哮喘联盟

   摘要
   背景和目的：小气道病变与哮喘严重程度及控制程度有关，但其与气道炎症的关系未知。本文通过在传导依赖性气道(Scond) 和更多外周扩散依赖性气道 (Sacin) 中进行多次呼吸氮冲洗来评估小气道病变发生位置，确定痰液炎性细胞与小气道病变位置的关系。
   方法：对53例（年龄20-67岁）采用吸入性糖皮质激素治疗的哮喘患者进行肺功能测定以及Scond、Sacin和诱导痰液细胞分类计数的特征统计。采用已发表的参考公式计算Scond和Sacin预测百分比以校正年龄的影响。运用Spearman检验进行单因素相关性分析。运用多元线性回归解释潜在混杂因素的影响，包括年龄、性别、疾病持续时间、体质指数和吸入性糖皮质激素剂量。
   结果：Sacin（预测百分比）与中性粒细胞百分比（rs  = 0.33, P = 0.02）、吸入性糖皮质激素剂量（rs  = -0.28, P = 0.04）和年龄（rs  = 0.27, P = 0.05）显著相关。在多元分析中，Sacin仅与中性粒细胞百分比（校正R2  = 0.18, P = 0.001）相关。Scond（预测百分比）仅与嗜酸性粒细胞百分比显著相关(rs  = 0.39, P = 0.004)，并与吸入性糖皮质激素剂量有负相关趋势(rs  = -0.26, P = 0.06)。多元分析中，Scond与嗜酸性粒细胞百分比和吸入性糖皮质激素剂量独立相关(adjusted R2  = 0.12, P = 0.02)。
   结论：腺泡及传导性气道病变与哮喘气道中的不同炎症状态有关，独立于年龄和疾病持续时间的影响。腺泡气道病变与中性粒细胞性气道炎症之间的关系可能给哮喘治疗带来提示。

（杨冬 审校）
Respirology. 2015 May 7. doi: 10.1111/resp.12550. [Epub ahead of print]

 

Association between peripheral airway function and neutrophilic inflammation inasthma.
 

Farah CS1,2,3, Keulers LA4, Hardaker KM1,2, Peters MJ2,3, Berend N1,2,5, Postma DS4, Salome CM1,2, King GG1,2,6.
Author information
 

Abstract
BACKGROUND AND OBJECTIVE:Small airway dysfunction is associated with asthma severity and control, but its association with airway inflammation is unknown. The aim was to determine the association between sputum inflammatory cells and the site of small airway dysfunction, measured by multiple breath nitrogen washout in convection-dependent (Scond) and more peripheral diffusion-dependent (Sacin) airways.
METHODS:Fifty-three (20-67 years) subjects with asthma on inhaled corticosteroid (ICS) treatment were characterized by spirometry, Scond, Sacin and induced sputum differential counts. %Predicted values for Scond and Sacin were calculated from published reference equations to adjust for the effects of age. Univariate correlations were assessed using the Spearman test. Multivariate linear regressions were performed to account for potential confounders, including age, gender, disease duration, body mass index and ICS dose.
RESULTS:Sacin (%predicted) correlated significantly with neutrophil% (rs  = 0.33, P = 0.02), ICS dose (rs  = -0.28, P = 0.04) and age (rs  = 0.27, P = 0.05). In multivariate analysis, Sacin related only to neutrophil% (adjusted R2  = 0.18, P = 0.001). Scond (%predicted) correlated significantly only with eosinophil% (rs  = 0.39, P = 0.004). There was a trend for a negative relationship with ICS dose (rs  = -0.26, P = 0.06). In multivariate analysis, Scond related to eosinophil% and ICS dose independently (adjusted R2  = 0.12, P = 0.02).
CONCLUSIONS:Acinar and conductive airway dysfunction is associated with different inflammatory profiles in asthmatic airways, independently of the effects of age and disease duration. The association between acinar airway dysfunction and neutrophilic airway inflammation may have implications for asthma treatment.

Respirology. 2015 May 7. doi: 10.1111/resp.12550. [Epub ahead of print]