哮喘患者痰液细胞因子和嗜酸细胞阳离子蛋白水平及意义

目的探讨痰中细胞因子、嗜酸细胞阳离子蛋白（ＥＣＰ）水平与哮喘严重程度的关系。方法采用酶联免疫法及荧光免疫法对轻（Ｍ组１０例）、中、重度（ＭＳ组１５例）哮喘患者痰液白细胞介素（ＩＬ）５、肿瘤坏死因子α（ＴＮＦ－α）、可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）、ＥＣＰ水平进行检测。结果中、重度哮喘患者痰液ＩＬ－５（３５ｎｇ／Ｌ以上）、ＴＮＦ－α（Ｍ组为１４９±５９ｎｇ／Ｌ，ＭＳ组为２６７±１４７ｎｇ／Ｌ）、ｓＩＬ－２Ｒ（Ｍ组为３４８±１０７ｋＵ／Ｌ，ＭＳ组为４８８±１２７ｋＵ／Ｌ）、ＥＣＰ（Ｍ组为１２７±９５μｇ／Ｌ，ＭＳ组为２７８±１５０μｇ／Ｌ）浓度均显著高于轻度哮喘患者。结论哮喘患者痰液中可检出有关的细胞因子及炎性介质，它们参与了哮喘的急性发作并反映哮喘的严重程度。     

广东地区健康人群和哮喘患者外周血嗜酸细胞阳离子蛋白水平的研究

用ＰａｒｍａｃｉａＣＡＰ方法测定了２５９例健康人和１０３例慢性哮喘活动的患者血清嗜酸细胞阳离子蛋白（ＥＣＰ）水平，并分析其与痰嗜酸细胞计数、血清特异性ＩｇＥ之间的关系。结果显示：①正常个体血清ＥＣＰ水平的几何均数是４．７１μｇ／Ｌ，９５％的百分位数是１２．２０μｇ／Ｌ。血清ＥＣＰ水平高于１３μｇ／Ｌ时提示嗜酸细胞活化。②活动性哮喘患者血清ＥＣＰ水平（８．７０±１３．４０）μｇ／Ｌ显著高于健康对照组（５．４１±２．３０）μｇ／Ｌ，（Ｐ＜０．０１），但其中７５％的患者血清ＥＣＰ值＜１３μｇ／Ｌ。哮喘患者血清ＥＣＰ与血清特异性ＩｇＥ（Ｐ＜０．０１）、痰嗜酸细胞计数（ｒ＝０．５１，Ｐ＜０．０５）之间有一定正相关。     

嗜酸细胞阳离子蛋白与支气管哮喘

本文综述了嗜酸细胞阳离子蛋白与嗜酸细胞、通气功能、气遭反应性及哮喘气道炎症之间的关系。并讨论了它在哮喘发病机制中的作用和临床应用的意义。     

新疆维吾尔族支气管哮喘患者123例血清嗜酸细胞阳离子蛋白水平研究

目的探讨新疆维吾尔族人群血清嗜酸细胞阳离子蛋白(ECP)与支气管哮喘发病的关系。方法2004-05共调查212名新疆和田地区维吾尔族人。其中支气管哮喘123例,根据临床特点、肺功能(FEV1占预计值%)和所需药物情况将患者分为间歇发作(30例)、轻度(30例)、中度(32例)、重度(31例)4个组,年龄(38.35±9.17)岁。健康成年人89名,年龄(38.12±8.23)岁,作为正常对照组。血清ECP(S-ECP)水平测定由固定资深专业测试人员应用UniCAP100全自动体外变应原检测系统进行测定。结果S-ECP与哮喘的症状评分、1秒用力呼气容积(FEV1)和最大峰流速(PEF)高度相关(P<0.01)。在哮喘各组之间,S-ECP差异均有显著性意义(均P<0.01),最高值在重度哮喘患者组[ECP=(15.21±1.12)μg/L]出现,且S-ECP水平与病情严重程度呈正相关关系(r=0.63,P<0.01)。变态反应的出现与S-ECP值增高有关。S-ECP值与哮喘发作的自觉症状和通过检查所得的客观体征具有高度相关性,ECP与PEF之间存在负相关关系(r=-0.67,P<0.05)。结论S-ECP主要取决于嗜酸粒细胞激活程度和分泌蛋白的能力,它们能反映哮喘气道炎症的活动情况,并可预示哮喘发作的严重程度。     

