雷公藤甲素通过IL-10/Th17细胞调节哮喘小鼠气道炎症

目的:探索雷公藤甲素对哮喘小鼠外周血白细胞介素-10(IL-10)、辅助性T17(Th17)细胞及气道炎症的影响。方法:32只雌性BALB/c小鼠随机分为对照组、哮喘组、雷公藤甲素组、地塞米松组,每组8只。对照组给予生理盐水致敏与激发,哮喘组给予卵清蛋白(OVA)致敏及激发,雷公藤甲素组在每次激发前给予40μg/(kg·d)雷公藤甲素腹腔注射干预,地塞米松组在每次激发前给予1 mg/(kg·d)地塞米松腹腔注射干预。最后一次激发24 h后收集各组小鼠肺泡灌洗液进行细胞分类计数,检测外周血细胞因子IL-10、外周血CD4+淋巴细胞中Th17细胞比例,对肺组织进行HE染色,评估小鼠气道炎症的变化。结果:哮喘组小鼠IL-10浓度明显低于对照组,Th17细胞比例明显高于对照组,且肺泡灌洗液细胞总数、嗜酸性粒细胞计数、中性粒细胞计数、气道周围炎症评分均明显高于对照组(均P 0. 01)。雷公藤甲素组及地塞米松组IL-10浓度较哮喘组明显升高,Th17细胞比例较哮喘组明显下降,且肺泡灌洗液细胞总数、嗜酸性粒细胞计数、中性粒细胞计数、气道周围炎症评分明显低于哮喘组(均P 0. 05),而雷公藤甲素组及地塞米松组之间上述指标比较差异无统计学意义(均P 0. 05)。结论:雷公藤甲素可能通过IL-10对Th17细胞的调节作用减轻气道周围炎症,为哮喘的临床治疗提供新的靶点。     

银杏内酯A通过p38MAPK通路减轻中性粒细胞性哮喘小鼠气道炎症

目的探索银杏内酯A(Ginkgolide A,GA)对中性粒细胞为主的哮喘小鼠气道炎症的影响及可能的机制。方法28只雌性BALB/c小鼠随机分为对照组、哮喘组、GA干预组、地塞米松(dexamethasone,DEX)干预组,每组7只。哮喘组于第0、14、21天给予20ug卵清蛋白(ovalbumin,OVA)+75ul氟氏制剂(complete Freund’s adjuvant,CFA)腹腔注射致敏,第22-24天连续3天5%OVA雾化激发,对照组给予PBS致敏与激发。GA干预组及DEX干预组分别在每次激发前1小时给予80mg/kg GA及1mg/kg DEX腹腔注射。末次激发24小时后,对各组小鼠进行肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中细胞总数及细胞分类计数,检测BALF中超氧化物歧化酶(superoxide dismutase,SOD)水平、肺组织中p-ERK、p-p38、p-p85的蛋白水平,并对各组小鼠肺组织病理学特征进行评价。结果与对照组比较,哮喘组小鼠BALF中细胞总数及中性粒细胞计数均明显增加、SOD水平明显下降,气道粘液分泌及周围炎症细胞聚集明显加重,肺组织中p-p38蛋白表达水平明显升高,差异具有统计学意义(P<0.05)。经银杏内酯A干预后,哮喘小鼠BALF中细胞总数及中性粒细胞计数明显减少、气道粘液分泌及气道周围炎症细胞聚集明显减轻,BALF中SOD水平明显升高,同时肺组织中p-p38的表达水平明显下降,差异具有统计学意义(P<0.05)。经地塞米松干预组,上述指标变化不明显(P>0.05)。结论银杏内酯A可减轻中性粒细胞为主的哮喘小鼠气道周围炎症及氧化应激过程,其作用机制与p38丝裂原激活蛋白激酶(p38 Mitogen-activated protein kinase,p38MAPK)通路有关,可作为中性粒细胞为主的哮喘的有效治疗药物。     

