嗜酸粒细胞性支气管炎与咳嗽变异性哮喘患者的气道炎症特征的研究  

The mechanism of airway inflammation in eosinophilic bronchitis and cough variant asthma

作　　者：王娇莉[1] 任振义[1] 夏俊波[1] 黄晟[1] 祁明浩[1] 王利民[1] 叶健[1] 

机构地区：[1]杭州市第一人民医院呼吸科,杭州310006

出　　处：《中华结核和呼吸杂志》2011年第6期433-437,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：杭州市科技发展计划基金（20080333804）;杭州市医药卫生科技计划项目（200880001）

摘　　要：目的探究嗜酸粒细胞性支气管炎（EB）和咳嗽变异性哮喘（CVA）患者气道炎症细胞、细胞因子和炎性介质的特征，阐明两者存在不同气道炎性特征的可能机制。方法检测杭州市第一人民医院门诊收治的15例EB患者（EB组）、15例CVA患者（CVA组）、14例支气管哮喘（简称哮喘）患者（哮喘组）和14名健康体检者（健康对照组）诱导痰中嗜酸粒细胞（EOS）百分比；流式细胞仪检测白细胞介素（IL）-5及干扰素（IFN）-γ刺激的EOS表面CD69的表达；实时荧光定量PCR方法检测各组诱导痰上清液中前列腺素E2（PGE2）、白三烯C4（LTC4）、IL-5、IFN-1mRNA的表达水平；酶联免疫吸附法（ELISA）检测各组诱导痰上清液中PGE2、LTC4、IFN-叫和IL-5蛋白表达水平。结果EB组、CVA组、哮喘组诱导痰中EOS百分比分别为（15．8±3．2）％、（13．04-2．7）％和（11．6±4．5）％，均明显高于健康对照组的（1．0±0．4）％（均P〈0．05）。在IL一5和IFN一叮刺激下，EB组诱导痰中EOS表达CD69分别为1．49±0．42和1．51±0．52、CVA组分别为1．37±0．41和1．42±0．32、哮喘组分别为1．42±0．72和1．37±0．46，3组间差异无统计学意义，但较健康对照组（分别为0．42±0．21和0．39±0．12）差异均有统计学意义（均P〈0．05）。EB组、CVA组、哮喘组诱导痰中IL-5的mRNA及蛋白表达水平明显高于健康对照组（均P〈0．05），但3组问差异无统计学意义；各组诱导痰中IFN-1的mRNA及蛋白表达水平较健康对照组差异均无统计学意义。EB组诱导痰中PGE2浓度为（8394-69）ng／L，明显高于CVA组的（33±8）ng／L、哮喘组的（25±6）ng／L和健康对照组的（24±8）ng／L（均P〈0．01），后3组差异无统计学意义；EB组PGE2限速酶前列腺素氧化环化酶2（PTGS2）的mRNA水平表达量显著增加，较CVA组、哮喘组及健康对照组差异均有统计学意义（均P〈0Objective To explore the characteristics of airway inflammatory cells, cytokines and inflammatory mediators in eosinophilic bronchitis （EB） and cough variant asthma （CVA） patients and to elucidate the underlying mechanism of distinct airway inflammation between EB and CVA. Methods This study included 15 patients with EB （EB group）, 15 patients with cough variant asthma （CVA, CVA group）, 14 patients with bronchial asthma （asthma group） and 14 healthy controls （healthy group）. Percentage of eosinophils （EOS） in sputum induced by hypertonic saline was detected by FACS. The percentage of CD69 EOS stimulated by interleukin-5 （1L-5） and interferon γ （IFN-γ） was also detected by FACS. The expression of leukotriene C4 synthase （LTC4S） and prostaglandin-endoperoxide synthase-2 （PTGS2） mRNA in sputum was measured by real-time PCR and the concentration of leukotriene C4 （LTC4） and prostaglandin E2 （ PGE2 ） in sputum was measured by ELISA. Results The percentage of EOS in induced sputum was 15. 8 ±3. 2 （EB group）, 13. 0 ±2. 7 （CVA group） and 11.6 ±4. 5 （asthma group）, respectively, which were significantly higher than 1.0 ± 0. 4 in the healthy group. The difference was significant and the t value was 16. 31, 15.23 and 14. 21 respectively （P 〈 0. 05）. After stimulated by IL-5 and IFN-γ the percentage of CD69 EOS in induced sputum was 1.5 ± 0.4 and 1.5 ±0. 5 （ EB group） , 1.4 ± 0. 4 and 1.4 ± O. 3 （ CVA group） and 1.42 ± 0. 72 and 1.37 -± 0. 46 （ asthma group） respectively. There was no statistical significance between these 3 groups, but when compared with 0. 4 ±0.2 and 0. 4± 0. 1 in healthy group, the difference was significant（P 〈0. 05 ）. The expression of IL-5 mRNA and protein in induced sputum of EB group, CVA group and asthma group were higher than the healthy group and the difference was all statistically different （ P 〈 0. 05 ） , but there was no statistical significance between EB group, CVA group and asthma gr

关 键 词：哮喘 支气管炎 慢性 炎症 地诺前列酮 

分 类 号：R562.25[医药卫生—呼吸系统]