Mediator concentrations in bronchoalveolar lavage fluid of patients with mild asymptomatic bronchial asthma.

Bronchoalveolar lavage (BAL) was performed on 11 atopic patients with mild asymptomatic bronchial asthma and 11 healthy nonasthmatic volunteers. All asthmatic subjects had evidence of bronchial hyperresponsiveness to inhaled carbachol. The concentrations of leukotriene (LT) C4, LTD4, LTE4, LTB4, prostaglandin D2 (PGD2), platelet-activating factor (PAF) and histamine in BAL fluid measured. The leukotrienes were measured by radioimmunoassay following reverse phase high performance liquid chromatography. PGD2 concentrations were determined by radio immunoassay after Amprep C2 extraction. PAF was quantitated by means of in vitro aggregation of rabbit platelets and histamine content was measured using a single isotope radio-enzymatic assay. There was an increase in the levels of PGD2 and a decrease in the concentration of LTB4 in asthmatic lavage samples. There were no significant differences in the lavage concentrations of LTC4/D4/E4 and histamine between the two groups of individuals. PAF was undetectable.     

Endotoxin, endotoxin-neutralizing-capacity, sCD14, sICAM-1, and cytokines in patients with various degrees of alcoholic liver disease

BACKGROUND: Chronic alcohol ingestion leads to endotoxemia which is believed to play an important role in the pathogenesis of alcoholic liver disease (ALD). The purpose of this study was to determine if chronic ethanol consumption, in addition to affecting plasma endotoxin and cytokines, also affects the endotoxin-neutralizing capacity (ENC), sCD14, and sICAM-1, in patients with ALD. A second aim was to identify correlations between these latter parameters, endotoxin, and cytokines, especially IL-10. METHODS: Hospitalized patients with various degrees of ALD (n = 59), and 20 healthy volunteers were studied. Plasma endotoxin and ENC were determined using our kinetic Limulus amebocyte lysate test. Cytokines, sCD14, and sICAM-1 were measured by enzyme-linked immunosorbent assay. RESULTS: Patients with ALD exhibited a mild endotoxemia (p < 0.01) and a marked decrease in ENC (p < 0.0002). TNF-alpha (p < 0.05), IL-6 (p < 0.0001), sICAM (p < 0.005), and sCD14 (p < 0.0005) were significantly elevated in all patients with ALD, and IL-10 (p < 0.05) in patients with cirrhotic ALD. With the exception of IL-10, the cytokines correlated with each other and with sICAM-1. No correlations occurred between endotoxin, ENC, and sCD14, and between these and the cytokines and sICAM-1. Elevated levels of endotoxin correlate with acute excessive alcohol ingestion. No gender differences were observed. CONCLUSIONS: Acute alcohol intoxication rather than severe ALD results in significant endotoxemia. The limited capacity of plasma to neutralize endotoxin in liver injury seems to be an important factor in ALD which may be responsible for the release of endotoxin-induced mediators, such as cytokines, as well as s-ICAM-1, that are relevant in the pathogenesis of ALD.     

早期矽肺患者血清IL-8及支气管灌洗液IL-6含量的测定及与肺功能相关性研究

目的通过对矽肺患者的血清IL-8及肺泡灌洗液的IL-6进行联合检测,并与肺功能进行相关性研究,探讨其在矽肺发病机制中所发挥的作用,为寻找敏感的矽肺诊疗标记物提供依据。方法选择矽肺患者60例为矽肺组,选取普通肺部病变行纤支镜检查明确为非肿瘤的患者50例为对照组,两组分别进行血清中IL-8水平与肺泡灌洗液(BALF)中IL-6含量以及肺功能的检测。结果矽肺组血清中IL-8水平、肺泡灌洗液中的IL-6含量较对照组明显增高(P0.01),差异有显著性,矽肺组在FEV1(%)、FVC(%)、FEV1/FVC(%)均明显较对照组降低,差异具有统计学意义(P0.05)。矽肺患者血清中IL-8水平与肺泡灌洗液中IL-6含量与肺功能检测均存在负相关(r分别为-0.24,-0.31,P均0.05)。结论矽肺患者血清IL-8和灌洗液IL-6含量不仅可作为矽肺早期生物标志物之一,也可以作为评估纤维化倾向和预后敏感指标,将会为早期评估患者病情提供一定的依据。     

