哮喘联盟

   摘要 
    背景：在哮喘患者中出现运动诱发的支气管收缩(EIB)取决于是否存在过敏性炎症。本研究旨在评价EIB与哮喘患者低水平的全身炎症之间的相关性。
    方法：本试验对24名哮喘患者（14名EIB患者和10名无EIB患者）和8名健康志愿者进行研究。受试者剧烈运动后检测血清和呼出气冷凝液(EBC)中的高敏C反应蛋白(hs-CRP)水平。对上述检测指标与哮喘诊断相关的其他检测结果、哮喘相关的实验室检查结果之间的相关性进行分析。
    结果：在EIB哮喘患者中，运动后的EBC和血清hs-CRP水平显著增加。运动后24 h，在EIB哮喘患者中，呼出气一氧化氮含量（FENO）、血清嗜酸性粒细胞阳离子蛋白(ECP)含量及支气管对组胺的高反应性显著增加。在EIB哮喘患者中，运动后血清和EBC中的hs-CRP增加的峰值与基线状态下FENO、运动24h后ECP和FENO显著相关。
    结论：剧烈运动导致的支气管收缩，伴随有血清和EBC中的hs-CRP水平增加。我们的结果表明，对于哮喘患者，由运动诱发的支气管收缩可能加剧全身的低水平炎症。

                                                               （刘国梁 审校）

Zietkowski Z, et al. Int Arch Allergy Immunol. 2010;153(1):75-85.

Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.

Zietkowski Z, Skiepko R, Tomasiak-Lozowska MM, Mroczko B, Szmitkowski M, Bodzenta-Lukaszyk A.

Abstract

Background: Exercise-induced bronchoconstriction (EIB) in asthmatics depends on the presence of allergic inflammation. This study was performed to assess the possible association of EIB with low-grade systemic inflammation, whose presence was revealed in asthmatic patients.

Methods: The study was conducted in a group of 24 asthmatics (14 with EIB, 10 without EIB) and 8 healthy volunteers. Changes in serum and exhaled breath condensate (EBC) high-sensitivity C-reactive protein (hs-CRP) levels induced by intensive exercise were determined. Moreover, the possible correlation of these measurements with the results of other tests used in the diagnosis of asthma as well as laboratory tests commonly associated with asthma were investigated.

Results: In asthmatic patients with EIB, a statistically significant increase in hs-CRP levels both in serum and EBC after an exercise test was observed. Twenty-four hours after the exercise test in the group of asthmatics with EIB, a statistically significant increase in exhaled nitric oxide (F(ENO)), serum eosinophil cationic protein (ECP) concentrations and bronchial hyperreactivity to histamine was revealed. A statistically significant correlation between the maximum increase in hs-CRP levels both in serum and EBC after exercise and either baseline F(ENO) and an increase in serum ECP or F(ENO) 24 h after exercise in the group of asthmatics with EIB was revealed.

Conclusions: We show that, as a result of intensive exercise leading to bronchoconstriction, an increase in serum and EBC hs-CRP occurs. Our observations could suggest that in asthmatic patients, as a consequence of exercise-induced bronchoconstriction, an intensification of low-grade systemic inflammation can be observed.