Tear fluid concentration of mmp–8 is elevated in non—allergic eosinophilic conjunctivitis and correlates with conjunctival inflammatory cell infiltration

Background  To investigate tear fluid concentration of matrix metalloproteinase 8 (MMP–8) and its relation to conjunctival inflammatory cell infiltration in persistent non—allergic eosinophilic conjunctivitis (NAEC). Methods  Two groups were included: 26 consecutive adult patients with NAEC (conjunctival eosinophils at least 1+ [1-10 eosinophils/slide], skin prick test [SPT] to common allergens negative), and 26 asymptomatic adult persons (no conjunctival eosinophils, SPT negative). MMP–8 tear fluid concentrations were determined by immunofluorometric assay, and conjunctival brush cytology samples from NAEC patients were used for MMP–8 immunocytochemistry. Gelatin zymography was used to illustrate proteolytic activity within the tear fluid samples. Results  The mean MMP–8 concentration was significantly higher among NAEC patients (214.3 ± 327.7 μg/l) than among healthy persons (50.4 ± 62.3 μg/l, P < 0.0001). In the NAEC patients, tear fluid MMP–8 correlated with the numbers of conjunctival neutrophils (r = 0.66, P = 0.0002) as well as with goblet cells and columnar epithelial cells (r = 0.54 for both, P = 0.045), but not with the lymphocyte numbers (r = -0.36, P = 0.0741). By immunocytology, MMP–8 protein could also be detected in vivo in the inflammatory cell population within the conjunctiva. Zymography revealed that proteolysis was significantly higher in the NAEC group, and activated enzymes were practically found only in the NAEC group. Conclusions  The results showed that NAEC is an inflammatory condition characterized by increased tear fluid MMP–8 levels, probably derived from both inflammatory and structural conjunctival cells. The increased proteolytic activity in NAEC patients may indicate risk of conjunctival structural changes (remodeling).     

Adult eosinophilic gastroenteritis and hypereosinophilic syndromes

Eosinophilic gastroenteritis （EGE） in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often, the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion, including parasitic infections and drug-induced causes. Occasionally, the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized, in large part, due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea, in particular, endoscopic imaging and mucosal biopsies. Definition of EGE, however, may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also, the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms, and, in some instances, eosinophil quantification in pre-treatment and posttreatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in definition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.     

白三烯受体拮抗剂对哮喘小鼠的气道炎症及肺内一氧化氮合酶的影响

目的:研究白三烯受体拮抗剂对哮喘气道炎症过程及肺内一氧化氮合酶(NOS)的影响.方法:C57BL/6J小鼠分为3组:哮喘组(7只),正常对照组(6只),扎鲁司特(白三烯受体拮抗剂)组(7只).建立小鼠哮喘模型,给予口服扎鲁司特40 mg*kg-1*d-1,共5 d,观察支气管肺泡灌洗液(BALF)中白细胞总数,嗜酸细胞百分比(EOS%),血涂片,骨髓片中EOS%,并用免疫组化的方法观察使用扎鲁司特后诱生型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)的表达情况.结果:哮喘组BALF中白细胞总数[(13.9±0.8)×106 ml-1]、EOS%[(47.75± 13.09)%]显著高于正常对照组(P<0.001),正常对照组相应数值分别为(1.9±0.5)×106 ml-1和(0.2±0.01)%,口服扎鲁司特后BALF中白细胞总数[(1.3±0.4)×106 ml-1]、EOS%[(1.33±1.07)%]显著低于哮喘组(P< 0.001),哮喘组激发后第一天血涂片中EOS%[(18.75±8.54)%]显著高于对照组[(1.5±1.0)%,P<0.001],扎鲁司特组在激发后第1天血涂片中EOS%则较正常对照组明显下降[(6.95±3.83)%],哮喘组骨髓片中EOS%[(13.5± 3.9)%]显著高于正常对照组[(2.5±2.9)%],而扎鲁司特组[(12.7±6.0)%]与哮喘组比较无显著变化.免疫组化结果显示,扎鲁司特可抑制iNOS表达,但不影响eNOS表达.结论:肺内哮喘炎症时的EOS来自于血循环边缘池和骨髓增生,扎鲁司特有效地抑制EOS浸润,从而抑制气道炎症,扎鲁司特可能通过间接或直接的途径抑制 iNOS的表达.     

痰液炎性细胞与儿童发作期哮喘关系的研究

目的：探讨反映气道炎症状况的痰液炎性细胞测定在哮喘临床中的应用价值。方法：应用Pin等的诱导痰技术,对105例哮喘发作期儿童（上呼吸道感染诱因组30例,非感染诱因组75例）的新鲜痰涂片进行迈－格氏加姬姆萨（May-Gruenwald′s Gimsa）复染法和巴氏（Papanicolaou)染色法染色,做细胞学分类计数,测定痰液炎性细胞百分比,同步检测变应厚皮试和肺通气功能。结果：上呼吸道感染诱因组中痰液嗜酸细胞和中性粒细胞中位数分别为4％、74％与非感染诱因组（分别为13％、30％）比较、两种细胞各组间差异无有显著性（P＜均＜0．01）,非吸入激素组和不正规吸入激素组中的嗜酸细胞中位数分别为75％、15％,与正规吸入激素组（1％）比较差异均有显著性（P均＜0．05）。伴有中性粒细胞增高的嗜酸细胞型18型中12例为中、重度哮喘发作者（67％）,气道阻塞明显,第1秒用力呼出量占用力肺活量的百分比的均值（66．09％）与嗜酸细胞型和非嗜酸细胞型（分别为84．16％、84．90％）比较差异有显著性（P均＜0．05）。结论：痰液炎性细胞可能成为反映哮喘患儿气道炎症程度,评价药物疗效的指标。     