支气管哮喘和COPD患者血清IL-10水平的临床研究

目的 探讨血清IL-10在哮喘和COPD炎症机制中的作用.方法 选对照组50例、哮喘急性发作期及缓解期组各50例、COPD急性加重期(AECOPD)及COPD稳定期组各50例.用ELISA法测定血清IL-10水平,统计学分析.结果 哮喘急性发作期IL-10水平低于缓解期,P＜0.05,且两组均低于对照组,P＜0.05.AECOPD IL-10水平低于稳定期,P＜0.05,且两组均低于对照组,P＜0.05.哮喘急性发作期IL-10水平低于AECOPD,P＜0.05.哮喘缓解期IL-10水平低于COPD稳定期,P＜0.05.结论 IL-10是参与哮喘和COPD发病的重要因子;血清IL-10水平的变化作为哮喘和COPD疾病分期的判断指标;对哮喘和COPD的鉴别有临床意义.     

脓毒症患者血清中TLR-4、TREM-1、sCD14和IL-18的变化

目的探讨脓毒症患者血清TLR-4、TREM-1、sCD14和IL-18含量的变化与脓毒症严重程度的相关性及用于诊断脓毒症的敏感度与特异度。方法选取60例脓毒症患者及30例正常体检者,分别抽血采用酶联免疫法(ELISA法)测TLR-4、TREM-1、sCD14和IL-18的含量。脓毒症患者根据当天进行APACHE-Ⅱ评分结果,按评分≥20分和20分进入高评分及低评分脓毒症组。结果脓毒症患者上述各因子的含量治疗前均明显高于治疗后,并高于正常对照组(p值均0.05),并且与APACHE-Ⅱ评分呈正相关(r=0.651、0.662、0.652、0.668,P均0.05)。治疗前高评分脓毒症组血清中TLR-4、TREM-1、sCD14、IL-18的含量均明显高于低评分脓毒症组(P均0.05);脓毒症患者治疗前血清中上述细胞因子的ROC曲线下面积分别为1.000、0.795、0.828、0.834及0.850,APACHE-Ⅱ、TLR4、TREM-1及sCD-14分别取20、25.8 ng/ml、89.6 ng/ml及75 ng/ml为截断点,评价预后敏感性分别为为99%、82%、82%及91%,特异性分别为为100%、52%、66%及72%。结论脓毒症患者血清中TLR-4、TREM-1、sCD14、IL-18的含量与脓毒症的发生发展关系密切;通过监测上述细胞因子的含量可以对脓毒症病情严重程度做出一定的判断;TREM-1有可能成为诊断脓毒症较好的实验室指标之一,sCDl4有望成为较为敏感的脓毒症诊断标志物之一。     

白细胞介素13在哮喘、COPD中的变化研究

目的探讨白细胞介素13（IL-13）在支气管哮喘、慢性阻塞性肺疾病（COPD）的变化。方法选择正常组30例、哮喘急性发作期和COPD急性加重期各30例,哮喘缓解期和COPD稳定期各30例。取静脉血,用ELISA方法测定血清中IL-13的水平,并进行统计学分析。结果哮喘IL-13水平分析：急性发作期68．18±2．24（pg／ml）显著高于缓解期43．49±4．04（pg／ml）,P〈0．01,且两组均显著高于正常对照组25．45±5．49（pg／m1）,P〈0．01;COPD IL-13水平分析：急性加重期组51．55±3．16（pg／m1）显著高于稳定期组34．89±2．16（pg／m1）,P〈0．01。且两组均显著高于对照组,P〈0．01。结论IL-13参与了哮喘和COPD慢性炎症的形成。     

