胆汁刀豆球蛋白A（ConA）结合蛋白在胆固醇性结石早期形成阶段的作用：胆汁ConA结合蛋白量与质分析

为了解胆固醇结石患者胆汁ＣｏｎＡ结合蛋白（ＣＰｓ）量与质的异常，应用亲和层析等方法对胆固醇结石、色素性结石及胆囊胆固醇息肉等患者的胆汁Ｃｐｓ进行了定量，并对不同个体的Ｃｐｓ与模拟胆汁泡相结合量及成核影响进行了比较。结果：色素结石（ｎ＝７）及非胆石患者（ｎ＝１０）胆汁ＣＰｓ浓度分别为０．２６±０．１２ｇ／Ｌ和０．２７±０．０９ｇ／Ｌ明显低于胆固醇结石患者（ｎ＝３６）的０．３９±０．１１ｇ／Ｌ（Ｐ＜０．０１）和胆固醇息肉患者（ｎ＝９）的０．４０±０．０９ｇ／Ｌ（Ｐ＜０．０１）；色素结石（ｎ＝５）及非胆石患者（ｎ＝２５）的成核活性（成核时间比）分别为０．７１±０．１９和０．７３±０．１１，也明显弱于胆固醇结石患者（ｎ＝２５）的０．５７±０．２１（Ｐ＜０．０１）和胆囊胆固醇息肉患者（ｎ＝５）的０．４４±０．２３（Ｐ＜０．０１）；胆固醇结石患者（ｎ＝２６）的ＣＰｓ与泡相结合量显著高于色素性结石患者（ｎ＝６）（２．４±０．９％比０．９±０．５％，Ｐ＜０．０１）。总结认为：胆汁ＣＰｓ量的升高及促成核活性增强，尤其是亲泡相ＣＰｓ的增加是胆固醇结石形成的重要原因。     

高血压患者凝血酶原及纤溶酶原激活物和其抑制物测定

目的探讨正常人各年龄组间和高血压病人血纤溶指标的差异及其意义。方法用发色底物法分别时≤３９岁（ｎ＝４９），４０～５９岁（ｎ＝１４９），≥６０岁（ｎ＝６４）各组健康人和高血压组（ｎ＝５６）的血纤溶活性指标凝血酶原（ＰＬＧ），组织型纤溶酶原激活物（ｔ－ＰＡ）和纤溶酶原激活物抑制物（ＰＡＩ）进行测定。结果≥６０岁组和高血压组的ＰＬＧ和ｔ－ＰＡ明显低于５９岁以下各组（Ｐ＜０．００１），ＰＡＩ则明显高于５９岁以下各组（Ｐ＜０．００１）。结论健康老人（≥６０岁）和高血压病人纤溶活性降低。     

高血压患者血小板α＿2肾上腺素能受体改变的临床意义

采用放射性配基结合法及高压液相色谱法对原发性高血压（Ａ组，ｎ＝２４）继发性高血压（Ｂ组，ｎ＝１９）患者及正常对照组（Ｃ组，ｎ＝２６）的血小板α肾上腺素受体（ＰＬα_２－ＡＲ）及血浆儿茶酚胺（ＣＡ－去甲肾上腺素ＮＥ）水平进行测定，结果表明：Ａ组ＰＬα２－ＡＲ密度高于Ｃ组及Ｂ组，受体密度与血压及ＣＡ水平正相关。本研究表明ＰＬα２－ＡＲ密度的变化能反映原发性高血压病人的交感神经活性，并能反映家族遗传的特性，在高血压病的诊断与鉴别上有一定临床意义。     

高血压患者凝血酶原纤溶酶原激活物和其抑制物测定

目的 探讨正常人各年龄组间和高血压病人血纤溶指标的差异及其意义。 方法 用发色底物法分别时≤３９岁（ｎ＝４９），４０￣５９岁（ｎ＝１４９），≥６０岁（ｎ＝６４）各组健康人和高血压组（ｎ＝５６）的血纤溶活性指标凝血酶原（ＰＬＧ），组织型纤溶酶原激活物（ｔ－ＰＡ）和纤溶酶原激活物（ｔ－ＰＡ）和纤溶酶原激活物抑制剂（ＰＡＩ）进行测定。 结果 ≥６０岁组和高血压组的ＰＬＧ和ｔ－ＰＡ明显低于５９岁以下各组（     

