肺泡巨噬细胞在慢性阻塞性肺疾病气道炎症中的作用

Alveolar macrophage and airway inflammation in patients with chronic obstructive pulmonary disease

目的 探讨肺泡巨噬细胞（ＡＭ）在慢性阻塞性肺疾病（ＣＯＰＤ）气道炎症中的作用。方法 收集支气管肺泡灌洗液（ＢＡＬＦ）和支气管黏膜，用ＥＬＩＳＡ法测定ＢＡＬＦ和ＡＭ培养上清液中巨噬细胞炎症蛋白（ＭＩＰ）－ｌα、明胶酶Ｂ（ＭＭＰ－９）及白细胞介素（ＩＬ）－８的浓度，用放射免疫法测内皮素（ＥＴ）浓度，用免疫组化法测ＢＡＬＦ中淋巴细胞功能相关抗原１阳性（ＬＦＡ－１＋）ＡＭ数、黏膜内ＣＤ６８＋细胞数和气道黏膜厚度。结果 ＣＯＰＤ组ＡＭ培养上清液中ＭＩＰ－ｌα、ＭＭＰ－９、ＥＴ、ＩＬ－８的浓度分别为（１４４６．９ ± １２６．７）μｇ／Ｌ、（１６．９８ ± ５．１５）μｇ／Ｌ、（４３．９８ ± ５．５４）ｎｇ／Ｌ、（１６８．１０± ２１．２２）μｇ／Ｌ，正常对照组为（１１２３．５ ± ９０．６）μｇ／Ｌ、（５．２４±０．９３）μｇ／Ｌ、（２５．９９±６．０５）ｎｇ／Ｌ、（１２４．６８±９．９６）μｇ／Ｌ；ＣＯＰＤ组支气管黏膜内ＣＤ６８＋细胞数为（１．７１± ０．４８）细胞／Ｈｐ，正常对照组为（０．５９±０．１８）细胞／Ｈｐ；ＣＯＰＤ组支气管黏膜厚度为（１．９６±０．９６）ｘ１０－１μｍ，正常对照组为（０．８３±０．４３）ｘ１０－１?

Objective:To investigate the effects of alveolar macrophage(AM) on airway inflammation of chronic obstructive pulmonary disease(COPD).Methods Broncho alveolar fluid(BALF) and bronchial mucosa biopsies were performed as usual. The levels of macrophage inflammatory-1a (MIP-1a),gelatinase B(MMP-9), interleukin(IL)-8 in BALF and the culture supernatants of AMs were measured with ELISA. The levels of endothelin(ET) were measured with radioimmunoassay method. The AMs expressing lymphocytic functional associated antigen-1 (LFA-1) in BALF, the AMs in mucosa and the thickness of mucosa were measured with immunocytochemistry and immunohistochemistry technique. Results The levels of MIP-lα, MMP-9,IL-8 and ET in the culture supernatants of AMs in patients with COPD were (l 446.9 ± 126.7) ac, (16.98 ± 5. 15) μg/L, (43.98 ± 5.54)ng/L, (168. 10 ±21.22) μg/L respectively; while thee were (1123.5± 90.6) μg/L, (5.24 ± 0.93)μg/L, (25.99 ± 6.05)ng/L, (124.68 ±t 9.96) μg/L in a control group. The number of macrophages in mucosa in patients with COPD was(l.71 ± 0.48)cells/HP, while that was (0.59 ± 0. 18)cell/Hp in the control group(0.63±0.25) x 104. Statistical significance was found between the two groups. The number of AMs and polymorphonuclear leucocyte in BALF were inversely correlated with forced expiratory volume in one secon as perentage of predicted value(FEV1%Pre) (r = - 0.511, P < 0.01; r =-0.562, P < 0.01). The levels of MMP-9 and ET in the culture supernatants of AMs were inversely correlated with FEV1%Pre(r = - 0.678, P < 0.01; r=-0.871, P<0.01). Both the level of MIP-lα and the positive number of AM expressing LFA-l in BALF were positively correlated with the number of AMs in BALF(r = 0.572, P < 0.01; r = 0.625, P < 0.01). Conclution AM may be involved in the process of airway inflammation and subsequent airway obstruction.