支气管扩张症合并支气管哮喘患者支气管肺泡灌洗液病原菌培养及药敏状况研究

目的 探讨支气管肺泡灌洗液(bronchoalveolar lavage fluids,BALF)病原菌培养及药敏试验在支气管扩张症合并支气管哮喘治疗中的临床应用价值.方法 选择90例支气管扩张症合并支气管哮喘的住院患者,收集其BALF标本进行病原菌培养及药敏试验.结果 90例患者病原菌检出阳性55例(61.1％),共57株.革兰阴性杆菌54株(94.7％),以铜绿假单胞菌为主,鲍曼不动杆菌次之;真菌2株(3.5％),为曲霉菌;革兰阳性球菌1株(1.8％),为金黄色葡萄球菌.混合菌感染2例,为鲍曼不动杆菌合并金黄色葡萄球菌1例、施氏假单胞菌合并铜绿假单胞菌1例.药敏试验发现,53株革兰阴性杆菌对妥布霉素、头孢哌酮舒巴坦、亚胺培南最敏感,对头孢噻肟、复方新诺明、左旋左氧氟沙星耐药性最高;嗜麦芽寡养食单胞菌对左旋左氧氟沙星、米诺环素及复方新诺明100％敏感;曲霉菌对两性霉素B、伊曲康唑、伏立康唑100％敏感;革兰阳性球菌只检出1株,药敏结果代表性不强,未给予深入研究.结论 支气管扩张症合并支气管哮喘患者BALF病原菌培养出细菌以革兰阴性杆菌为主,真菌感染率亦显现,革兰阳性球菌少;2种或2种以上混合细菌感染虽然占少数,但混合菌感染的出现说明各病原菌对多种抗菌药物的耐药性可能增加;药敏结果对临床治疗支气管扩张症合并支气管哮喘有重要指导意义;BALF取样部位针对性强,提供结果较可靠,培养阳性率高,临床应用价值较大;通过肺泡灌洗将有助于支气管扩张症的感染性分泌物清除,改善患者支气管阻塞,降低局部病原菌数量和浓度,有助于改善其喘息症状,并有助于控制感染.     

血清sVCAM-1和sICAM-1与冠状动脉病变相关性研究

目的 探讨血清血管细胞黏附分子—1(sVCAM—11)和细胞间黏附分子—1(sICAM—1)水平与冠状动脉病变程度及稳定性之间的相关关系。方法 采用ELISA方法测定52例急性冠脉综合征(ACS)、20例稳定型心绞痛(SAP)患者和对照组24例血清sVCAM—1和sICAM—1浓度，用Censini积分系统评价其冠状动脉照影结果，进行统计学分析。结果 SAP组和ACS组的sVCAM—1、sICAM—1水平和Censini积分均显著高于对照组(P＜0．01)，ACS组的sVCAM—1水平显著高于SAP组(P＜0．01)；SAP组和ACS组之间的sICAM—1水平和Censini积分无显著性差别(P＞0．05)。sVCAM—1、sICAM—1与Censini积分均有高度相关性(相关系数分别为0．694，P=0.000；0．412，P＝0．000)。结论 血清sVCAM—1和sICAM—1水平与冠状动脉病变程度有一定相关性，ACS组的血清sVCAM—1水平高于SAP组。     