布地奈德上调支气管哮喘小鼠肺组织IDO、抑制气道炎症和气道高反应性的研究

目的研究布地奈德对急性支气管哮喘(简称哮喘)模型小鼠肺组织吲哚胺-2,3双加氧酶(IDO)表达、气道炎症和气道高反应性的干预作用。方法 18只SPF级BALB/c小鼠随机分为正常组、哮喘组、布地奈德组。卵白蛋白(OVA)致敏和激发建立哮喘模型。末次激发24h后,测定气道对乙酰胆碱的反应性,HE染色观察气道炎症细胞浸润,ELISA法检测血清总IgE、OVA特异性IgE(OVA-sIgE)以及支气管肺泡灌洗液(BALF)Th2细胞因子(IL-4和IL-13)。Western blot检测肺组织IDO蛋白表达。结果正常组小鼠气道阻力随乙酰胆碱浓度增加仅轻度增加,哮喘组气道阻力较正常组显著增高,布地奈德组气道阻力较哮喘组显著下降(P0.05);哮喘组血清总IgE和OVA-sIgE、BALF炎症细胞总数和嗜酸粒细胞分类计数、Th2细胞因子水平较正常组显著增高,布地奈德组炎症指标较哮喘组显著降低(P0.05);哮喘组肺组织IDO较正常组显著下降,布地奈德组肺组织IDO较哮喘组显著增高(P0.05)。结论布地奈德抑制急性哮喘模型气道炎症和气道高反应性,可能与上调肺组织IDO有关。     

布地奈德上调支气管哮喘小鼠肺组织IDO、抑制气道炎症和气道高反应性的研究

目的 研究布地奈德对急性支气管哮喘(简称哮喘)模型小鼠肺组织吲哚胺-2,3双加氧酶(IDO)表达、气道炎症和气道高反应性的干预作用.方法 18只SPF级BALB/c小鼠随机分为正常组、哮喘组、布地奈德组.卵白蛋白(OVA)致敏和激发建立哮喘模型.末次激发24 h后,测定气道对乙酰胆碱的反应性,HE染色观察气道炎症细胞浸润,ELISA法检测血清总IgE、OVA特异性IgE(OVA-sIgE)以及支气管肺泡灌洗液(BALF) Th2细胞因子(IL-4和IL-13).Western blot检测肺组织IDO蛋白表达.结果 正常组小鼠气道阻力随乙酰胆碱浓度增加仅轻度增加,哮喘组气道阻力较正常组显著增高,布地奈德组气道阻力较哮喘组显著下降(P＜0.05);哮喘组血清总IgE和OVA-sIgE、BALF炎症细胞总数和嗜酸粒细胞分类计数、Th2细胞因子水平较正常组显著增高,布地奈德组炎症指标较哮喘组显著降低(P＜0.05);哮喘组肺组织IDO)较正常组显著下降,布地奈德组肺组织IDO较哮喘组显著增高(P＜0.05).结论 布地奈德抑制急性哮喘模型气道炎症和气道高反应性,可能与上调肺组织IDO有关.     

哮喘气道中性粒细胞性炎症表型的临床意义

目的探讨哮喘中性粒细胞性气道炎症与临床控制的关系,为哮喘临床防治提供指导。方法选择2011年8月至2014年6月在第三军医大学新桥医院呼吸内科门诊就诊的中性粒细胞性哮喘患者40例,采集患者病史、ACT评分、诱导痰和肺功能等检查结果,统计分析诱导痰中性粒细胞百分比、绝对计数与ACT评分、FEV1%pred的相关性。结果在纳入的40例中性粒细胞哮喘患者中,女性26例(65.00%),男性14例,平均年龄(42.70±13.74)岁,发病年龄>12岁31例(77.50%),病程(11.32±12.25)年,ACT(17.15±4.80)分,诱导痰嗜酸粒细胞比例(0.49±0.80)%,诱导痰嗜酸粒细胞计数(0.03±0.06)×106/g,诱导痰中性粒细胞比例(73.79±5.83)%,诱导痰中性粒细胞计数(5.21±2.09)×106/g,FEV1%pred(75.50±21.83)%。在中性粒细胞哮喘组中,诱导痰中性粒细胞百分比、中性粒细胞绝对计数、细胞总数、ACT评分与FEV1%pred存在相关性(P<0.05,r分别为-0.373、-0.530、-0.519、0.552)。结论中性粒细胞性哮喘其临床特征多种多样;哮喘患者气道中性粒细胞性炎症与临床控制存在相关性,提示中性粒细胞炎症可能参与了气道阻塞的发生发展;ACT是一种简易评价哮喘控制水平的工具。     