雌激素对雌性大鼠血清与肝组织中ALT,AST,ALP及GGT活性的 …

目的 观察雌二醇对雌性大鼠血清与肝组织丙氨酸转氨酶（ＡＬＴ）、天门冬氨酸转氨酶（ＡＳＴ）、碱性磷酸酶（ＡＬＰ）和谷氨酰转肽酶（ＧＧＴ）活性的影响。方法 血清Ｅ２含量用放射免疫分析检测，肝组织与血清ＡＳＴ、ＡＬＴ，ＡＬＰ和ＧＧＴ活性活性采用酶速率法检测。结果 大鼠摘除卵巢与注射二醇（Ｅ２）后，随着血清Ｅ２水平的呈升高，血清与肝组织的ＡＳＴ、ＡＬＴ及ＡＬＰ活性也发生相应的变化。结论 Ｅ２可促进肝组织合     

肝硬变时细胞外基质代谢的血清学研究

目的研究肝纤维化时细胞外基质代谢的血清学变化规律,以及抗肝纤维化治疗的重要性．方法实验对象２６９例分为３个观察组,即正常对照组（ｎ＝３０）ＣｈｉｌｄＡ组（ｎ＝１０３）及ＣｈｉｌｄＢ＋Ｃ组（ｎ＝１６６）．对每例观察对象作血清透明质酸（ＨＡ）,Ⅲ型前胶原肽（ＰⅢＰ）,Ⅳ型前胶原肽（ＰⅣＰ）．层粘蛋白（ＬＮ）水平测定和肝功能有关指标,如ＡＳＴ,ＡＬＴ,甘胆酸（ＣＧ）和吲哚氰绿（ＩＣＧ）潴留率等检测．结果和正常组比较,ＣｈｉｌｄＡ组及ＣｈｉｌｄＢ＋Ｃ组ＨＡ,ＰⅢＰ,ＰⅣＰ,ＬＮ以及ＡＬＴ,ＡＳＴ,ＣＧ,ＩＣＧ潴留率均值呈异常升高（Ｐ＜００１）,但ＣｈｉｌｄＡ组及ＣｈｉｌｄＢ＋Ｃ组间无统计学差异．进一步研究还发现ＰⅢＰ,ＰⅣＰ,ＨＡ以及ＬＮ等血清浓度和ＣＧ,ＩＣＧ潴留率,ＡＳＴ,ＡＬＴ间呈密切正相关,经保肝、利胆等治疗,在血清ＡＳＴ,ＡＬＴ,ＣＧ及ＩＣＧ潴留率好转后ＨＡ,ＰⅢＰ,ＰⅣＰ,ＬＮ的血清水平也呈同向变化．结论部分肝硬变患者,肝纤维化的形成仍很活跃,积极有效的保肝,利胆,抗纤维化治疗十分必要     

原发性高血压伴脑腔隙性病变患者凝血和纤溶系统失衡的研究

目的进一步探讨高血压病患者合并脑腔隙性病变者与凝血纤溶系统之间的关系,为早期防治寻找依据。方法健康对照组３１例及观察组轻中度高血压病患者５８例（根据头颅核磁共振分为脑腔隙性病变组（ｎ＝４６）和非脑腔隙性病变组（ｎ＝１２）进行组织型纤溶酶原激活物（ｔ－ＰＡ）及其抑制物（ＰＡＩ）的活性、血管性假血友病因子抗原（ｖＷＦ：Ａｇ）和纤溶酶原（ＰＩＧ）活性、凝血因子Ⅷ促凝活性（Ⅷ：Ｃ）测定。结果（１）高血压病组与对照组各项指标比较：前组ｔ－ＰＡ、ＰＡＩ、ＰＬＧ明显高于后组（Ｐ＜０．０１）,两组ｖＷＦ：Ａｇ、Ⅷ：Ｃ无明显差别;（２）腔隙性病变组与对照组比较：ｔ－ＰＡ（Ｐ＜０．０１）,ｖＷＦ：Ａｇ（Ｐ＜０．０５）明显高于对照组,Ⅷ：ｃ无明显变化;（３）非腔隙性病变组与对照组比较：前组ｔ－ＰＡ（Ｐ＜０．０５）,ＰＡＩ（Ｐ＜０．０１）明显高于后组,两组ＰＬＧ、ｖＷＦ：Ａｇ无明显变化;（４）脑腔隙性病变组与非腔隙性病变组比较：各项指标均无明显差异。结论高血压病无论是否合并腔隙性病变均存在凝血和纤溶功能的失衡,提示早期预防具有重要意义     