支气管扩张症合并支气管哮喘患者支气管肺泡灌洗液病原菌培养及药敏状况研究

目的 探讨支气管肺泡灌洗液(bronchoalveolar lavage fluids,BALF)病原菌培养及药敏试验在支气管扩张症合并支气管哮喘治疗中的临床应用价值.方法 选择90例支气管扩张症合并支气管哮喘的住院患者,收集其BALF标本进行病原菌培养及药敏试验.结果 90例患者病原菌检出阳性55例(61.1%),共57株.其中革兰阴性杆菌54株(94.7%),以铜绿假单胞菌为主,鲍曼不动杆菌次之;真菌2株(3.5%),为曲霉菌;革兰阳性球菌1株(1.8%),为金黄色葡萄球菌.混合菌感染2例,为鲍曼不动杆菌合并金黄色葡萄球菌1例、施氏假单胞菌合并铜绿假单胞菌1例.药敏试验发现,53株革兰阴性杆菌对妥布霉素、头孢哌酮舒巴坦、亚胺培南最敏感,对头孢噻肟、复方新诺明、左旋左氧氟沙星耐药性最高;嗜麦芽寡养食单胞菌对左旋左氧氟沙星、米诺环素及复方新诺明100%敏感;曲霉菌对两性霉素B、伊曲康唑、伏立康唑100%敏感;革兰阳性球菌只检出1株,药敏结果代表性不强,未给予深入研究.结论 支气管扩张症合并支气管哮喘患者BALF病原菌培养出细菌以革兰阴性杆菌为主,真菌感染率亦显现,革兰阳性球菌少;2种或2种以上混合细菌感染虽然占少数,但混合菌感染的出现说明各病原菌对多种抗菌药物的耐药性可能增加;药敏结果对临床治疗支气管扩张症合并支气管哮喘有重要指导意义;BALF取样部位针对性强,提供结果较可靠,培养阳性率高,临床应用价值较大;通过肺泡灌洗将有助于支气管扩张症的感染性分泌物清除,改善患者支气管阻塞,降低局部病原菌数量和浓度,有助于改善其喘息症状,并有助于控制感染.     

Serum concentrations of sICAM-1, sE-, sP- and sL-selectins in patients with Schistosoma mansoni infection and association with disease severity

Increased serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1, CD54) and of soluble E- (CD62E), but not soluble P- (CD62P) and L- (CD62 L) selectins, were detected in Malagasy patients living in an hyperendemic focus of Schistosoma mansoni . Levels of sICAM-1 remained elevated for several months after treatment with praziquantel. Serum levels of ICAM-1, but not of other markers, were significantly correlated with the disease severity, as indicated by ultrasonographical data, and with some circulating fibrosis markers (at least hyaluronic acid). sICAM-1 level may reflect endothelial inflammatory reactions, probably harmful, in the liver and may be useful for monitoring morbidity evolution in schistosomiasis mansoni .     

Proangiogenic activity in bronchoalveolar lavage fluid from patients with asthma

RATIONALE: Asthmatic airways have an increased number and size of vascular structures, which contribute to airflow obstruction and hyperresponsiveness. OBJECTIVES: We examined whether proangiogenic mediators are elevated in bronchoalveolar lavage fluid (BALF) from subjects with asthma and if this translated to induction of angiogenesis. METHODS: Angiogenic activity in BALF from 12 healthy, nonatopic subjects and 10 atopic subjects with mild asthma was evaluated by examining tubule formation at 11 days in cocultures of human endothelial cells with dermal fibroblasts. Vascular structures were visualized by anti-CD31 labeling and quantified by image analysis. Angiogenic growth factors in BALF from healthy subjects and subjects with asthma were identified using antibody arrays and by ELISA. MEASUREMENTS AND MAIN RESULTS: Angiogenic activity induced by BALF from healthy subjects was not different from basal tubule formation (p>0.05). However, induction of tubular structures by asthmatic BALF was 2.5-fold greater (p<0.001) compared with healthy samples. Similarly, levels of proangiogenic growth factors (angiogenin, vascular endothelial growth factor [VEGF], monocyte chemotactic protein-1) were increased approximately 2.5-fold (p<0.05) in BALF from subjects with asthma, whereas antiangiogenic factors (endostatin, Ang-2) were unchanged. A blocking anti-VEGF antibody abolished tubule formation induced by BALF from either healthy subjects or subjects with asthma (p<0.01). Immunodepletion of VEGF had no effect on basal tubule formation induced by healthy BALF but abrogated enhanced tubule formation by asthmatic BALF (p<0.01). CONCLUSIONS: BALF collected from subjects with asthma but not healthy subjects is functionally active in promoting angiogenesis in vitro. The proangiogenic capacity of BALF from subjects with asthma resides in elevated VEGF derived from asthmatic airways. This observation supports VEGF as a key factor in vascular remodeling in asthma.     

Comparison of induced sputum with bronchial wash, bronchoalveolar lavage and bronchial biopsies in COPD.