白介素17抗体减轻吸烟所致慢性阻塞性肺疾病模型小鼠的气道炎症

目的 研究白介素17(interhukin-17,IL-17)抗体在吸烟所致慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)模型小鼠气道炎症中的作用.方法 C67/BL6雄性小鼠随机分为COPD组(8只)、COPD+IL-17抗体干预组(简称COPD+干预组,8只)和正常对照组(10只).对支气管肺泡灌洗液(BALF)进行细胞计数、染色和分类;用酶联免疫吸附试验检测小鼠肺组织匀浆IL-17水平,观察各组小鼠气道病理改变.结果 COPD组与COPD+干预组相比肺功能差异无统计学意义.COPD组、COPD+干预组小鼠与正常对照组相比BALF细胞总数显著增高[分别为(19.64±1.89)×104/ml,(15.47±2.99)×104/ml和(5.13±1.00)×104/ml,P＜0.01];COPD+干预组较COPD组细胞总数下降(P＜0.01);中性粒细胞比例[分别为(8.58+6.77)%,(22.98±8.46)%]及绝对值[(1.28±0.96)×104/ml,(4.53±1.73)×104/ml]显著下降(P值均＜0.01).肺组织HE染色病理评分COPD+干预组(73.25±18.58)较cOPD组(106.13±36.27)炎症有所减轻(P＜0.05).COPD+干预组小鼠肺组织匀浆中IL-17含量(0.084±0.041)pg/mg pro与COPD组(0.221±0.081)pg/mg pro相比显著降低(P＜0.01).结论 吸烟所致COPD小鼠模型中IL-17参与了中性粒细胞引起的气道炎症,抑制IL-17的表达,可以减少气道内中性粒细胞的数量,减轻气道炎症.     

粉防己碱抑制支气管哮喘小鼠肺组织核因子-κB和诱导型一氧化氮合酶的研究

目的：探讨粉防己碱对支气管哮喘(简称哮喘)小鼠肺组织核因子-κB(NF-κB)、诱导型一氧化氮合酶(iNOS)表达、气道炎症和气道高反应性的影响。方法将32只 SPF 级 BALB/c 小鼠随机分为正常组、哮喘组、地塞米松组(激素组)和粉防己碱组(Tet 组)。卵白蛋白(OVA)致敏和激发建立哮喘小鼠模型。末次激发24 h 后,肺功能仪测定小鼠气道阻力;HE 染色观察气道炎症细胞浸润;ELISA 检测血清总 IgE、OVA 特异性 IgE(OVA-sIgE)及 BALF 中 Th2细胞因子 IL-4和 IL-13水平;显微镜下计BALF 中细胞总数,瑞氏染色计嗜酸粒细胞分类计数;Western blot 检测肺组织 NF-κB 和 iNOS 蛋白表达水平。结果与正常组比较,哮喘组气道阻力、气道炎症浸润、BALF 炎症细胞总数和嗜酸粒细胞分类计数、血清总 IgE 和 OVA-sIgE、BALF 中 IL-4和 IL-13以及 NF-κB 和 iNOS 蛋白表达水平均显著增高(P <0.05);与哮喘组比较,激素和 Tet 干预组上述各项指标均显著降低(P <0.05)。结论粉防己碱可下调哮喘小鼠肺组织 NF-κB 和 iNOS 表达并抑制气道炎症和气道高反应性。     