哮喘患者嗜酸粒细胞阳离子蛋白及其细胞密度的改变

为研究哮喘患者体内嗜酸性粒细胞（ＥＣ）、Ｔ淋巴细胞功能状态及相互关系，对哮喘，急者外周血ＥＣ密度及血清嗜酸细胞阳离子蛋白（ＥＣＰ）、可溶性白介素－２受体（ｓＩＬ－２Ｒ）浓度进行检测。结果表明，哮喘患者外周血低密度ＥＣ增多，血清ＥＣＰ、ｓＩＬ－２Ｒ浓度同时增高且幅度一致。提示ＥＣ的激活与Ｔ淋巴细胞激活有关，两者共同参与哮喘的发病过程。     

过敏性哮喘患者二丙酸倍氯米松治疗前后血清嗜酸细胞阳离子蛋白水平的变化

分别测定发作期及缓解期过敏性哮喘共２９６例和４０例健康人血嗜酸性粒细胞（Ｅｏｓ）计数，血清嗜酸细胞阳离子蛋白（ＥＣＰ）和ＩｇＥ抗体。并观察了其中３０例患者吸入二丙酸倍氯米松（ＢＤＰ）４周前后上述指标和肺功能变化。结果：发作期过敏性哮喘患者血Ｅｏｓ计数，血清ＥＣＰ、ＴＩｇＥ、ｓＩｇＥ水平明显高于其它两组（均为Ｐ＜００１）。治疗前、后血Ｅｏｓ、ＥＣＰ和肺功能（ＦＥＶ１、ＰＥＦ、Ｒａｗ、ｓＧａｗ等）指标相比均有显著或非常显著性差异（Ｐ＜００５或Ｐ＜００１）。过敏性哮喘发作期病人Ｅｏｓ与ＥＣＰ水平变化呈高度正相关（ρ＝０７２１，Ｐ＜００１），而Ｅｏｓ、ＥＣＰ分别与ＦＥＶ１％呈高度负相关（ρ＝－０７８２，ρ＝－０６９５；Ｐ均＜００１）。结论：血清ＥＣＰ水平可作为哮喘气道炎症监测及指导治疗的客观指标     

哮喘患者血清嗜酸细胞阳离子蛋白及白细胞介素2受体观察

通过对哮喘急性发作组和正常对照组血清嗜酸细胞阳离子蛋白（ECP）、可溶性白细胞介素2受体肝thZR）及外周血嗜酸细胞计数（EOS）及一秒钟用力呼气容积占预计值的百分比（FEVl占预计值％）的观察，探讨在哮喘发病中T淋巴细胞的激活对嗜酸细胞活化的调节及血清ECP、theZR水平、血EOS计数在哮喘临床应用中的价值，为临床应用糠皮质激素抗炎治疗哮喘提供实验依据。对象与方法正常对照组32名，男匕名，女17名，年龄M－59岁，排除过敏性、寄生虫等病史，分别用荧光免疫法和酶联免疫吸附试验双抗体夹心法测定血清ECP及sILZR水平。哮喘…     