一氧化氮对缺氧性肺动脉高压大鼠血浆降钙素基因相关肽？…

目的 探讨一氧化氮（ＮＯ）对缺氧性肺动态高压（ＨＰＨ）大鼠血浆降钙素基因相关肽（ＣＧＲＰ）含量的影响。方法 将Ｗｉｓｔａｒ大鼠４０只分为四组：对照组（ｎ＝１０）,缺氧组（ｎ＝１０）,缺氧＋Ｌ－ＮＡＭＥ组（ｎ＝１０）,缺年头＋Ｌ－Ａｒｇ组（ｎ＝１０）。通过Ｐ５０压力传感器测量定四组大鼠肺动脉平均压（ＰＡＭＰ）,缺氧＋Ｌ－Ａｒｇ组的ＰＡＭＰ显著低于缺氧组（Ｐ〈０．０５）;缺氧组的右室（ＲＶ）干重／左室     

表皮生长因子受体和PCNA在食管癌及癌前病变组织中的表达意义

目的探讨ＥＧＦＲ及ＰＣＮＡ的表达在食管癌发生发展过程中的临床意义．方法采用免疫组化ＳＰ法对各级食管鳞癌（Ⅰ级ｎ＝１８，Ⅱ级ｎ＝３０，Ⅲ级ｎ＝２２）、各级不典型增生（轻度ｎ＝１４，中度ｎ＝１７，重度ｎ＝１３）及正常食管粘膜（ｎ＝２０）进行ＥＧＦＲ及ＰＣＮＡ检测．结果ＥＧＦＲ及ＰＣＮＡ阳性表达在各组食管病变中呈明显递增趋势，正常组、轻度及中度不典型增生组间ＥＧＦＲ及ＰＣＮＡ表达均有显著性差异，ＥＧＦＲ阳性表达分别为：０／２０，３／１４及１０／１７；ＰＣＮＡⅠ，Ⅱ，Ⅲ，Ⅳ级表达分别为：１９／２０，１／２０，０／２０，０／２０；７／１４，６／１４，１／１４，０／１４；２／１７，７／１７，７／１７，１／１７（Ｐ＜００５）．鳞癌Ⅰ，Ⅱ级组间ＰＣＮＡ表达有显著性差异，ＰＣＮＡⅠ，Ⅱ，Ⅲ，Ⅳ级表达分别为１／１８，７／１８，８／１８，２／１８；２／３０，５／３０，８／３０，１５／３０（Ｐ＜００５）；而中、重度不典型增生与Ⅰ级鳞癌组间均无显著性差异（Ｐ＞００５）．结论食管中重度不典型增生者，其基因表达及增殖特性已具有明显的潜在恶性趋势，与食管癌的发生有直接关系，临床应对这类病例积极治疗并密切随访，以防癌变     

糖尿病酮症酸中毒并肝损害临床分析

目的探讨导致糖尿病酮症（ＤＫ）及酮症酸中毒（ＤＫＡ）患者肝损害的相关因素．方法ＤＫ或ＤＫＡ患者９９例,其中ＡＬＴ及ＡＳＴ均异常升高１１例（Ａ组）,单项ＡＬＴ异常升高１３例（Ｂ组）,肝功能正常７５例（Ｃ组）,对以上各组患者的血二氧化碳结合力（ＣＯ２ＣＰ）、尿素氮（ＢＵＮ）、血糖（ＢＧ）和血浆渗透压（ＯＳＭ）进行了统计分析．结果Ａ,Ｂ两组患者的ＣＯ２ＣＰ明显低于Ｃ组（Ｐ＜００１,ｔ＝６３３和ｔ＝６４３）,而ＢＵＮ则明显升高（Ｐ＜００１,ｔ＝３６１,ＡｖｓＣ;Ｐ＜００１,ｔ＝４３５,ＢｖｓＣ）,Ａ组的ＢＧ（Ｐ＜００５,ｔ＝２８４）和血浆ＯＳＭ（Ｐ＜００５,ｔ＝３１０）水平也显著高于Ｃ组,而Ｂ组患者的ＢＧ及血浆ＯＳＭ与Ｃ组比较无差异;与Ｂ组相比,Ａ组患者的ＣＯ２ＣＰ明显降低（Ｐ＜００２,ｔ＝２７１）,ＢＧ（Ｐ＜００５,ｔ＝２８９）和血浆ＯＳＭ（Ｐ＜００５,ｔ＝２３６）明显升高．此外,Ⅰ型糖尿病患者血清转氨酶异常升高的发生率明显高于Ⅱ型糖尿病患者（Ｐ＜００５,χ２＝４３８）．结论酸中毒和脱水是导致糖尿病酮症及酮症酸中毒患者肝损害的重要因素,酸中毒及脱水程度与肝损害程度相关．     