瘦素对支气管哮喘大鼠气道炎症及Th1/Th2细胞因子表达作用的影响

目的 探讨瘦素对支气管哮喘(简称哮喘)大鼠气道炎症和Th1/Th2细胞因子表达的影响.方法 应用随机数字表法将40只雌性SD大鼠随机分为正常体重对照组(A组)、正常体重哮喘组(B组)、正常体重瘦素干预组(C组)、肥胖对照组(D组)和肥胖哮喘组(E组),建立大鼠肥胖和哮喘模型.测定气道反应性,计数BALF中白细胞总数、嗜酸粒细胞及中性粒细胞数目,ELISA法测定血清和BALF中白细胞介素(IL)-4、γ-干扰素(IFN-γ)及瘦素浓度,Western blot及逆转录PCR法测定肺组织瘦素蛋白及mRNA的表达.结果 C、E组大鼠以10、100、300 ug/kg浓度乙酰胆碱尾静脉注射后气道阻力[分别为(0.89±0.11)、(1.02±0.10)、(1.13±0.11)cm H2O·ml-1·s-1(1 cm H2O=0.098 kPa)和(0.95±0.10)、(1.12±0.10)、(1.14±0.10)cm H2O·ml-1·s-1],明显高于B组[分别为(0.64±0.13)、(0.74±0.07)、(0.77±0.09)cm H2O·ml-1·s-1],均P<0.05.C、E组BALF中白细胞总数[分别为(91±9)×104/ml和(108±21)×104/ml],中性粒细胞计数[分别为(12.4±4.0)×104/ml和(14.2±5.9)×104/ml]均高于B组[分别为(79±7)×104/ml和(2.4±1.1)×104/ml],均P<0.05.C、E组血清及BALF中IFN-γ浓度[分别为(42.3±3.5)、(45.1±4.8)、(19.2±1.8)和(20.3±1.5)ng/L]明显高于B组[分别为(16.5±1.4)和(9.3±1.0)ng/L],均P<0.05.C、E组肺组织瘦素蛋白及mRNA表达[分别为(0.40±0.07)、(0.44±0.05)ng/L和(0.34±0.06)、(0.38±0.04)ng/L]均明显高于B组[(0.31±0.03)ng/L和(0.21±0.04)ng/L],均P<0.05.结论 瘦素可促进哮喘气道炎症,并以中性粒细胞浸润和Th1型炎症反应增强为特点.     

半乳糖凝集素-1抑制过敏性哮喘小鼠Th2型炎症反应的研究

目的探讨半乳糖凝集素-1(galectin-1)抑制过敏性哮喘小鼠模型Th2型炎症反应的作用机制。方法54只BALB/c雌性小鼠随机均分为健康对照组、卵清蛋白(OVA)组和治疗组。在第0、3、7天,OVA组和治疗组小鼠分别皮下注射致敏液[含100μg OVA混合相同体积10%Al(OH)3佐剂],健康对照组注射等量生理盐水。最后1次注射后7 d,OVA组和治疗组小鼠分别进行滴鼻激发(50μg OVA),健康对照组使用50μl生理盐水,每天激发1次。治疗组在激发2 h后,给予galectin-1(1μg/ml)进行滴鼻治疗,健康对照组和OVA组使用生理盐水(10μl),连续7 d。第22天,检测3组小鼠气道高反应;收集肺泡灌洗液(BALF),吉氏染色后,对炎症细胞进行分类并计数;肺组织切片用HE染色后,镜下观察肺组织炎症病理变化;取眼球血,ELISA检测血清中过敏原特异性IgE和Th2型炎症细胞因子白细胞介素-4(IL-4)、IL-5、IL-13,以及γ干扰素(IFN-γ)、IL-10、转化生长因子-β(TGF-β)的表达水平。取脾淋巴细胞,流式细胞术检测调节性T细胞(Treg)的比例。结果气道高反应性结果显示,治疗组小鼠的气道高反应性(Penh值为2.08±0.17)较OVA组(Penh值为5.77±0.64)降低(P<0.05)。治疗组小鼠BALF中的嗜酸粒细胞、巨噬细胞和中性粒细胞数量分别为(1.33±0.52)×10^4/ml、(1.16±0.41)×10^4/ml、(1.33±0.52)×10^4/ml,与OVA组的[(7.00±1.41)×10^4/ml、(5.00±0.63)×10^4/ml、(5.50±0.84)×10^4/ml]比较,差异有统计学意义(P<0.05)。肺组织HE染色切片镜检显示,OVA组小鼠支气管周围出现炎症细胞浸润和气道壁增厚;治疗组小鼠的肺部炎症较OVA组改善,且与健康对照组相似。血清ELISA检测结果显示,治疗组血清中过敏原特异性IgE为0.24±0.06,IL-4、IL-5、IL-13的表达水平分别为(104.49±20.76)pg/ml、(82.82±7.71)pg/ml和(31.59±9.78)pg/ml,均较OVA组的[0.87±0.10,(442.72±14.97)、(445.18±35.60)和(434.67±9.78)pg/ml]降低(P<0.05)。治疗组血清中的IFN-γ、IL-10、TGF-β的表达水平分别为(120.80±9.71)、(63.05±6.05)、(67.89±6.64)pg/ml,均较OVA组的[(47.28±5.01)、(23.89±2.98)、(15.49±3.75)pg/ml]提高(P<0.05)。流式细胞术检测结果显示,治疗组的Treg比例为(9.64±0.41)%,较OVA组的(1.81±0.48)%增加(P<0.05)。结论Galectin-1通过促进机体调节性T细胞和调节性细胞因子IFN-γ、IL-10、TGF-β的生成抑制小鼠过敏性哮喘Th2型炎症反应。     