嗜酸细胞阳离子蛋白与支气管哮喘

本综述了嗜酸细胞阳离子蛋白与嗜酸细胞、通气功能、气道反应性及哮喘气道炎症之间的关系。并讨论了它在哮喘发病机制中的作用和临床应用的意义。     

哮喘患者痰液中亚硝酸盐/硝酸盐含量的变化及其意义

目的　探讨痰液中一氧化氮（ Ｎ Ｏ） 代谢终产物———亚硝酸盐／ 硝酸盐（ Ｎ Ｏ２／ Ｎ Ｏ３） 测定在哮喘临床中的应用价值。方法　应用 Ｇｒｉｅｓｓ 重氮法测定４５ 例不同时期、不同程度哮喘患者及１５ 例慢性支气管炎（ 慢支） 合并肺心病急性发作期患者痰液、血清 Ｎ Ｏ２／ Ｎ Ｏ３ 含量，同步测定哮喘患者痰液中嗜酸细胞阳离子蛋白（ Ｅ Ｃ Ｐ） 水平及肺通气功能。结果　哮喘轻、中、重度发作期患者痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 中位数浓度（ 分别为１３１ μｍｏｌ／ Ｌ、１３６ μｍｏｌ／ Ｌ） 与缓解期组（８５ μｍｏｌ／ Ｌ） 及正常对照组（６３ μｍｏｌ／ Ｌ） 比较，差异有显著性（ Ｐ＜ ００５） ；发作期组与缓解期组比较差异有显著性（ Ｐ＜ ０ ．０５） ；慢支合并肺心病急性发作期患者痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 水平（３３ μｍｏｌ／ Ｌ） 与各哮喘组及正常对照组比较，差异有显著性（ Ｐ＜ ００５） 。缓解期及发作期哮喘患者痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 与一秒钟用力呼气容积占预计值百分比（ Ｆ Ｅ Ｖ１ 占预计值％ ）间呈显著负相关（ｒ 分别＝ － ０５８７ 、－ ０４８５ ， Ｐ 均＜ ００５） ；而痰液 Ｎ Ｏ２／ Ｎ Ｏ３ 与 Ｅ Ｃ Ｐ 间呈     

Eosinophil soluble protein levels, eosinophil peroxidase and eosinophil cationic protein in asthmatic patients.

Eosinophil granular proteins are useful eosinophil activation markers in asthmatic patients. In this study, eosinophil peroxidase (EPO) and eosinophil cationic protein (ECP) levels were assessed in different stages of bronchial asthma in 123 patients suffering from intrinsic (n = 42) and extrinsic (n = 81) asthma, with the aim of evaluating the difference in the protein levels between both types of asthma and their importance as a severity marker of the disease. The geometric mean serum level of EPO was 12.3 +/- 2.17 ng/ml (mean +/- SD) in controls, and 38.6 +/- 3.4 ng/ml in the asthmatic patients. Mean ECP levels were 13.22 +/- 1.11 ng/ml in controls and 30.5 +/- 2.38 ng/ml in patients. Depending on the asthma severity, the EPO levels were 30.4 +/- 4.35, 38.7 +/- 5.29, and 54.46 +/- 9.46 ng/ml in mild, moderate and severe asthmatics, respectively, with the differences being significant between the groups of patients with mild and severe asthma (p < 0.001). ECP levels were 24.23 +/- 3.37 in mild, 31.69 +/- 4.21 in moderate, and 37.61 +/- 4.52 ng/ml in severe asthma. There were significant differences in ECP levels between mild and moderate asthma (p < 0.001) and between mild and severe asthma (p < 0.001). Peripheral eosinophil count was 157 +/- 20 eosinophils/mm3 in controls, 334 +/- 35 eosinophils/mm3 in mild asthmatics, 510 +/- 87 eosinophils/mm3 in moderate asthmatics and 658 +/- 72 eosinophil/mm3 in severe asthmatics, with significant differences between all groups (p < 0.05-p < 0.001). Serum EPO and ECP levels and peripheral eosinophil count were significantly greater in patients with active asthma than in patients with silent asthma (p < 0.001). Significant negative correlations (p < 0.001) were found between serum EPO levels and FEV1 (rs = -0.30), MEF25-75 (rs = -0.33), MEF50 (rs = -0.34). There was also a significant (p < 0.001) and negative correlation between ECP levels and FEV1 (rs = -0.31), MEF25-75 (rs = -0.31), MEF50 (rs = -0.32). A good positive correlation was found between peripheral eosinophil count and EPO levels (rs = 0.80, p < 0.001), and ECP levels (rs = 0.67, p < 0.001). We also found a significant positive correlation between clinical score and peripheral eosinophil count (rs = 0.54, p < 0.001), EPO levels (rs = 0.46, p < 0.001) and ECP levels (rs = 0.52, p < 0.001).     