The role of prostaglandins E and F in acalculous gallbladder disease

Prostaglandins have been postulated to be involved in the formation of gallstones and the pain and inflammation of calculous gallbladder disease. This report evaluated prostaglandin E and F levels in patients with acalculous gallbladder disease. Control gallbladders were obtained from patients undergoing cholecystectomy during insertion of hepatic artery catheters for regional, hepatic chemotherapy. Patients without gallstones and with long-standing post-prandial biliary colic with abnormal cholecystokinin administration underwent cholecystectomy for chronic acalculous cholecystitis. A third group of patients underwent cholecystectomy for acute acalculous cholecystitis. Gallbladder mucosa and muscle were separated, and prostaglandin E and F concentrations in mucosal and muscle or mucosa were identified in gallbladders from patients with chronic acalculous cholecystitis compared to gallbladders from patients without biliary tract symptoms. In gallbladders from patients with acute acalculous cholecystitis a seven-fold increase in PGE production by muscle tissue and mucosal cells was found. The more histologically inflamed gallbladders had higher mucosal and muscle prostaglandin E concentrations than were found in less inflamed gallbladders. Prostaglandin F levels were not significantly changed or were decreased, resulting in a significant increase in the ratio of PGE/PGF in acutely diseased gallbladders when compared to normal gallbladders. Prostaglandin E may be a manipulatable intermediary in the sequence of events that results in the development of acute acalculous cholecystitis.     

Increased biliary group II phospholipase A2 and altered gallbladder bile in patients with multiple cholesterol stones

BACKGROUND & AIMS: Multiple cholesterol stones are associated with more biliary complications and show more rapid cholesterol nucleation than solitary stones. Group II phospholipase A2 (PLA2-II) may play a critical role in the process of mucosal inflammation, which in turn may produce pronucleating agents. PLA2-II concentrations in gallbladders and gallbladder bile from patients with different types of gallstone disease were assayed to correlate PLA2-II with alterations in biliary composition. METHODS: PLA2-II protein concentrations were assayed immunoradiometrically using monoclonal antibodies against human splenic PLA2-II. RESULTS: Immunoreactive PLA2-II levels in gallbladder bile were significantly higher in patients with multiple cholesterol stones (68.2 +/- 6.3 ng/dL, mean +/- SEM; n = 24) than in those with solitary stones (24.9 +/- 2.8; n = 20; P < 0.01), those with multiple pigment stones (24.2 +/- 3.7; n = 18; P < 0.01), or control subjects (13.4 +/- 1.7; n = 19; P < 0.01). Increased biliary immunoreactive PLA2-II levels in multiple cholesterol stones were associated with a concomitant increase in the lysophosphatidylcholine to phosphatidylcholine ratio; free arachidonate, protein, and hexosamine concentrations; and gallbladder bile viscosity. The gallbladders showed an increased PLA2- II protein mass and steady-state messenger RNA levels, which was associated with increased prostaglandin E2 levels. CONCLUSIONS: Increased biliary PLA2-II may be of pathogenetic importance in multiple cholesterol stones, probably through potentiating gallbladder mucosal inflammation with associated biliary alterations favoring cholesterol crystal formation. (Gastroenterology 1997 Jun;112(6):2036-47)     

