肺泡巨噬细胞在慢性阻塞性肺疾病气道炎症中的作用

目的探讨肺泡巨噬细胞(AM)在慢性阻塞性肺疾病(COPD)气道炎症中的作用.方法收集支气管肺泡灌洗液(BALF)和支气管黏膜,用ELISA法测定BALF和AM培养上清液中巨噬细胞炎症蛋白(MIP)-lα、明胶酶B(MMP-9)及白细胞介素(IL)-8的浓度,用放射免疫法测内皮素(ET)浓度,用免疫组化法测BALF中淋巴细胞功能相关抗原1阳性(LFA-1+)AM数、黏膜内CD+/68细胞数和气道黏膜厚度.结果COPD组AM培养上清液中MIP-1α、MMP-9、ET、IL-8的浓度分别为(1446.9±126.7)μg/L、(16.98±5.15)μg/L、(43.98±5.54)ng/L、(168.10±21.22)μg/L,正常对照组为(1123.5.5±90.6)μg/L、(5.24±0.93)μg/L、(25.99±6.05)ng/L、(124.68±9.96)μg/L;COPD组支气管黏膜内CD+/68细胞数为(1.71±0.48)细胞/Hp,正常对照组为(0.59±0.18)细胞;COPD组支气管黏膜厚度为(1.96±0.96)×100-μm,正常对照组为(0.83±0.43)×10-1μg;两组比较差异均有显著性.BALF中AM数、AM培养上清液中MMP-9及ET的浓度、黏膜内CD+/68细胞数均与1秒钟用力呼气容积(FEV1)占预计值的百分比呈负相关(r=-0.511,P《0.01;r=-0.678,P《0.01;r=-0.871,P《0.01;r=-0.588,P《0.01);BALF中MIP-1α浓度、IFA-1+AM数与AM数呈正相(r=0.572,P《0.01;r=0.625,P《0.01).结论AM在COPD气道炎症和气道重建的发展过程中可能具有重要作用.

Alveolar macrophage and airway inflammation in patients with chronic obstructive pulmonary disease

OBJECTIVE: To investigate the effects of alveolar macrophage(AM) on airway inflammation of chronic obstructive pulmonary disease(COPD). METHODS: Broncho alveolar fluid(BALF) and bronchial mucosa biopsies were performed as usual. The levels of macrophage inflammatory-1 alpha (MIP-1 alpha), gelatinase B (MMP-9), interleukin(IL)-8 in BALF and the culture supernatants of AMs were measured with ELISA. The levels of endothelin (ET) were measured with radioimmunoassay method. The AMs expressing lymphocytic functional associated antigen-1 (LFA-1) in BALF, the AMs in mucosa and the thickness of mucosa were measured with immunocytochemistry and immunohistochemistry technique. RESULTS: The levels of MIP-1 alpha, MMP-9, IL-8 and ET in the culture supernatants of AMs in patients with COPD were (1 446.9 +/- 126.7) microg/L, (16.98 +/- 5.15) microg /L, (43.98 +/- 5.54) ng/L, (168.10 +/- 21.22) microg/L respectively; while those were (1 123.5 +/- 90.6) microg/L, (5.24 +/- 0.93) microg/L, (25.99 +/- 6.05) ng/L, (124.68 +/- 9.96) microg/L in a control group. The number of macrophages in mucosa in patients with COPD was (1.71 +/- 0.48) cells/Hp, while that was (0.59 +/- 0.18) cells/Hp in the control group (0.63 +/- 0.25) x 10(4). Statistical significance was found between the two groups. The number of AMs and polymorphonuclear leucocyte in BALF were inversely correlated with forced expiratory volume in one second as percentage of predicted value(FEV(1)% Pre) (r = -0.511, P < 0.01; r = -0.562, P < 0.01). The levels of MMP-9 and ET in the culture supernatants of AMs were inversely correlated with FEV(1)% Pre(r = -0.678, P < 0.01; r = -0.871, P < 0.01). Both the level of MIP-1 alpha and the positive number of AM expressing LFA-1 in BALF were positively correlated with the number of AMs in BALF(r = 0.572, P < 0.01; r = 0.625, P < 0.01). CONCLUSION: AM may be involved in the process of airway inflammation and subsequent airway obstruction.