法舒地尔对支气管哮喘小鼠肺组织Rho激酶-1表达及气道炎症的影响

目的 观察Rho激酶-1抑制剂法舒地尔对支气管哮喘(简称哮喘)小鼠肺组织Rho激酶-1表达及气道炎症的影响,探讨Rho激酶-1在哮喘气道炎症中的作用机制.方法 将24只BalB/c小鼠采用随机数字表法分为对照组、哮喘组和干预组,每组8只.哮喘组、干预组小鼠分别给予卵清白蛋白(OVA)致敏和激发.每次雾化前1 h,干预组给予法舒地尔(10 mg/kg)腹腔注射.末次激发后收集BalF,离心后计数细胞总数及嗜酸粒细胞(EOS)数量.ELISA法测定BalF上清液中嗜酸粒细胞趋化因子(Eotaxin)、白细胞介素(IL)-5和IL-13水平.肺组织HE染色.采用逆转录PCR和免疫组织化学测定各组小鼠肺组织中Rho激酶-1 mRNA和蛋白的表达水平.结果 (1)哮喘组BalF中细胞总数及EOS数量分别为(1.45±0.12)× 10~9/L和(0.52 ±0.06)× 10~9/L,明显高于对照组[分别为(0.58±0.06)×10~9/L和(0.01±0.01)×10~9/L](q值分别为25.909和35.002,均P＜0.01)和干预组[分别为(0.89 ±0.09)×10~9/L和(0.20±0.04)×10~9/L](q值分别为16.676和21.537,均P＜0.01).(2)哮喘组Eotaxin、IL-5及IL-13水平分别为(45±8)ng/L、(157 ±23)ng/L和(429±46)ng/L,明显高于对照组[分别为(10 ±3)ng/L、(26±6)ng/L和(126 ±20)ng/L](q值分别为18.246、23.009、25.826,均P＜0.01);干预组分别为(20±5)ng/L、(57 ±14)ng/L和(254±28)ng/L,明显低于哮喘组(q值分别为13.119、17.503、8.449,均P＜0.01).(3)对照组小鼠气道周围无炎症细胞浸润,哮喘组小鼠气道黏膜水肿,气道壁及管周有大量以EOS为主的炎症细胞浸润,干预组气道炎症反应较哮喘组减轻.(4)哮喘组肺组织Rho激酶-1 mRNA和蛋白的表达水平明显高于对照组(q值分别为25.614和8.156,均P＜0.01),干预组Rho激酶-1 mRNA和蛋白表达水平低于哮喘组(q值分别为20.379和4.135,均P＜0.01).(5)Rho激酶-1 mRNA表达量与BalF中EOS数量、Eotaxin、IL-5和IL-13水平呈正相关(r值分别为0.709、0.600、0.613、0.650,均P＜0.01).结论 Rho激酶-1参与过敏原诱导的哮喘小鼠气道炎症的发生,应用法舒地尔抑制其表达和活性可能改善哮喘气道炎症.     

