支气管哮喘患者下呼吸道鼻病毒存在情况
2008/09/28
已知感冒病毒、人鼻病毒（HRV）感染是哮喘急性发作最常见的原因，但人鼻病毒在慢性持续性哮喘中的作用却不得而知。
来自波兰的Wos M 教授领导的研究小组采用免疫组化及间接原位RT-PCR方法测定了哮喘患者与非哮喘对照组支气管粘膜活检标本中的HRV存在情况。
结果发现：使用免疫组化方法，14份哮喘患者支气管活检标本中有9份标本可检出HRV存在（阳性率64.3%），6份非哮喘对照组支气管活检标本中2份标本HRV阳性（阳性率33.3%），哮喘组与对照组无显著差异。使用更敏感的间接原位RT-PCR方法，73%的哮喘患者及22%的对照组支气管活检标本HRV阳性（P<0.001）。HRV阳性个体表现出较低的肺功能、较高的血嗜酸粒细胞和白细胞计数以及支气管粘膜中嗜酸粒细胞侵润。
因此研究得出结论：支气管哮喘患者下呼吸道中HRV较非哮喘者更常见，HRV的存在与疾病加重的临床特征相关。
（农英 卫生部中日友好医院呼吸内科 100029 摘译）
（Am J Respir Crit Care Med. 2008 May 15;177(10):1082-1089.）
The Presence of Rhinovirus in Lower Airways of Patients with Bronchial Asthma.
Wos M, Sanak M, Soja J, Olechnowicz H, Busse WW, Szczeklik A.
Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
Rationale. The common cold virus, human rhinovirus (HRV), is the most frequent cause of asthma exacerbations. However, a possible contribution of HRV to the pathogenesis of chronic, persistent asthma has not been defined. Objective. Our objective was to determine if stable asthmatic patients, who are free of clinical signs of a respiratory infection for at least 3 weeks, harbor HRV in their bronchi more frequently than non-asthmatic controls, and whether clinical features of asthma are associated with the presence of HRV. Methods. Immunohistochemistry (IHC) and indirect in situ RT-PCR method were used to detect the presence of HRV in bronchial mucosal biopsies in asthmatic patients and non-asthmatic controls. Measurements and Main Results. HRV was found by IHC in 9 of 14 bronchial biopsies from asthmatic subjects (64.3%) and 2 of 6 non-asthmatic controls (33.3%), p = 0.38. With the more sensitive, indirect in situ RT-PCR method, HRV was found in the mucosal biopsies of 73% of asthmatic patients and 22% non-asthmatic controls (p < 0.001). Subjects positive for HRV had lower pulmonary function, higher numbers of blood eosinophils and leukocytes, and eosinophilic infiltration in bronchial mucosa. Conclusions. HRV was detected in the lower airway tissue of asthmatic patients significantly more often than non-asthmatic subjects, and its presence was associated with clinical features of more severe disease.
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