than asthma group （P 〈 0. 05, P 〈 0. 01 ） , and there were also significant differences between the two treament groups（P 〈0.05）. Compared with asthma group, IL-5 immunoreactive cells, CD34^＋ and CD3 ^＋ cells in the bone marrow of treatment groups were significantly decreased （ P 〈 0. 01, P 〈 0. 05 ） , while there was no significant difference between the two treatment groups （P 〉 0. 05）. Conclusion MK and Dex can well inhibit airway inflammation and expression of IL-5mRNA in lung and bone marrow cells, though MK may be inferior to Dex in some aspects. The combined treatment of leukotriene receptor antagonist and glucocorticosteroid may be a new direction for asthma.

关 键 词：哮喘 白介素类 CD34 孟鲁司特 地塞米松 

分 类 号：R562.25[医药卫生—呼吸系统] R-332[医药卫生—内科学]