IRAK-M knockout promotes allergic airway inflammation,but not airway hyperresponsiveness,in house dust mite-induced experimental asthma model

BackgroundIL-1 receptor associated-kinase (IRAK)-M, expressed by airway epithelium and macrophages, was shown to regulate acute and chronic airway inflammation exhibiting a biphasic response in an OVA-based animal model. House dust mite (HDM) is a common real-life aeroallergen highly relevant to asthma pathogenesis. The role of IRAK-M in HDM-induced asthma remains unknown. This study was aimed to investigate the effect of IRAK-M on allergic airway inflammation induced by HDM using IRAK-M knockout (KO) mice and the potential underlying mechanisms.MethodsIRAK-M KO and wild-type (WT) mice were sensitized and challenged with HDM. The differences in airway inflammation were evaluated 24 hours after the last challenge between the two genotypes of mice using a number of cellular and molecular biological techniques. In vitro mechanistic investigation was also involved.ResultsLung expression of IRAK-M was significantly upregulated by HDM in the WT mice. Compared with the WT controls, HDM-treated IRAK-M KO mice showed exacerbated infiltration of inflammatory cells, particularly Th2 cells, in the airways and mucus overproduction, higher epithelial mediators IL-25, IL-33 and TSLP and Th2 cytokines in bronchoalveolar lavage (BAL) fluid. Lung IRAK-M KO macrophages expressed higher percentage of costimulatory molecules OX40L and CD 80 and exhibited enhanced antigen uptake. However, IRAK-M KO didn’t impact the airway hyperreactivity (AHR) indirectly induced by HDM.ConclusionsThe findings indicate that IRAK-M protects allergic airway inflammation, not AHR, by modifying activation and antigen uptake of lung macrophages following HDM stimulation. Optimal regulation of IRAK-M might indicate an intriguing therapeutic avenue for allergic airway inflammation.     

γ-促分泌酶抑制剂阻断Notch信号对支气管哮喘模型小鼠气道炎症的影响

目的研究γ-促分泌酶抑制剂阻断Notch信号对支气管哮喘（简称哮喘）模型小鼠气道炎症反应的影响,为哮喘治疗寻找新的药物提供理论基础。方法制作小鼠哮喘模型,在小鼠激发阶段尾静脉注射γ-促分泌酶抑制剂MW167,采用RT-PCR方法检测小鼠肺T细胞IL-4mRNA及IFN-γmRNA的表达,ELISA方法检测外周血清及BALF上清中IL-4及IFN-γ水平。结果 MW167注射组较哮喘组病理学改变减轻,而肝及肾无明显形态学改变,MW167阻断Notch信号后,MW167注射组小鼠肺T细胞IL-4mRNA的表达较哮喘组减弱,而IFN-γmRNA的表达增强（IL-4：0.119±0.045比0.414±0.214,P〈0.01;IFN-γ：0.459±0.205比0.170±0.050,P〈0.01）;MW167注射组外周血清及BALF中IL-4的表达较哮喘组减弱[血清：（19.601±0.870）ng/L比（26.046±2.211）ng/L,P〈0.05;BALF：（75.077±14.438）ng/L比（113.478±8.628）ng/L,P〈0.01）];外周血清中及BALF中IFN-γ的表达较对照组增强[血清：（10.644±3.338）ng/L比（5.119±2.230）ng/L,P〈0.01];BALF：（26.131±3.608）ng/L比（21.299±2.830）ng/L,P〈0.01]。结论静脉注射γ-促分泌酶抑制剂抑制了哮喘模型小鼠气道炎症,对哮喘有潜在的治疗价值。     

Eicosanoids modulate hyperpnea-induced late phase airway obstruction and hyperreactivity in dogs.