It is unclear how cellular and soluble inflammatory markers in induced sputum relate to markers in lavage fluid and biopsies in chronic obstructive pulmonary disease (COPD). This was investigated and also the possible differences between subjects with COPD and healthy controls assessed. Eighteen nonatopic subjects with COPD and 11 healthy controls were studied. Sputum was induced by inhalation of hypertonic saline. The airways were lavaged, using the first 50 mL for bronchial wash (BW) and the subsequent 150 mL for bronchoalveolar lavage (BAL), and biopsies were taken from subsegmental carinae. Neutrophils were the predominant cell type in sputum in COPD (median 77.3%) but not in BW (5.5%) and BAL fluid (1.7%). Differential cell counts in sputum did not correlate with the counts in BW or BAL fluid or biopsies, whereas sputum eosinophil cationic protein (ECP) levels correlated with BW fluid ECP levels (p=0.66, p=0.007) and sputum interleukin-8 (IL-8) concentration with BAL fluid IL-8 concentration (p= 0.52, p=0.026). Subjects with COPD had a higher percentage of sputum neutrophils and eosinophils and higher concentrations of ECP and IL-8 than healthy controls. The higher percentages of eosinophils and concentrations of ECP were also seen in BW and BAL fluid. Finally, higher numbers of macrophages and eosinophils were found in biopsies. In conclusion, induced sputum is derived from a different compartment from BW and BAL fluid and biopsies. Induced sputum may be useful for studying the contribution of luminal neutrophils and eosinophils in chronic obstructive pulmonary disease.     

The bronchial lavage of pediatric patients with asthma contains infectious Chlamydia

There has been a worldwide increase in the incidence of asthma, and the disease has greatly impacted the public health care system. Chlamydia pneumoniae has been reported as a possible contributing factor in asthma. The organism has been detected by polymerase chain reaction (PCR) in bronchial tissue, but there has been no direct evidence of viability. To determine the frequency of viable Chlamydia in children, blood and bronchoalveolar lavage were collected from 70 pediatric patients undergoing flexible fiberoptic bronchoscopy. Forty-two of these patients had asthma, whereas the remaining patients had various respiratory disorders. Fifty-four percent (38) of the bronchoalveolar lavage samples were PCR-positive for Chlamydia, and 31% (22) of the PCR-positive samples were positive when cultured on macrophages. Twenty-eight samples (40%) and 14 samples (20%) of the PCR- and culture-positive samples, respectively, were from patients with asthma. Culture of the blood samples revealed that 24 (34.3%) of 70 were positive for Chlamydia compared with 8 (11%) of 70 matched nonrespiratory control subjects (p < 0.01); 17 (24%) of the positive blood cultures from the respiratory group were from patients with asthma. Elevation of total IgE was strongly associated with lavage culture positivity for Chlamydia. We therefore conclude that viable Chlamydia pneumoniae organisms are frequently present in the lung lavage fluid from this cohort of predominantly asthmatic pediatric patients.     

Comparison between bronchial and alveolar samples of bronchoalveolar lavage fluid in asthma.

