哮喘儿童的基底膜增厚与临床表现
2007/10/26
2007年6月《Allergy》上刊登了韩国E.S.Kim等的一项实验研究“哮喘患儿的基底膜增厚与临床表现”。该文章指出，哮喘是一种慢性炎症性疾病，以气道炎症、气道高反应性及气道阻塞为特征。虽然哮喘导致的气道阻塞部分可逆，这种阻塞有时也会变成不可逆。这可能是气道重塑的结果，造成一系列结构改变，如上皮分离、基底膜（BM）增厚、平滑肌增生以及新生血管形成。
作者观察了哮喘患儿BM增厚的情况。他们对18名哮喘患儿和24名对照儿童通过可屈式支气管镜检进行了气管内膜活检。采用光镜观察石蜡包埋组织的BM厚度，并比较了BM厚度与年龄、性别、哮喘持续时间、哮喘严重度、FEV1、FEV1/FVC、FEF25-75%、甲基胆碱PC20、嗜酸性细胞计数和特应性的相关性。
结果发现，哮喘患儿基底膜厚度明显大于对照组。多元回归分析显示性别、FEV1/FVC、总IgE及特应性（屋尘螨IgE＞0.34kUA/l）与基底膜厚度显著相关。BM厚度与年龄、哮喘持续时间、FEV1、FEF25-75%、甲基胆碱PC20、嗜酸性细胞计数以及哮喘严重度无相关性。因此作者得出结论，哮喘儿童存在基底膜增厚，其厚度与性别、FEV1/FVC、总IgE及屋尘螨IgE增高相关。
作者观察了哮喘患儿BM增厚的情况。他们对18名哮喘患儿和24名对照儿童通过可屈式支气管镜检进行了气管内膜活检。采用光镜观察石蜡包埋组织的BM厚度，并比较了BM厚度与年龄、性别、哮喘持续时间、哮喘严重度、FEV1、FEV1/FVC、FEF25-75%、甲基胆碱PC20、嗜酸性细胞计数和特应性的相关性。
结果发现，哮喘患儿基底膜厚度明显大于对照组。多元回归分析显示性别、FEV1/FVC、总IgE及特应性（屋尘螨IgE＞0.34kUA/l）与基底膜厚度显著相关。BM厚度与年龄、哮喘持续时间、FEV1、FEF25-75%、甲基胆碱PC20、嗜酸性细胞计数以及哮喘严重度无相关性。因此作者得出结论，哮喘儿童存在基底膜增厚，其厚度与性别、FEV1/FVC、总IgE及屋尘螨IgE增高相关。
（陈莉娜 四川大学华西第二医院 610041 摘译）
（Allergy 62 ： 635–640）
Basement Membrane Thickening and Tlinical Features of Chidren with A sthma
E.S.Kim, S.H.Kim, K.W.Kim, J.W.Park, Y.S.Kim, M.H.Sohn, K.-E.Kim
Abstract 摘要
Background: Asthma is a chronic inflammatory disease, characterized by airway inflammation, bronchial hyper-responsiveness, and airway obstruction. Although asthma induces partially reversible airway obstruction, obstruction can sometimes become irreversible. This may be a consequence of airway remodeling, which includes a number of structural changes, such as epithelial detachment, basement membrane (BM) thickening, smooth muscle hypertrophy, and new vessel formation. This study evaluated children with asthma for the presence of BM thickening.
Methods: Eighteen children with asthma and 24 control subjects underwent flexible bronchoscopy with endobronchial biopsy. Light microscopy was used to measure BM thickness in paraffin-embedded biopsy sections. The association between BM thickening and age, sex, duration of asthma, asthma severity, FEV1, FEV1/FVC, FEF25 75%, methacholine PC20, eosinophil count, and presence of atopy was examined.
Results: Basement membrane thickness was greater in subjects with asthma (8.3 ± 1.4μM) than in control subjects (6.8 ± 1.3μM, P = 0.0008). Multiple regression analysis revealed that sex, FEV1/FVC, total IgE, and atopy (IgE for Dermatophagoides pteronyssinus >0.34 kUA/l) were significant predictive factors for BM thickness. There was no significant association between BM thickness and age, duration of asthma, FEV1, FEF25 75%, methacholine PC20, eosinophil count, or asthma severity.
Conclusions: Basement membrane thickening has been known to be present in children with asthma. In addition, we report an association between BM thickness and sex, FEV1/FVC, total IgE, and the presence of IgE specific to D. pteronyssinus.
Key words:
airway remodeling;basement membrane thickening;children;endobronchial biopsy.
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Eotaxin启动子上游的核苷酸重复序列与哮喘，血清总IgE及血浆Eotaxin水平相关
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哮喘患者血管形成素I和Ⅱ在气道微血管渗漏中的作用