丹参抗大鼠乙醇性胃粘膜损伤的作用及机制

目的 :探讨丹参抗大鼠乙醇性胃粘膜损伤的作用及机制。方法 :采用 10 0 %乙醇复制大鼠乙醇性胃粘膜损伤模型 ,用放射免疫法测定胃粘膜内前列腺素 E2 (PGE2 )、前列腺素 I2 (PGI2 )的含量 ,用浓盐法测定胃粘膜内DNA的含量。结果 :丹参组的胃粘膜损伤指数低于对照组 (P <0 .0 1) ;胃粘膜内 PGE2 、PGI2 含量高于对照组 (均 P<0 .0 1) ;DNA含量高于对照组 (P <0 .0 1)。结论 :丹参促进胃粘膜细胞 DNA的合成和胃粘膜细胞的增殖 ,使PGE2 、PGI2 含量增加 ,进而促进了胃粘液的分泌。     

一氧化氮对实验性肾炎中肾小球花生四烯酸产物的影响

目的：探讨一氧化氮（ＮＯ）在实验性肾小球肾为中对肾小球花生四烯酸（ＡＡ）产物合成的调节作用。方法：制备大鼠加速性肾毒性肾炎（ＮＳＮ）模型,应用市郊和液相层析及放免法测定肾小球合成的前列腺素（ＰＧ）Ｅ２、６－酮－ＰＧＦ１α、血栓素（ＴＸ）Ｂ２、白三烯（ＬＴ）Ｂ４、ＬＴＣ４、５－羟二十碳四烯酸（５－ＨＥＴＥ）、１２－ＨＥＴＥ、１５－ＨＥＴＥ。对ＮＳＮ大鼠应用诱生型ＮＯ合成酶（ｉＮＯＳ）抑制剂Ｌ－ＮＩＬ     

Eicosanoid synthesis in duodenal ulcer disease: decrease in leukotriene C4 by colloidal bismuth subcitrate.

The release of immunoreactive prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) from antral and duodenal mucosal biopsy specimens taken from 20 patients with duodenal ulcer disease was measured by radioimmunoassay before and four weeks after treatment with colloidal bismuth subcitrate. Gastroscopic and histological examination showed complete ulcer healing in 15/18 patients and duodenal histology looked normal (n = 15) or improved (n = 3): two patients failed to attend for a second endoscopy. Analysis of the supernatant from incubations of biopsy tissue in vitro showed that unstimulated antral release of PGE2 was significantly more than that from the duodenal mucosa (p less than 0.05), whereas basal release of LTC4 was significantly lower from antral biopsy specimens (p less than 0.05). Subsequent incubation of specimens with calcium ionophore A23187 caused an increase in LTC4 but not in PGE2 generation. The ability of antral and duodenal mucosa to form ionophore mediated LTC4 in patients with duodenal ulcer disease was significantly greater (p less than 0.05; p less than 0.01 respectively) than that of normal gastroduodenal mucosa. After colloidal bismuth subcitrate treatment, basal synthesis of PGE2 was unchanged in duodenal and antral specimens. In contrast, basal duodenal LTC4 was reduced (p less than 0.05), and the capacity for ionophore mediated duodenal LTC4 formation was substantially and significantly reduced after treatment (p less than 0.001). These results indicate that after therapeutic healing of duodenal ulcer (accompanied by clearance of inflammatory cell infiltrate), there is a reduced ability of duodenal mucosa to generate proinflammatory peptidoleukotrienes.     

Role of mucosal prostaglandins and DNA synthesis in gastric cytoprotection by luminal epidermal growth factor.

This study compares the effect of epidermal growth factor and prostaglandins (PGE2 or PGI2), applied topically to gastric mucosa, on gastric secretion and formation of ASA-induced gastric ulcerations in rats. Epidermal growth factor given topically in non-antisecretory doses prevented dose-dependently the formation of ASA-induced ulcers without affecting prostaglandin generation but with a significant rise in DNA synthesis in the oxyntic mucosa. The anti-ulcer effect of topical prostaglandins was also accompanied by an increase in DNA synthesis. This study indicates that topical epidermal growth factor, like PGE2 or PGI2, is cytoprotective and that this cytoprotection is not mediated by the inhibition of gastric secretion or prostaglandin formation but related to the increase in DNA synthesis in oxyntic mucosa.     