BACKGROUND: Cell content of BALF may vary according to the segment of the lung washed. It was proposed to separate BALF into several aliquots, the first sample being more related to bronchi. The present study compared bronchial and alveolar samples by fractionating aliquots of BALF in normal and asthmatic subjects. METHODS: One hundred asthmatic subjects (mean +/- SEM: 37 +/- 1.5 yr in age) were compared with 31 normal subjects (mean +/- SEM: 32 +/- 2.2 yr in age). None of the subjects was a smoker and none was taking drugs that might interfere with the results. The severity of asthma was defined by the clinical score of Aas examining the chronic severity of asthma and ranging from 1 to 5 (range: 1 to 4; mean +/- SEM: 2.2 +/- 0.1) and FEV1 (range: 45 to 130 percent; mean +/- SEM: 82 +/- 1.8 percent of predicted values). Bronchoscopy was done in a standardized manner. A first aliquot of 50 ml of saline each were instilled and the BALF recovered was pooled (alveolar sample). After centrifugation, total and differential cell counts (May Grünwald-Giemsa) were carried out on bronchial and alveolar samples. RESULTS: The alveolar sample contained significantly more cells per milliliter of BALF than the bronchial sample in normal (p less than 0.0077, Wilcoxon test) and in asthmatic subjects (p = 0.0001, Wilcoxon test). Both in normal and asthmatic subjects, bronchial samples contained significantly more neutrophils and epithelial cells and fewer macrophages and lymphocytes than alveolar samples. In asthmatic subjects, the bronchial sample contained a significantly greater percentage of eosinophils than the alveolar sample. Eosinophils were significantly increased in asthmatic subjects for both the bronchial and alveolar samples. Bronchial and alveolar eosinophilia both were correlated with the Aas score (r = 0.25, p = 0.024 and r = 0.38, p = 0.0006, respectively, by Spearman Rank test). CONCLUSIONS: This study shows in a large number of subjects that the cell content of bronchial and more distal segments of the lung is not comparable, indicating that studies should not give pooled data in asthmatic subjects. Moreover, it confirms the presence of BALF eosinophilia in asthmatic subjects.     

The effect of inhaled corticosteroids on bronchoalveolar lavage cells and IL-8 levels in stable COPD patients

Chronic obstructive pulmonary disease (COPD) is characterised by a chronic inflammatory process in the large and small airways, as well as in the lung parenchyma. Although the role of oral corticosteroids in the management of acute exacerbations of COPD is well documented, its role in stable COPD is not clear. We examined the anti-inflammatory effect of inhaled budesonide on the percentage of neutrophils and on interleukin-8 (IL-8) levels in bronchoalveolar lavage (BAL) and their correlation with spirometry and symptom scores. Twenty-six patients with stable COPD were randomised, in a double-blinded, placebo-controlled trial with either 800 microg of inhaled budesonide or placebo for a 6-month period. The budesonide-treated subjects had significant reductions in IL-8 levels in the BAL after therapy (mean+/-sem, 1.53+/-0.72 at baseline vs. 0.70+/-0.48 ng/ml at 6 months, P=0.004) and a reduction in the mean percentages of neutrophils (17.16+/-2.67% vs. 13.25+/-2.28% P=0.002). The improvement in sputum production was of borderline (P=0.058) significance but there was no improvement in lung function. In stable patients with COPD, treatment with inhaled budesonide for a period of 6 months has a positive effect on markers of lung inflammation, as assessed by reduction in percentage neutrophils and IL-8 concentration in BAL.     

肝硬化患者血清可溶性sCD8水平变化及临床意义

探讨肝硬化患者血清可溶性CD8(sCD8)水平变化与肝细胞损伤的关系。采用酶联免疫吸附法测定血清sCD8水平。肝硬化患者血清sCD8水平高于正常对照组 ,其血清sCD8水平与肝功能指标天门冬酸氨基转移酶(AST)水平呈正相关 (r=0 35 4 ,P <0 0 5 ) ,与白蛋白 (A)水平呈负相关 (r=- 0 339,P <0 0 5 ) ,血清sCD8在Child -Pugh分级中差别无统计学意义。肝硬化患者血清sCD8水平增高与肝细胞损伤、肝功能障碍有关 ,血清sCD8水平监测可作为观察肝硬化患者病变的重要免疫学指标之一     

In vivo evaluation of bronchoalveolar lavage (BAL) fluid in atopic bronchial asthma, chronic bronchitis and sarcoidosis patients

The intensity of inflammatory response was evaluated in skin test on guinea pig using bronchoalveolar lavage (BAL) fluid obtained from patients with some diseases of the respiratory tract. The results of skin test were verified with activities of proteases in BAL fluid. The study was performed on 24 patients with atopic bronchial asthma, 21 with chronic bronchitis, 13 with sarcoidosis (II phase) and 18 control subjects. All patients were undergoing fiberoptic bronchoscopies and BAL fluid was obtained. The results of skin test on guinea pig using BAL fluid were correlated with the activities of acid and neutral proteases. The highest activity of proteases and intensity of skin reactions were noted in patients with atopic bronchial asthma and sarcoidosis. Authors suggest that the skin test on guinea pig with BAL fluid may be useful tool for total evaluation of inflammatory response in patients with atopic bronchial asthma, chronic bronchitis and sarcoidosis.     

