哮喘联盟

   摘要
   前言：众所周知，臭氧暴露能降低肺功能、增加气道中性粒细胞，但哮喘患者之间对臭氧暴露的反应存在着较大差异。
   目的：本试验旨在研究哮喘患者臭氧暴露后功能性和炎症性气道反应可能的预测因子。
   材料与方法：120名轻度至中度哮喘患者随机分为空气暴露组和臭氧暴露组（0.3 ppm处理2 h）。暴露前和暴露后即刻检测症状和肺功能。暴露6 h后，收集诱导痰液。基于患者对臭氧的功能性（FEV1反应者）和中性粒细胞性（中性粒细胞反应者）反应对其进行评价。我们入选的可能预测因素有：年龄、基础FEV1、前期皮质激素吸入治疗（ICS）、基线状态痰液中性粒细胞、基线状态痰液嗜酸性粒细胞、乙酰甲胆碱反应性、特应性和吸烟习惯。
   结果：FEV1反应者的基线FEV较低，其中少数接受ICS治疗。中性粒细胞反应者更年轻，基线状态下痰液炎症较低、乙酰甲胆碱反应性较高。多因素logistic分析证实上述结果。
   讨论和结论：前期未接受ICS治疗的哮喘患者和FEV1较低的哮喘患者，臭氧暴露后更容易出现功能性反应。基线状态下气道炎症水平较低、支气管高反应性可预测哮喘患者臭氧暴露后的中性粒细胞性气道反应。因此，针对臭氧暴露的功能性和炎症性反应决定因素存在差异。
 

（刘国梁 审校）
Inhal Toxicol. 2013 Feb;25(3):127-33. doi: 10.3109/08958378.2013.763313.
 

Baseline airway inflammation may be a determinant of the response to ozone exposure in asthmatic patients.
 
Bartoli ML, Vagaggini B, Malagrinò L, Bacci E, Cianchetti S, Dente FL, Novelli F, Costa F, Paggiaro P.

Source
Cardio-Thoracic and Vascular Department, University of Pisa , Pisa , Italy.

Abstract 
CONTEXT: It is well known that ozone exposure decreases lung function and increases airway neutrophilia, but large variability has been observed among asthmatic patients.
OBJECTIVE: To find possible predictors of functional and inflammatory airway response to ozone in asthmatic patients.
MATERIALS AND METHODS: We studied 120 patients with mild-to-moderate asthma, randomly exposed to either air or ozone (0.3 ppm for 2 h) in a challenge chamber. Symptoms and pulmonary function test (PFT) were measured before and immediately after exposure. Six hours after exposure, induced sputum was collected. Patients were evaluated according to their functional (FEV(1) responders) or neutrophilic (neutrophil responders) response to ozone. We considered, as possible predictors of response: age, baseline FEV(1), previous treatment with inhaled corticosteroids (ICS), baseline sputum neutrophils, baseline sputum eosinophils, methacholine responsiveness, atopy and smoking habit.
RESULTS: FEV(1) responders had lower baseline FEV(1), and a lower percentage of these had received ICS treatment. Neutrophil responders were younger, with lower baseline sputum inflammation and greater methacholine responsiveness. These results were confirmed by multivariate logistic analysis.
DISCUSSION AND CONCLUSION: Patients not previously treated with ICS and patients with lower FEV(1) are more prone to functional response to ozone. Lower baseline airway inflammation and greater bronchial hyperresponsiveness may predict neutrophilic airway response to ozone in asthmatic patients. Thus, determinants of functional and inflammatory responses to ozone are different.
 

Inhal Toxicol. 2013 Feb;25(3):127-33. doi: 10.3109/08958378.2013.763313.