壮医特色针挑疗法对支气管哮喘患者白细胞介素-4及嗜酸性粒细胞阳离子蛋白影响的研究

目的研究壮医特色针挑疗法对支气管哮喘患者血清中自细胞介素4（IL-4）和嗜酸性粒细胞阳离子蛋白（ECP）水平含量治疗前后的变化。以探讨其致病机制。方法选择符合病例纳入标准的支气管哮喘患者各35例。观察三组哮喘患者治疗4个疗程后其血清中IL-4及ECP水平含量的前后变化。结果壮医针挑治疗组哮喘患者血清中IL-4和ECP含量明显降低,且IL-4降低水平优于对照1组,对照2组（P〈O．01,P〈0．05）,但ECP水平含量的降低与对照1组、对照2组比较差异无统计学意义（P〉0．05）。结论壮医特色针挑疗法能够有效地降低哮喘患者血清中IL-4和ECP,减轻支气管哮喘患者气道变应性炎症,提高临床疗效。     

Serum concentrations of eosinophil cationic protein and eosinophils of patients with Kimura's disease.

BACKGROUND: To clarify the role of eosinophils in the pathogenesis of Kimura's disease and the values of measuring serum levels of eosinophil cationic protein (ECP) for monitoring disease activity might be very important, but there are few reports about this matter. METHODS: A total 14 serum and 7 tissue samples from patients with Kimura's disease were studied. The concentrations of ECP and cytokines (interleukin-4 (IL-4), granulocyte-macrophage colony-stimulating factor (GM-CSF), and interleukin 5 (IL-5)) in sera from patients with Kimura's disease were measured by enzyme-linked immunosorbent assay (ELISA). The density of eosinophils and the degree of activation of eosinophils in the tissue were also studied immunohistochemically. RESULTS: The concentration of ECP in sera from patients with Kimura's disease was significantly higher than that in the control group (p<0.05). At the time of the remission, a significant decrease of ECP was observed. In interfollicular areas, most infiltrated eosinophils were positive for EG2 antibody (64.0-94.0%) and the mean percentage of EG2-positive eosinophils was 75.7%. The concentrations of IL-4, GM-CSF, and IL-5 in sera from patients with Kimura's disease were within normal ranges or below the detectable level in all sera examined. CONCLUSIONS: Our findings suggest that eosinophils play an important role in the pathogenesis of Kimura's disease and ECP may be used as an additional parameter of disease activity.     

Effects of different anti-asthmatic agents on induced sputum and eosinophil cationic protein in mild asthmatics

