成人中重度哮喘患者支气管对组胺的反应性与气道重构有关
2010/12/17
摘要
背景：慢性嗜酸性粒细胞性炎症能够促进气道重构，包括网状基底膜(RBM)增厚、肥厚和气道平滑肌(ASM)增生，以及肌腱蛋白产生增加。本试验旨在中度至重度哮喘患者中研究气道重构与支气管对组胺（Hist）和乙酰胆碱（ACh）反应性之间的关系。
方法：30名成人哮喘患者入选本项研究，通过检测吸入不同浓度ACh和Hist前后的第一秒用力呼气体积 (FEV1)（激发后是否增加>20%），及吸入β受体激动剂后FEV1的恢复百分比，评价患者的支气管高反应性（BHR）。在给予皮质激素治疗后，评价RBM和ASM以及支气管样本中的肌腱蛋白含量。
结果：ACh或Hist 吸入后FEV1的增加百分比与FEV₁恢复百分比有关。ASM肥厚与Hist（而非ACh）激发后FEV1下降百分比有关，ASM肥厚、RBM肌腱蛋白增加和哮喘持续时间与Hist（而非ACh）激发后FEV₁恢复百分比呈负相关。
结论：对于中度至重度的成人哮喘患者，Hist诱发的支气管强烈收缩和随后小幅度恢复显示存在气道重构。
（苏楠 审校）
J Asthma. 2010 Oct;47(8):841-848.
Bronchial reactivity to histamine is correlated with airway remodeling in adults with moderate to severe asthma.
Tsurikisawa N, Oshikata C, Tsuburai T, Saito H, Sekiya K, Tanimoto H, Takeichi S, Mitomi H, Akiyama K.
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan. n-tsurikisawa@sagamihara-hosp.gr.jp
Abstract
BACKGROUND: Chronic eosinophilic inflammation may promote airway remodeling, including thickening of the reticular basement membrane (RBM), hypertrophy and hyperplasia of the airway smooth muscles (ASM), and an increase in the production of tenascin. The authors examined the correlation between airway remodeling and bronchial reactivity to histamine (Hist) and acetylcholine (ACh) in patients with moderate to severe asthma.
METHODS: In 30 adult patients with asthma, the authors assessed bronchial hyperresponsiveness (BHR) to various concentrations of ACh and Hist by measuring decreases in forced expiratory volume in one second (FEV₁) of >20% from the preprovocation state, and % recoveries of FEV₁ after inhalation of β-stimulant. After corticosteroid therapy, the authors evaluated the thickening of RBM and ASM and the production of tenascin in bronchial specimens.
RESULTS: The % decrease in FEV₁ was correlated with the % recovery in FEV₁ after provocation by ACh or Hist. Hypertrophy of ASM was correlated with the % decrease in FEV₁ after provocation by Hist, but not by ACh. Thickening of ASM, up-regulation of tenascin in RBM, and duration of asthma were inversely correlated with the % recovery of FEV₁ after provocation by Hist, but not by ACh.
CONCLUSIONS: In adult patients with moderate to severe asthma, a strong bronchial contraction provoked by Hist and a subsequent small recovery indicate airway remodeling.
J Asthma. 2010 Oct;47(8):841-8.
背景：慢性嗜酸性粒细胞性炎症能够促进气道重构，包括网状基底膜(RBM)增厚、肥厚和气道平滑肌(ASM)增生，以及肌腱蛋白产生增加。本试验旨在中度至重度哮喘患者中研究气道重构与支气管对组胺（Hist）和乙酰胆碱（ACh）反应性之间的关系。
方法：30名成人哮喘患者入选本项研究，通过检测吸入不同浓度ACh和Hist前后的第一秒用力呼气体积 (FEV1)（激发后是否增加>20%），及吸入β受体激动剂后FEV1的恢复百分比，评价患者的支气管高反应性（BHR）。在给予皮质激素治疗后，评价RBM和ASM以及支气管样本中的肌腱蛋白含量。
结果：ACh或Hist 吸入后FEV1的增加百分比与FEV₁恢复百分比有关。ASM肥厚与Hist（而非ACh）激发后FEV1下降百分比有关，ASM肥厚、RBM肌腱蛋白增加和哮喘持续时间与Hist（而非ACh）激发后FEV₁恢复百分比呈负相关。
结论：对于中度至重度的成人哮喘患者，Hist诱发的支气管强烈收缩和随后小幅度恢复显示存在气道重构。
（苏楠 审校）
J Asthma. 2010 Oct;47(8):841-848.
Bronchial reactivity to histamine is correlated with airway remodeling in adults with moderate to severe asthma.
Tsurikisawa N, Oshikata C, Tsuburai T, Saito H, Sekiya K, Tanimoto H, Takeichi S, Mitomi H, Akiyama K.
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan. n-tsurikisawa@sagamihara-hosp.gr.jp
Abstract
BACKGROUND: Chronic eosinophilic inflammation may promote airway remodeling, including thickening of the reticular basement membrane (RBM), hypertrophy and hyperplasia of the airway smooth muscles (ASM), and an increase in the production of tenascin. The authors examined the correlation between airway remodeling and bronchial reactivity to histamine (Hist) and acetylcholine (ACh) in patients with moderate to severe asthma.
METHODS: In 30 adult patients with asthma, the authors assessed bronchial hyperresponsiveness (BHR) to various concentrations of ACh and Hist by measuring decreases in forced expiratory volume in one second (FEV₁) of >20% from the preprovocation state, and % recoveries of FEV₁ after inhalation of β-stimulant. After corticosteroid therapy, the authors evaluated the thickening of RBM and ASM and the production of tenascin in bronchial specimens.
RESULTS: The % decrease in FEV₁ was correlated with the % recovery in FEV₁ after provocation by ACh or Hist. Hypertrophy of ASM was correlated with the % decrease in FEV₁ after provocation by Hist, but not by ACh. Thickening of ASM, up-regulation of tenascin in RBM, and duration of asthma were inversely correlated with the % recovery of FEV₁ after provocation by Hist, but not by ACh.
CONCLUSIONS: In adult patients with moderate to severe asthma, a strong bronchial contraction provoked by Hist and a subsequent small recovery indicate airway remodeling.
J Asthma. 2010 Oct;47(8):841-8.
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