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首页> 外文期刊>American journal of respiratory and critical care medicine >Bronchial Responsiveness to Distilled Water and Methacholine and Its Relationship to Inflammation and Remodeling of the Airways in Asthma
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Bronchial Responsiveness to Distilled Water and Methacholine and Its Relationship to Inflammation and Remodeling of the Airways in Asthma

机译：支气管对蒸馏水和甲胆碱的反应及其与哮喘气道炎症和重塑的关系

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Although bronchial hyperresponsiveness in asthma is associated with inflammation within the airways, it is not known whether the degree and type of inflammation influence the response to different stimuli and whether pathologic changes of airway structure influence the bronchoconstrictive responses. Therefore, number of inflammatory cells in the epithelium and the lamina propria and the basement membrane thickness were estimated from bronchial biopsies taken in 27 asthmatic subjects (range percent predicted FEV_1: 75.6 to 132.1, range of daily PEF variability: 1.9% to 20%) and related to the degree of bronchial responsiveness to ultrasonically nebulized distilled water (UNDW) and methacho-line (M). PD_(20)UNDW (provocative dose) was measurable in 15 of 27 patients and ranged between 1.01 and 20.4 ml. PC_(20)M (provocative concentration) ranged between 0.15 and 31.7 mg/ml. In the 15 responders to UNDW, total inflammatory cells (p < 0.04) and eosinophils (p < 0.015) within the epithelium were higher than in 12 nonresponders to UNDW (PD_(20) > 34.8 ml). There was no correlation between PD_(20)UNDW and any cell counts whereas negative correlations were found between PC_(20)M and both total inflammatory cells (r_s = -0.57; p < 0.005) and eosinophils (r_s = -0.63; p < 0.0015) within the epithelium. The degree of thickening of subepithelial layer ranged between 7 and 16 μm (n = 26). Thickness correlates both with total inflammatory cells (r_s = 0.49; p < 0.025) and eosinophils (r_s = 0.61; p < 0.003) within the epithelium. Moreover, it was correlated with baseline FEV_1 (r_s = -0.57; p < 0.003) and daily peak expiratory flow (PEF) variability (r_s = 0.51; p < 0.01). A weak but significant correlation was also found between subepithelial layer thickness and PC_(20)M (r_s = -0.42; p < 0.04). The results of this study demonstrate that eosinophilic inflammation of bronchial epithelium plays a role in determining UNDW and M responsiveness in asthma. Moreover, they suggest that remodeling of the airways such as thickening of subepithelial layer correlates with indices of asthma severity and could contribute to the degree of M but not to UNDW responsiveness.
机译：尽管哮喘中的支气管高反应性与气道内的炎症相关，但尚不清楚炎症的程度和类型是否会影响对不同刺激的反应，以及气道结构的病理变化是否会影响支气管收缩反应。因此，根据对27名哮喘受试者进行的支气管活检，估计了上皮和固有层中炎性细胞的数量以及基底膜的厚度（预测FEV_1的百分比范围：75.6至132.1，每日PEF变异范围：1.9％至20％）与支气管对超声雾化蒸​​馏水（UNDW）和乙酰甲胆碱（M）的反应程度有关。在27名患者中有15名患者可测量PD_（20）UNDW（激发剂量），范围为1.01至20.4 ml。 PC_（20）M（促凝剂浓度）介于0.15和31.7 mg / ml之间。在对UNDW有15个反应者中，上皮内的总炎症细胞（p <0.04）和嗜酸性粒细胞（p <0.015）高于对UNDW的12个无反应者（PD_（20）> 34.8 ml）。 PD_（20）UNDW与任何细胞计数之间没有相关性，而PC_（20）M与总炎症细胞（r_s = -0.57; p <0.005）和嗜酸性粒细胞（r_s = -0.63; p < 0.0015）。上皮下层的增厚程度在7和16μm之间（n = 26）。厚度与上皮内的总炎症细胞（r_s = 0.49; p <0.025）和嗜酸性粒细胞（r_s = 0.61; p <0.003）相关。此外，它与基线FEV_1（r_s = -0.57; p <0.003）和每日最大呼气流量（PEF）变异性（r_s = 0.51; p <0.01）相关。在上皮下层厚度与PC_（20）M之间也发现了弱但显着的相关性（r_s = -0.42; p <0.04）。这项研究的结果表明，支气管上皮的嗜酸性炎症在确定哮喘的UNDW和M反应性中起着作用。此外，他们认为气道重塑（如上皮下层增厚）与哮喘严重程度指标相关，可能有助于M程度，但不会影响UNDW反应性。

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