糖皮质激素对肺部炎性效应细胞凋亡作用的异质性

Diverse effects of glucocorticoids on diverse leucocytes apoptosis

目的观察糖皮质激素对呼吸系统炎性病变中几种主要类型炎细胞凋亡过程影响的不同特点。方法对健康人外周血分离的中性粒细胞（ＰＭＮ）、嗜酸性粒细胞（ＥＯＳ）、Ｔ淋巴细胞（ＴＬＣ）在体外分别与糖皮质激素一起孵育，使用原位末端标记ＤＮＡ技术观察细胞凋亡过程的时相动力学特征，同时观察急性呼吸窘迫综合征（ＡＲＤＳ）患者激素治疗前后ＰＭＮ凋亡的改变，以及支气管哮喘患者激素治疗前后ＥＯＳ、ＴＬＣ凋亡的改变。结果体外培养的ＰＭＮ、ＥＯＳ、ＴＬＣ的自发凋亡开始时间和全部凋亡时间分别为１２ｈ／４３ｈ、１５ｈ／６５ｈ、６５ｈ／１２８ｈ，地塞米松可显著促进ＥＯＳ和ＴＬＣ的凋亡，但却抑制ＰＭＮ的凋亡。ＡＲＤＳ患者外周血ＰＭＮ和支气管哮喘患者外周血ＥＯＳ、ＴＬＣ均处于不同程度的凋亡抑制状态，三者的凋亡开始时间和全部凋亡时间分别为４２ｈ／９３ｈ、２９ｈ／１００ｈ、９２ｈ／１５２ｈ。糖皮质激素治疗未能影响ＡＲＤＳ患者ＰＭＮ的凋亡，而糖皮质激素治疗却可以解除支气管哮喘发作期ＥＯＳ和ＴＬＣ的凋亡抑制状态。结论糖皮质激素对不同类型白细胞的凋亡有着不同的作用，这对于使用糖皮质激素治疗各种类型的肺部炎性病变具有区别指导意义。

Objective To observe effects of glucocorticoids on the process of apoptosis in main inflammatory cells related to pulmonary inflammation. Method Human peripheral blood neutrophil(PMN),eosinophil(EOS) and T lymphocyte(TLC) were cultured in vitro under glucocorticoids condition.In situ end labeling technique of fragmented DNA was used to detect the dynamic fesatures of apoptosisin experimental collected cell. The peripheral PMN apoptosis in acute respiratory distress syndrome(ARDS) and EOS,TLC apoptosis in bronchial asthma were determined by the same method before and after treatment with glucocorticoids. Result PMN, EOS and TLC showed signs of apoptosis spontaneously and no signs of surviving cells after 12 h/43 h,15 h/65 h and 65 h/128 h of culture respectively.Dexamethasone accelerated EOS and TLC apoptosis,while inhibited PMN apoptosis.The PMN apoptosis in ARDS and EOS,TLC apoptosis in bronchial asthma were in various degreof inhibitory state . The above time of PMN, EOS and TLC apoptosis were 41.5 h/92.6 h,29.3 h/100 h,92.4 h/152.2 h respectively.The inhibitory state of PMN apoptosis was not influenced by glucocorticoids therapy, but the EOS and TLC apoptosis were relieved from their inhibitory state. Conclusion Effects of glucocorticoids are different in diverse leucocyte apoptosis. This could have an differential significance in pulmonary inflammation.