OBJECTIVES: Inhaled corticosteroids, leukotriene receptor antagonists, and theophylline are recommended for the treatment of mild persistent asthma. The aim of this study was to compare the changes in sputum total cell and eosinophil counts, and eosinophil cationic protein (ECP) levels in serum and sputum following treatment with leukotriene receptor antagonists, inhaled corticosteroids, and theophylline in patients with mild persistent asthma. METHODOLOGY: Total cell counts, eosinophil percentage, and ECP levels in induced sputum and serum were determined both before and after treatment. Prior to sputum induction, FEV1 and PEF values and symptom scores were recorded at baseline and after 8 weeks of treatment. After baseline measurements, the asthmatic patients (n = 30) were randomized into three groups. A total of 10 patients were treated with zafirlukast, 20 mg bd, 10 with budesonide inhaler 200 microg bd, and 10 with theophylline 200 mg bd. RESULTS: There were significant decreases in sputum total cell counts and eosinophil percentage in all treatment groups. However, the decrease in sputum eosinophil counts was more significant in the corticosteroid-treated group. Although sputum ECP levels decreased significantly in the groups treated with zafirlukast and budesonide (zafirlukast group, 580-135 microg/L, P < 0.01; budesonide group, 683-268 microg/L, P < 0.01), the decrease was not statistically significant in the theophylline-treated group (498-361 microg/L, P > 0.05). In contrast, there were no significant changes in serum ECP levels in any of the treatment groups. CONCLUSIONS: All three treatments resulted in significant decreases in sputum total cell counts and eosinophil percentage, but the decrease in sputum ECP level was only seen in the groups treated with budesonide and zafirlukast. These results suggest that although all three treatments are considered as first-line treatments in most consensuses, theophylline seems to have less of an inhibitory effect on eosinophil activation.     

Changes in serum eosinophil cationic protein levels after exercise challenge in asthmatic children.

The aim of the present study was to assess the relationship between serum eosinophil cationic protein levels and the severity of exercise-induced bronchoconstriction in asthmatic children. The 48 asthmatic children were divided into exercise-induced bronchoconstriction group and non-exercise-induced bronchoconstriction group. In the exercise-induced bronchoconstriction group, the post-exercise serum eosinophil cationic protein levels were significantly increased as compared with the pre-exercise serum eosinophil cationic protein levels. These results suggested that eosinophil cationic protein may serve as a possible contributor to the pathophysiology of exercise-induced bronchoconstriction in asthmatic children.     

哮喘患者吸入表面激素减量后哮喘症状变化与诱导痰嗜酸性粒细胞比例的关系

目的 探讨吸入表面激素（ICS）减量后哮喘症状变化与诱导痰嗜酸性粒细胞（EOS）比例的关系.方法 选择专科门诊已使用ICS治疗的39例缓解期哮喘患者,进行诱导痰检查.根据减量时间分为两组,一组16例为缓解1个月后ICS剂量减半（减量1组16例）,另一组23例为缓解3个月后ICS剂量减半（减量2组）,予诱导痰检查.分别予目前使用ICS剂量减半,并于ICS减量后1个月、2个月、3个月及6个月复诊,复查诱导痰,观察气道炎症变化,对所得数据应用SPSS15.0软件分析.结果 两组患者ICS减量后3个月（43.8％ vs.21.7％）及6个月（43.8％ vs.43.5％）内哮喘症状复发率无显著差异（P ＞0.05）;ICS减量后3个月复发组与未复发组患者减量前诱导痰EOS比例存在显著差异（10.3％ vs.2.5％,P＜0.05）.ICS减量后6个月复发组与未复发组患者减量前诱导痰EOS比例也存在显著差异（11.5％ vs.2.5％,P＜0.05）.结论 诱导痰EOS比例对判断缓解期患者ICS减量后症状复发具有重要参考价值,临床症状缓解后,参考诱导痰EOS比例进行ICS减量,有可能减少哮喘的复发.     