A canine model of exercise-induced asthma was used to test the hypothesis that the development of a late phase response to hyperventilation depends on the acute production of pro-inflammatory mediators. Peripheral airway resistance, reactivity to hypocapnia and aerosol histamine, and bronchoalveolar lavage fluid (BALF) cell and eicosanoid content were measured in dogs approximately 5 h after dry air challenge (DAC). DAC resulted in late phase obstruction, hyperreactivity to histamine, and neutrophilic inflammation. Both cyclooxygenase and lipoxygenase inhibitors administered in separate experiments attenuated the late phase airway obstruction and hyperreactivity to histamine. Neither drug affected the late phase inflammation nor the concentrations of eicosanoids in the BALF obtained 5 h after DAC. This study confirms that hyperventilation of peripheral airways with unconditioned air causes late phase neutrophilia, airway obstruction, and hyperreactivity. The late phase changes in airway mechanics are related to the hyperventilation-induced release of both prostaglandins and leukotrienes, and appear to be independent of the late phase infiltration of inflammatory cells.     

Lipopolysaccharides promote a shift from Th2-derived airway eosinophilic inflammation to Th17-derived neutrophilic inflammation in an ovalbumin-sensitized murine asthma model

Introduction: The currently available treatments for severe asthma are insufficient. Infiltration of neutrophils rather than eosinophils into the airways is an important inflammatory characteristic of severe asthma. However, the mechanism of the phenotypic change from eosinophilic to neutrophilic inflammation has not yet been fully elucidated. Methods: In the current study, we examined the effect of lipopolysaccharides (LPS) on eosinophilic asthmatic mice sensitized with ovalbumin (OVA), as well as the roles of interleukin (IL)-17A/T helper (Th) 17 cells on the change in the airway inflammatory phenotype from eosinophilic to neutrophilic inflammation in asthmatic lungs of IL-17A-deficient mice. Results: Following exposure of OVA-induced asthmatic mice to LPS, neutrophil-predominant airway inflammation rather than eosinophil-predominant inflammation was observed, with increases in airway hyperresponsiveness (AHR), the IL-17A level in bronchoalveolar lavage fluid (BALF) and Th17 cells in the spleen and in the pulmonary hilar lymph nodes. Moreover, the neutrophilic asthmatic mice showed decreased mucus production and Th2 cytokine levels (IL-4 and IL-5). In contrast, IL-17A knockout (KO) mice exhibited eosinophil-predominant lung inflammation, decreased AHR, mucus overproduction and increased Th2 cytokine levels and Th2 cells. Conclusion: These findings suggest that the eosinophilic inflammatory phenotype of asthmatic lungs switches to the neutrophilic phenotype following exposure to LPS. The change in the inflammatory phenotype is strongly correlated with the increases in IL-17A and Th17 cells.     

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

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-γ mRNA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-γ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)%、(13.0±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-5和IFN-γ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组间差异无统计学意义;各组诱导痰中IFN-γ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(839±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<0.01);CVA、EB和哮喘组诱导痰中LTC4浓度明显高于健康对照组(均P<0.05),CVA、EB及哮喘组中LTC4限速酶白三烯C4合成酶(LTC4S)的mRNA表达水平明显高于健康对照组(均P<0.05),EB组LTC4的mRNA及蛋白表达水平与CVA组和哮喘组比较,差异也有统计学意义(均P<0.05).CVA组、哮喘组诱导痰中LTC4/PGE2比值明显高于EB组(t值分别为8.67和13.12,均P<0.05).结论 EB患者诱导痰中PGE2高表达以及CVA组LTC4/PGE2比值较EB组显著增高,这两者可能是EB缺乏气道高反应性的炎症基础.

Abstract：

Objective 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 CD+69 EOS stimulated by interleukin-5 (IL-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 CD+69 EOS in induced sputum was 1.5±0.4 and 1.5±0.5 (EB group), 1.4±0.4 and 1.4±0.3 (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 group. The expression of IFN-γ mRNA and protein in induced sputum of each group was not different when compared with healthy group (P＞0.05). The concentration of PGE2 in induced sputum of EB group was(839±69)ng/L, which was higher than (33±8) ng/L of CVA group, (25±6) ng/L of asthma group and (24±8) ng/L of healthy group (all P<0.01). There was no statistical difference between CVA group, asthma group and healthy group. The expression of PTGS2 in induced sputum of EB group increased significantly; when compared with CVA group, asthma group and healthy group, the difference was significant (all P<0.01). The concentration of LTC4 in induced sputum of EB group, CVA group and asthma group was all higher than the healthy group (all P<0.05). The expression of LTC4S mRNA of EB group, CVA group and asthma group was also higher than the healthy group (all P<0.05). The expression of LTC4S mRNA and LTC4 in the EB group was higher than that in the CVA group and the asthma group (P<0.05). The value of LTC4/PGE2 in the CVA group and the asthma group was higher than that in the EB group (t=8.7 and 13.1, P<0.05). Conclusion These data suggest that the difference in airway function observed in subjects with eosinophilic bronchitis and CVA (or asthma) may be due to the results of differences in PGE2 production and an imbalance between the production of bronchoconstrictor LTC4 and bronchoprotective PGE2 lipid mediators.     

