小剂量茶碱对哮喘患者诱导痰中嗜酸粒细胞 Bcl-2、Bax蛋白表达的影响

目的 :研究小剂量茶碱对哮喘患者气道嗜酸粒细胞 (eosinophils ,Eos)Bcl 2、Bax蛋白表达的影响。方法 :选择 2 2名哮喘患者口服茶碱缓释片 (舒弗美 ,2 0 0mg·12h-1,平均血浆药物浓度 7.5mg·L-1)治疗 4周 ,观察治疗前后各项指标的变化。结果 :使用茶碱治疗后 ,Eos%明显低于治疗前 (2 9.0 5± 8.30vs 2 2 .5 4± 10 .32 ,P <0 .0 1) ;痰涂片Bcl 2 (+)Eos%治疗后显著低于治疗前 (4 .82± 2 .82vs 7.14± 3.5 1,P <0 .0 1) ;Bax(+)Eos%治疗后显著高于治疗前 (6 .0 9± 3.2 3vs 1.5 9± 1.4 0 ,P <0 .0 1) ;哮喘患者的症状明显好转 ,即哮喘症状评分好转 (5 .12± 1.4 7vs 7.17± 1.4 3,P <0 .0 5 ) ;肺功能明显改善。结论 :小剂量茶碱可使哮喘患者诱导痰中Eos的Bcl 2蛋白表达水平降低 ,Bax蛋白表达水平上升。提示哮喘患者诱导痰中Eos的Bcl 2蛋白表达水平可能作为衡量哮喘严重程度的一项指标 ;茶碱可能通过影响气道Eos的凋亡而发挥抗炎作用 ,其机制可能是通过在Eos中凋亡蛋白的表达水平来实现的。

Effects of Theophylline on the Expression of Bcl-2 and Bax Protein in Eosinophils in Induced Sputum of Asthmatic Patients

Objective: To study whether low dose theophylline has an impact on the expression of protein-Bcl-2,Bax in eosinophils(Eos) in airway of asthmatic patients. Methods: 22 asthmatic subjects were administered orally controlled releasing theophylline tablets (Shufumei) 200 mg twice a day for 4 weeks,and several indexes were determined. Results: It showed that Bcl-2(+)Eos% in the induced sputum was significantly lower than that before the treatment (4.82±2.82 vs 7.14±3.51,P<0.01) and Bax(+)Eos% was significantly higher than that before the treatment (6.09±3.23 vs 1.59±1.40,P<0.01) after the treatment of theophylline for four weeks. The symptom scores decreased significantly(17±1.43 vs 5.12±1.47,P<0.05). Conclusion: It is suggested that the administration of a low dose of oral theophylline in asthmatic patients seems to reduce the level of expression of protein-Bcl-2 and to increase the expression of protein-Bax. The level of expression of protein-Bcl-2 in eosinophils in the induced sputum may be applied as a marker of the severity of the asthma. Theophylline may reduce the airway inflammation by its effect on the apoptosis of airway eosinophils,and this mechanism may be in its influence in the apoptosis proteins.