Cytokine concentrations in bronchoalveolar lavage fluid of patients with systemic sclerosis

Objective. The pathophysiology of pulmonary fibrosis in patients with systemic sclerosis (SSc) is poorly understood, but a number of recent studies have demonstrated an inflammatory process involving the lower respiratory tract. The objective of the present study was to determine the concentrations of several cytokines in the bronchoalveolar lavage (BAL) fluid of patients with SSc and to assess whether the enhanced expression of certain cytokines is associated with the presence of alveolitis. Methods. BAL was performed on patients with SSc (with or without alveolitis) and on normal control subjects. Lyophilized BAL fluid samples were assayed by enzyme-linked immunosorbent assay for tumor necrosis factor α (TNFα), interleukin-1α (IL-1α), IL-4, IL-6, IL-8, macrophage inflammatory protein 1α (MIP-1α), and RANTES. Results. There were significant differences between groups in the BAL fluid concentrations of TNFα (P = 0.0005, with levels in SSc patients with alveolitis higher than those in normal controls), IL-8 (P = 0.006, with levels in both SSc groups higher than those in normal controls), MIP-1α (P = 0.009, with levels in SSc patients with alveolitis higher than those in SSc patients without alveolitis and than those in normal controls), and RANTES (P = 0.03, with levels in SSc patients without alveolitis higher than those in normal controls). With the exception of RANTES, the highest levels were detected in SSc patients with alveolitis. Conclusion. Each of these cytokines, either alone or in combination, may play an important role in the pathogenesis of pulmonary fibrosis in SSc.     

Safety of nifedipine in subjects with bronchial asthma and COPD

This prospective study was undertaken to evaluate the safety of nifedipine, a calcium channel blocking agent, on 60 subjects with asthma, chronic obstructive pulmonary disease (COPD), angina, and normal subjects. All subjects received nifedipine, 20 mg, sublingually. Spirometry was done pre-drug administration and every 20 minutes after for two hours. Parameters measured were forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow at 25 percent to 75 percent of total volume (FEF25-75%). Subjects with asthma and COPD were also given nifedipine 20 mg three times daily, orally for two weeks, and tested biweekly during this period. All bronchodilators, beta-blockers, and long acting nitrates were withheld for five half-lives of the drug prior to test day. There was no adverse effect on the pulmonary function. We found a statistically significant improvement (p less than 0.05) in FEV1 after nifedipine. There was no tachyphylaxis at the end of two weeks. Nifedipine is safe in patients with asthma and/or chronic bronchitis.     

支气管哮喘患者血浆肾上腺髓质素的质量浓度及临床意义

目的　探讨支气管哮喘 (简称哮喘 )患者血浆肾上腺髓质素 (ADM)的质量浓度变化及其临床意义。方法　用放射免疫分析法测定 2 3例哮喘急性发作期患者和 18例缓解期患者血浆ADM质量浓度 ,并与动脉血氧分压 [Pa(O2 ) ]及 1秒钟用力呼气容积占预计值的百分比 (FEV1 % )进行相关分析。 2 0例健康人为正常对照组。结果　哮喘急性发作期组血浆ADM质量浓度 [( 2 8 73± 7 12 )ng L]高于缓解组 [( 13 85± 4 48)ng L ,P <0 0 1]和正常对照组 [( 11 78± 4 2 9)ng L ,P <0 0 1],并与 Pa(O2 )及FEV1 %呈负相关 ( r=- 0 5 5 ,P <0 0 1,r=- 0 63 ,P<0 0 1)。哮喘缓解期组血浆ADM质量浓度与Pa(O2 )及FEV1 %无显著相关性 (P >0 0 5 )。结论　ADM可能参与了哮喘的急性发作和炎症反应过程