慢性阻塞性肺病患者肺泡巨噬细胞凋亡测定及其意义

Detection of alveolar macrophage apoptosis in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺病(chron ic obstructive pu lmonary d isease,COPD)患者肺泡巨噬细胞(alveolarm acro-phage,AM)凋亡特点。方法经支气管肺泡灌洗获取肺泡巨噬细胞AM。①利用髓过氧化物酶(MPO)染色法观察AM的染色阳性率;②利用TUNEL技术观察支气管肺泡灌洗液中AM凋亡的变化和地塞米松对其凋亡的影响。结果①COPD患者AM之MPO染色阳性率(0.8±0.3)%显著低于对照组(1.2±0.4)%(P<0.05)。②支气管肺泡灌洗液中AM凋亡率(1.9±0.7)%显著低于对照组(4.8±1.3)%(P<0.01)。地塞米松处理12、24、48 h后的AM凋亡率分别为(9.2±2.3)%,(35.4±12.6)%和(45.8±9.2)%,显著高于对照组(5.9±1.8)%,(10.8±2.7)%和(24.1±4.6)%的凋亡率(P均<0.01)。结论吸烟等多种因素可导致COPD患者AM凋亡减少,其对凋亡中性粒细胞(PMN)的吞噬能力下降;较大剂量的糖皮质激素能诱导AM凋亡。

Objective To investigate the apoptosis of alveolar macrophage and its significance in patients with chronic obstructive pulmonary disease （COPD）. Methods A total of 11 patients with COPD and 10 healthy controls were enrolled in the study. Alveolar macrophages （ AM ） were harvested from the BALF （ bronchoalveolar lavage fluid）. The positive rate of myeloperoxidase （MPO） staining of alveolar macrophages by MPO staining was observed so as to indirectly reflect neutrophil apoptosis and the phagocytosis of apoptotic neutrophils by alveolar macrophages. Apoptosis were detected by the transferase-mediated dUTP nick end labeling （TUNEL） technique. Results The positive rate of alveolar macrophages by MPO staining was lower in COPD group [ （0.8 ±0. 3）% ] than the control group [ （ 1.2 ±0.4）% ] （P 〈0.01 ）. The apoptotic rate of macrophages within BALF from COPD group was much lower than the control group [ （ 1.9 ± 0.7 ） % vs （4.8 ± 1.3）% ] （P 〈0. 01 ）. DEX induced the apoptosis of cultured alveolar macrophages in a time-dependent manner and the apoptotic rate of AM treated with DEX for 12, 24, 48 h in COPD group was higher than the control group. Conclusion There was a decreased apoptosis of alveolar macrophages and a less phagocytosis of apoptotic neutrophil by alveolar macrophages in patients with COPD. DEX can significantly induce the apoptosis of alveolar macrophages.