YKL-40（BRP-39）与支气管哮喘

支气管哮喘（简称哮喘）是-种由多种炎症细胞、炎症因子参与的慢性气道炎症性疾病,Th2分化过度在哮喘气道炎症中起重要作用。YKL40（BRP-39）是新近发现的壳质酶类似物蛋白,参与多种疾病的炎症反应、组织结构重塑等病理过程。YKL-40可通过促进哮喘患者Th2活化、分化并减少其凋亡,增加Th2数量,在哮喘慢性气道炎症中起着重要作用。     

Eosinophilic and Neutrophilic Airway Inflammation in the Phenotyping of Mild-to-Moderate Asthma and Chronic Obstructive Pulmonary Disease

Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases with different inflammatory phenotypes. Various inflammatory mediators play a role in these diseases. The aim of this study was to analyze the neutrophilic and eosinophilic airway and systemic inflammation as the phenotypic characterization of patients with asthma and COPD. Twenty-four patients with asthma and 33 patients with COPD were enrolled in the study. All the patients were in mild-to-moderate stage of disease, and none of them were treated with inhaled corticosteroids. Concentrations of IL-6, neutrophil elastase (NE), matrix metalloproteinase 9 (MMP-9), eosinophil cationic protein (ECP), and IL-33 and IL-17 in serum and induced sputum (IS) were measured by enzyme-linked immunosorbent assay (ELISA). The cellular composition of blood and IS was evaluated. Hierarchical clustering of patients was performed for the combination of selected clinical features and mediators. Asthma and COPD can be differentiated based on eosinophilic/neutrophilic systemic or airway inflammation with unsatisfactory efficiency. Hierarchical clustering of patients based on blood eosinophil percentage and clinical data revealed two asthma clusters differing in the number of positive skin prick tests and one COPD cluster with two subclusters characterized by low and high blood eosinophil concentrations. Clustering of patients according to IS measurements and clinical data showed two main clusters: pure asthma characterized by high eosinophil/atopy status and mixed asthma and COPD cluster with low eosinophil/atopy status. The neutrophilic phenotype of COPD was associated with more severe airway obstruction and hyperinflation.     

Continuous exposure to house dust mite elicits chronic airway inflammation and structural remodeling

It is now fully appreciated that asthma is a disease of a chronic nature resulting from intermittent or continued aeroallergen exposure leading to airway inflammation. To investigate responses to continuous antigen exposure, mice were exposed to either house dust mite extract (HDM) or ovalbumin intranasally for five consecutive days, followed by 2 days of rest, for up to seven consecutive weeks. Continuous exposure to HDM, unlike ovalbumin, elicited severe and persistent eosinophilic airway inflammation. Flow cytometric analysis demonstrated an accumulation of CD4+ lymphocytes in the lung with elevated expression of inducible costimulator a marker of T cell activation, and of T1/ST2, a marker of helper T Type 2 effector cells. We also detected increased and sustained production of helper T cell Type 2-associated cytokines by splenocytes of HDM-exposed mice on in vitro HDM recall. Histologic analysis of the lung showed evidence of airway remodeling in mice exposed to HDM, with goblet cell hyperplasia, collagen deposition, and peribronchial accumulation of contractile tissue. In addition, HDM-exposed mice demonstrated severe airway hyperreactivity to methacholine. Finally, these responses were studied for up to 9 weeks after cessation of HDM exposure. We observed that whereas airway inflammation resolved fully, the remodeling changes did not resolve and airway hyperreactivity resolved only partly.