哮喘患者痰液中炎症介质和细胞因子与气道重塑的关系研究

目的　以支气管粘膜网状基底膜厚度作为气道重塑的指标 ,探讨哮喘患者气道重塑与痰液中细胞因子和炎症介质的关系。方法　对 2 0例哮喘患者和 10名正常对照者经纤维支气管镜行(纤支镜 )支气管粘膜活检 ,测量支气管粘膜网状基底膜厚度 ,用荧光酶联免疫方法测定痰液中的嗜酸细胞阳离子蛋白 (ECP) ,酶联免疫法测定白细胞介素 5 (IL 5 )、肿瘤坏死因子 (TNF α)的水平 ;采用SPSS8 0统计软件作等级相关分析 ,探讨哮喘患者痰液中ECP、IL 5、TNF α水平与支气管粘膜厚度的关系。结果　缓解期哮喘患者支气管粘膜网状基底膜厚度为 (10 1± 2 6 ) μm ,与正常对照组 (4 4± 1 2 )μm]比较 ,差异有显著性 (P <0 0 0 5 ) ;哮喘组痰液中ECP水平为 (14 4± 80 ) μg/L、IL 5为 (17± 4 ) μg/L、TNF α为 (14 6± 79) μg/L ,与正常对照组 (81± 4 4 ) μg/L、(14± 4 ) μg/L、(5 3± 36 ) μg/L]比较 ,差异有显著性 (P <0 0 0 5 ) ;两组痰液中ECP、IL 5与支气管粘膜厚度呈明显正相关 (r =0 5 6 9、0 4 6 6 ,P均 <0 0 0 5 ) ;两组痰液中TNF α水平与粘膜厚度无明显相关 (r=0 2 5 4 ,P >0 0 5 )。结论　缓解期哮喘患者支气管粘膜网状基底膜厚度均存在不同程度增厚 ;而痰液ECP和IL 5水平与支气管粘膜厚度呈

Relationship between airway remodeling and inflammatory mediators and cytokines in sputum in patients with bronchial asthma

OBJECTIVE: To compare the thickness of subepithelial reticular basement membrane (BM) in asthmatic patients and healthy subjects and to compare the BM thickness to inflammatory mediators and cytokines. METHODS: Fiberoptic bronchoscopy with bronchial biopsy was performed on 20 stable asthmatics and 10 normal subjects. The subepithelial reticular BM thickness was measured. Levels of eosinophil cationic protein (ECP), interleukin 5 (IL-5 ), and tumor necrosis factor alpha (TNF alpha ) in sputum were measured by immunoassay. The relationship between ECP, IL-5, TNF alpha and BM thickness was estimated by the spearman rank correlation. RESULTS: The mean BM thickness was significantly higher in asthmatic patients (10.1 +/- 2.6) microm than in normal subjects (4.4 +/- 1.2) microm (P < 0.005). In asthmatic patients, the ECP (144 +/- 80) microgram/L and the IL-5 (17 +/- 4) microgram/L levels in sputum were positively correlated with BM thickness (r = 0.569, P < 0.005 and r = 0.466 P < 0.005, respectively ). Sputum TNF-alpha (53 +/- 36) microgram/L showed no significant correlation with BM thickness (r = 0.254 P > 0.05). CONCLUSIONS: Airway remodeling is a distinctive and characteristic pathologic finding of asthma. Airway remodeling is related to levels of sputum ECP and IL-5, but not that of TNF-alpha.