哮喘患者血管形成素I和Ⅱ在气道微血管渗漏中的作用
2007/10/26
《Chest》中文章：血管内皮生长因子能增加微血管的通透性。近期研究的焦点在于血管内皮生长因子的两个调节因子血管形成素I和血管形成素Ⅱ的生理调节作用。文章的研究目的是探讨血管形成素I和血管形成素Ⅱ对哮喘患者气道微血管通透性的作用。研究测定了30名哮喘患者和12名对照者的血管源性因子和气道微血管渗出的指标。经过两周的随访后，哮喘患者被随机的分配到氟替卡松（400mg/日）组和孟鲁司特钠（10mg/日）组。结果发现哮喘患者的血管内皮生长因子、血管形成素I和血管形成素Ⅱ的水平均高于对照组。血管渗出性指标与血管形成素I呈负相关，而与血管形成素Ⅱ呈正相关。氟替卡松治疗组，气道微血管通透性的改善与血管形成素I的下降水平呈负相关。孟鲁司特纳治疗组，气道微血管通透性的改善与血管形成素Ⅱ的下降水平呈正相关。
结论：血管形成素I和血管形成素Ⅱ在调解哮喘患者微血管通透性方面具有协调和互补作用。糖皮质激素与抗白三烯药物联用，可以改善血浆的滤过性，从而提供一种新的哮喘治疗方法。
(杨萌 卫生部中日友好医院呼吸科 100029 摘译)
METHODS: Levels of these angiogenic factors and airway vascular permeability index were examined in 30 asthmatics and 12 control subjects. After 2-week run-in period, all asthmatics were randomly assigned to receive fluticasone propionate (400 mug/d) or montelukast (10 mg) for 12 weeks. RESULTS: VEGF, angiopoietinI, and angiopoietinⅡ levels in induced sputum were significantly higher in asthmatics than in control subjects. We found an inverse correlation between angiopoietinI level and vascular permeability index in asthmatics, while there was a positive correlation between angiopoietinⅡ level and that index. VEGF and angiopoietinI levels were significantly decreased after fluticasone therapy, while VEGF and angiopoietinⅡ levels were significantly decreased after montelukast therapy. Although VEGF levels after treatment were different between two groups, vascular permeability index in the montelukast group was the same level as that in the fluticasone group. Moreover, improvement in vascular permeability index after fluticasone therapy was inversely correlated with decrease in angiopoietinI level, while that after montelukast therapy was positively correlated with decrease in angiopoietinⅡ level.
CONCLUSIONS: AngiopoietinI and angiopoietinⅡ play complementary and coordinated roles in regulating microvascular permeability stimulated by VEGF in asthma. Combination of corticosteroids with leukotriene antagonists might effectively improve plasma leakage and provide a new strategy in treating bronchial asthma.
结论：血管形成素I和血管形成素Ⅱ在调解哮喘患者微血管通透性方面具有协调和互补作用。糖皮质激素与抗白三烯药物联用，可以改善血浆的滤过性，从而提供一种新的哮喘治疗方法。
(杨萌 卫生部中日友好医院呼吸科 100029 摘译)
(Chest 2007：131: 1035-1041)
Kanazawa H, Nomura S, Asai K. Roles of angiopoietinI and angiopoietinⅡ on airway microvascular permeability in asthmatic patients. Chest JT - Chest, 2007,131(4):1035-41.
BACKGROUND: Vascular endothelial growth factor (VEGF) increases microvascular permeability. Recently, considerable attention has been devoted to the physiologic roles of angiopoietinI and angiopoietinⅡ as regulatory factors of VEGF. This study was designed to examine the roles of angiopoietinI and angiopoietinⅡ in controlling airway microvascular permeability in asthma.
METHODS: Levels of these angiogenic factors and airway vascular permeability index were examined in 30 asthmatics and 12 control subjects. After 2-week run-in period, all asthmatics were randomly assigned to receive fluticasone propionate (400 mug/d) or montelukast (10 mg) for 12 weeks. RESULTS: VEGF, angiopoietinI, and angiopoietinⅡ levels in induced sputum were significantly higher in asthmatics than in control subjects. We found an inverse correlation between angiopoietinI level and vascular permeability index in asthmatics, while there was a positive correlation between angiopoietinⅡ level and that index. VEGF and angiopoietinI levels were significantly decreased after fluticasone therapy, while VEGF and angiopoietinⅡ levels were significantly decreased after montelukast therapy. Although VEGF levels after treatment were different between two groups, vascular permeability index in the montelukast group was the same level as that in the fluticasone group. Moreover, improvement in vascular permeability index after fluticasone therapy was inversely correlated with decrease in angiopoietinI level, while that after montelukast therapy was positively correlated with decrease in angiopoietinⅡ level.
CONCLUSIONS: AngiopoietinI and angiopoietinⅡ play complementary and coordinated roles in regulating microvascular permeability stimulated by VEGF in asthma. Combination of corticosteroids with leukotriene antagonists might effectively improve plasma leakage and provide a new strategy in treating bronchial asthma.
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