嗜酸细胞活化趋化因子在变应性鼻炎中的作用

目的 通过建立变应性鼻炎(allergjcrhinitis,AR)豚鼠模型,探讨嗜酸细胞活化趋化因子(eotaxin)对鼻黏膜中嗜酸细胞(eosinophils,Eos)局部浸润及活化的作用,进一步阐明Eos在鼻黏膜的摹集及其活化的机制.方法 卵清蛋白致敏法制备AR豚鼠模型,分别采用免疫组化、逆转录聚合酶链反应技术检测eotaxin蛋白及mRNA在鼻黏膜中的表达,免疫荧光法测定鼻腔冲洗液中嗜酸细胞阳离子蛋白(eosinophilcationic protein,ECP)含量标示Eos活化程度,鼻黏膜HE切片每高倍视野下Eos平均个数标示Eos浸润程度.结果与对照组相比,AR模型组鼻黏膜中eotaxin蛋白阳性表达率、eotaxin mRNA表达、Eos个数以及鼻腔灌洗液中ECP含量均显著增加(P<0.001,P=0.006,P<0.001,P<0.001);相关分析表明eotaxin表达与Eos浸润程度及ECP含量呈正相关(r分别=0.849、0.691、0.656、0.81 9).地塞米松干预后以上指标一致性下降.结论 AR豚鼠鼻黏膜中eotaxin表达增强,是Eos局部浸润和活化的重要影响因素;地塞米松可以通过降低AR豚鼠鼻黏膜中eotaxin的表达减少鼻黏膜中Eos的局部浸润和活化.     

支气管哮喘患者血清嗜酸细胞趋化因子水平的变化及意义

目的探讨嗜酸细胞趋化因子(Eotaxin)在支气管哮喘发病中的作用。方法选择我院呼吸内科门诊就诊的哮喘患者76例,按病程分为哮喘急性发作组25例,哮喘持续组27例,哮喘缓解组24例;选择同期在我院体检的健康志愿者28例设为健康对照组。所有研究对象均行肺功能检测及外周血嗜酸细胞(Eos)计数和血清Eotaxin水平测定并进行比较。结果哮喘急性发作组、哮喘持续组外周血Eos计数及血清Eotaxin水平明显高于哮喘缓解组和健康对照组,哮喘缓解组外周血Eos计数及血清Eotaxin水平明显高于健康对照组,差异均有统计学意义(P<0.05)。哮喘急性发作组、哮喘持续组、哮喘缓解组血清Eotaxin水平与其外周血Eos计数呈正相关(r=0.592,0.598,0.584;P=0.031,0.033,0.029),与最大呼气流速改变率(ΔPEF%)呈正相关(r=0.589,0.591,0.585;P=0.035,0.041,0.042),与第一秒用力呼气容积(FEV1)占预计值百分比呈负相关(r=-0.582,-0.576,-0.569;P=0.042,0.044,0.039)。结论支气管哮喘患者血清Eotaxin水平明显升高,并与肺功能受累情况及气道高反应性显著相关,Eotaxin是参与哮喘气道炎性反应过程的重要因子。     

胃溃疡伴重度贫血患者胃部钩虫寄生1例

本文报道了1例胃溃疡伴重度贫血患者胃部钩虫寄生病例,以期为此类疾病的临床诊断提供指导.     

AD患儿外周血白细胞介素-17、白细胞介素-8、血清IgE及EOS水平变化及其意义

目的 探讨特应性皮炎(AD)患儿外周血白细胞介素-17(IL-17)、白细胞介素-8(IL-8)、免疫球蛋白E(IgE)及嗜酸性粒细胞计数(EOS)的水平变化及其意义.方法 选取120例AD患儿作为AD组,以同期30名健康儿童作为对照组,检测并比较两组外周血IL-17、IL-8、IgE及EOS的水平,依据皮损严重程度对AD患儿进行分层分析.结果 AD组患儿的外周血中IL-17、IL-8、IgE及EOS水平均显著高于对照组(P＜0.05);AD组患儿的外周血中IL-17、IL-8、IgE、EOS水平及AD严重程度评分各亚组间比较,重度组＞中度组＞轻度组,且差异具有统计学意义(P＜0.05);AD组患儿的外周血中IL-17、IL-8、IgE、EOS水平与AD严重程度评分均呈显著正相关(P＜0.05).结论 AD儿童外周血IL-17、IL-8、IgE及EOS水平均显著的增高,且与病情严重程度密切相关.     

嗜酸性中耳炎的研究新进展

嗜酸性中耳炎(EOM)其显著特点是中耳腔中的黏液中含有大量的嗜酸性粒细胞,常合并支气管哮喘或变应性鼻炎.传统的治疗中耳炎的方法,如:鼓膜切开、抗生素消炎、乳突根治术等并不能取得良好的效果.经过临床治疗发现,全身或局部运用类固醇类激素及生物靶向治疗,效果显示优于传统治疗.因嗜酸性中耳炎相对少见,临床表现并不典型,发现时已...