Protective action of endogenous prostacyclin (PGI2) and prostaglandin E2 (PGE2) in endoscopic polypectomy-induced human ulcers

To assess how endogenous prostaglandin (PG) in gastric mucosa acts against ulcer formation, we determined the mucosal prostacyclin (PGI2), PGE2, PGF2 alpha, and thromboxane A2(TXA2) concentrations before and after polypectomy in 6 patients in whom gastric ulcers were produced by electric burning resection of gastric polyps. These artificially induced ulcers all healed within short periods (25.7 +/- 7.4 days, mean +/- SE). Of the PGs assayed, the level of PGI2 was highest. The pG levels were increased at 4 and 7 days post-polypectomy; the most remarkable increase took place in the mucosa along the ulcer margin rather than the mucosa far from the ulcer site. We suggest that the observed increase in endogenous PGs represents a physiological response against polypectomy-induced ulcer formation.     

Effect of endogenously produced leukotrienes and thromboxane on renal vascular resistance in rabbit hydronephrosis

Ureteral obstruction in rabbits is characterized by mononuclear cell invasion of the renal cortex and proliferative fibrosis that is associated with exaggerated prostaglandin synthesis in response to vasoactive and inflammatory cell agonists. In this investigation, we studied the effects of the chemotactic peptide N-formylmethionyl-leucyl-phenylalanine (fMLP) and bradykinin (BK) on eicosanoid synthesis and renal vascular resistance in the ex vivo perfused hydronephrotic kidney (HNK). Administration of fMLP resulted in the dose-dependent synthesis of leukotrienes, thromboxane A2 (TXA2), prostaglandin E2 (PGE2), and prostacyclin (PGI2). Peptidoleukotriene synthesis was monitored by specific radioimmunoassay and by guinea pig ileum bioassay and it was then validated by inhibition of the ileal contractile activity with the peptidoleukotriene receptor antagonist FPL-55712. The leukotrienes produced were identified as LTB4, LTC4, LTD4, and LTE4 by comigration with authentic standards on reverse phase high-performance liquid chromatography (RP-HPLC) and by ultraviolet spectroscopy. BK administration stimulated the synthesis of TXA2, PGE2, and PGI2 but not the synthesis of leukotrienes, in contrast to the results with fMLP, suggesting the involvement of different cell types. Administration of fMLP to the HNK also resulted in a renal vasoconstriction that was partially inhibited by FPL-55712 and that was completely inhibited by the thromboxane synthase inhibitor OKY-1581. Consistent with this result, exogenous administration of LTC4 resulted in the synthesis of TXA2 and in a renal vasoconstriction that was inhibited by either FPL-55712 or OKY-1581.(ABSTRACT TRUNCATED AT 250 WORDS)     

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.     

Effect of oral ibuprofen on formation of prostaglandins E and F by human gallbladder muscle and mucosa

In a randomized double-blind trial, the effect of ibuprofen on the pain produced by gallbladder disease and on gallbladder mucosa and muscle wall tissue PGE and PGF production was evaluated to determine if the pain of cholecystitis and prostaglandin formation were altered by administration of a prostaglandin synthetase inhibitor. To ascertain potential differences in extracellular and intracellular prostaglandin production rates, gallbladder mucosal cells and muscle tissues were maintained in tissue culture medium and then subsequently homogenized. PGE and PGF concentrations were measured in culture medium and homogenates utilizing radioimmunoassay. Gallbladder mucosa and muscle tissue produced nanogram per milligram protein amounts of PGE and PGF. As the histological estimation of the degree of inflammation increased, so also did the production of PGE. Increased inflammation was associated with unchanged PGF levels, resulting in an increased ratio of PGE/PGF with increasing inflammation. Oral ibuprofen administration was effective in decreasing PGE production by gallbladder mucosa and muscle and eliminating the significant correlation between PGE levels and the histologic degree of inflammation found in the placebo-treated patients. Ibuprofen significantly decreased the pain of cholecystitis when compared to placebo-treated patients. However, there was poor correlation between pain relief and changes in PGE production by gallbladder mucosa and muscle. PGE may play a mediator role in inflammation associated with cholecystitis. Prostaglandin synthetase inhibition decreases the pain associated with cholecystitis; however, the absence of correlation with decreased PGE formation suggests that other prostanoids may play an important role in producing the symptoms of cholecystitis.