Nasopharyngeal eosinophil cationic protein in bronchiolitis

A prospective 4-month follow-up of children hospitalized with bronchiolitis revealed that high concentrations of eosinophil cationic protein (ECP) in nasopharyngeal aspirates (NPA) are predictive of wheezing after bronchiolitis. In the 29 patients who received no anti-inflammatory therapy the median concentration of NPA ECP was 882 ng/g in those with physician-diagnosed wheezing and 154 ng/g in those without subsequent physician-diagnosed wheezing (P = 0.02). The NPA ECP concentrations of the whole study group of 88 children with and without subsequent hospital admissions for wheezing were 531 and 299 ng/g, respectively (P = 0.02). At entry the children with negative viral findings had significantly higher concentrations of respiratory tract ECP than those with positive viral findings (515 vs. 240 ng/g; P = 0.01). The concentration of ECP in respiratory secretions decreased significantly after bronchiolitis (P = 0.01) provided that no new viral or mycoplasmal infection occurred. NPA ECP values decreased in relation to time regardless of whether anti-inflammatory therapy was used or not. Children with high concentrations of respiratory tract ECP seemed to benefit from anti-inflammatory therapy with nebulized cromolyn sodium or budesonide; both drugs significantly decreased the number of subsequent physician-diagnosed bronchial obstructions (P = 0.0006), and they tended to decrease the number of hospital admissions for wheezing (P = 0.08). Our results suggest that high concentrations of ECP in respiratory tract secretions in children with bronchiolitis reflect the presence of eosinophilic inflammation also seen in asthma. Pediatr. Pulmonol. 1997;24:35–41. © 1997 Wiley-Liss, Inc.     

Serum levels of eosinophil cationic protein and eosinophils in asthmatic children during a course of prednisolone therapy

Eosinophils play an important role in the inflammatory events of allergic asthma. Serum eosinophil cationic protein (ECP) is a marker of disease activity and of treatment efficacy in bronchial asthma. To understand the role of ECP concentrations in disease activity of acute asthma, we determined changes in serum concentrations of ECP elaborated by activated eosinophil before and after prednisolone therapy. Circulating levels of ECP in 15 normal control subjects, and in sera of 20 asthmatic children who were allergic to house dust mites, were measured during an acute exacerbation and when the children were in stable condition, using commercially available assay kits. The mean concentrations of serum ECP were significantly higher during an acute asthma exacerbation than when the children were stable (26.41 +/- 21.66 microg/L vs 15.74 +/- 11.36 microg/L P < 0.01) or when compared to control subjects (7.50 +/- 1.42 microg/L; P < 0.001). The mean eosinophil counts (EC) during acute asthma attacks (575 +/- 286/mm3) and when stable (467 +/- 204/mm3) were higher than in the control group (181 +/- 164/mm3). The differences were statistically significant among the three groups (P < 0.05). A significant correlation was found between serum levels of ECP and EC (r = 0.788, P = 0.001) in asthmatic children; there were also significant correlations between ECP and EC in nonallergic normal control subjects (r = 0.662; P = 0.007). In conclusion, this study provides further evidence that changes in serum ECP may serve as an objective indicator for clinical activity and results of treatment in allergic asthmatics.     

Exhaled nitric oxide and sputum eosinophil markers of inflammation in asthmatic children.

Exhaled nitric oxide and eosinophil sputum markers are considered noninvasive ways in which to evaluate airway inflammation in asthma. The aim of this study was to evaluate the relationships between these methods of evaluation in asthmatic children. In a cross-sectional study of 25 mild-moderate asthmatic children (aged 6-13 yrs, 10 patients on inhaled steroids) exhaled NO was measured along with induced sputum by inhalation of hypertonic saline solution. The sputum was processed for eosinophil count and eosinophil cationic protein (ECP) determination. Serum ECP and lung function (forced expiratory volume in one second (FEV1)) were also measured. A significant correlation was observed between exhaled NO and sputum eosinophils (r = 0.438, p = 0.032) as well as between sputum eosinophils and sputum ECP (r = 0.532, p<0.01). No correlation was observed among exhaled NO and serum ECP, sputum ECP, FEV1, respectively. Furthermore no correlation was observed between sputum eosinophil (%) and serum ECP and between sputum eosinophils and FEV1. There was no correlation among the investigated parameters in children treated with inhaled steroids. In conclusion, exhaled NO and sputum eosinophil counts are concordant in evaluating the degree of airway inflammation in patients with mild-to-moderate asthma. However, the association between these two noninvasive markers becomes less in steroid treated patients.