哮喘缓解3年以上者血管细胞黏附分子-1和气道反应性等因素的关系

The relationship among plasma soluble vascular cell adhesion molecule-1 level ,airway responsiveness and blood eosinophil cationic protein in asthmatics with remission at least 3 years

目的 阐明哮喘缓解 3年以上者外周血可溶性血管细胞黏附分子 1(sVCAM 1)及气道反应性等有关因素的关系 ,以探讨其哮喘缓解的机制。方法 选择哮喘缓解 3年以上者 (以下简称哮喘缓解者 ) 2 0例 ,正常健康人 2 1例。采用ELISA法检测上述受试者外周血浆中sVCAM 1水平 ,用乙酰甲胆碱支气管激发试验测定其气道反应性———PC2 0 值 [引起 1秒钟用力呼气容积 (FEV1)下降 2 0 %所需激发药物的浓度 ]。用酶免疫荧光法检测受试者外周血嗜酸细胞阳离子蛋白 (ECP) ,并检测其外周血嗜酸粒细胞和嗜碱粒细胞数。结果 (1)哮喘缓解者sVCAM 1水平为 (6 3 7± 31 7) μg/L ,显著高于正常健康人 [(41 9± 11 7) μg/L]。 (2 )哮喘缓解者中有 3例外周血嗜酸粒细胞数增高 (3/ 2 0 ,15 0 % ) ,与正常健康人 (1/ 2 1,4 8% )相比 ,差异无显著性 ;而嗜碱粒细胞数有 9例增高 (9/ 2 0 ,4 5 0 % ) ,多于正常健康人 (1/ 2 1,4 8% ;P <0 0 1)。 (3)哮喘缓解者ECP水平为 (2 7± 1 3) μg/L ,与正常健康人 [(2 2± 0 5 ) μg/L]相比 ,差异无显著性。 (4)哮喘缓解者的PC2 0 值为 2 6g/L (中位数 ) ,显著低于正常健康人 (12 8g/L ,中位数 )。 (5 )哮喘缓解者的嗜碱粒细胞数与PC2 0 值呈负相关 (r =- 0 6 6 ) ,而sVCAM 1与嗜?

Objective To study the mechanism of asthma remission The plasma soluble vascular cell adhesion molecule 1 (sVCAM 1),airway responsiveness(PC 20 ) and other relative factors were measured in asthmatics with remission at least 3 years and compared with healthy controls Methods Group Ⅰ(asthmatics with remission at puberty): 20 cases including 11 males and 9 females , mean age of 21 years All of the patients were definitely diagnosed as asthmatics in childhood and got natural remission for at least 3 years(with median duration of 6 years) Group Ⅱ(normal controls): 21 healthy college students including 10 males and 11 females, mean age of 22 5 years, had no history of asthma or other allergic diseases The intravenous blood was taken from all subjects with EDTA as anticoagulant for study The airway responsiveness were measured by methacholine bronchial provocation test(PC 20 ) The sVCAM 1 was measured with ELISA, according to the manual of the kit. Methacholine was atomized by Wright atomizer [Devilbiss AP 50, USA ,driven by air compressor, with a constant atomizing volume of (0 13±0 02)ml/min, diameter of atomizes particles 1 3～3 0 μm] Its concentration was redoubled from 0 03 to 128 g/L until a certain dose as PC 20 value triggering forced expiratory volume in one second (FEV 1) decresed by 20% reached The eosinophil cationic protein (ECP) levels were measured with enzyme linked immuno CAP system. Blood eosinophils( >330/mm 3 as being above normal) and basophils( >33/mm 3 as abnormally increased)were counted using Acian blue dyeing Results (1) The mean value of sVCAM 1 of groupⅠ (63 7±31 7) μg/L was signficantly higher than that of group Ⅱ (41 9±11 7) μg/L (2) The percentage of the cases with increased eosinophils in group Ⅰ was 15 0% (3/20),had no significant difference compared with that in group Ⅱ(4 8%,1/21) The percentage of the cases with increased basophils of group Ⅰwas 45 0%(9/20), significantly higher than that of group Ⅱ,4 8%(1/21), P <0 01 (3) The blood ECP level of group Ⅰ was (2 7±1 3) μg/L, simillar to that of group Ⅱ(2 18±0 5) μg/L (4) The PC 20 value of group Ⅰ( M =2 6 g/L) was significantly lower than that of group Ⅱ( M =128 g/L) (5) The basophil count negatively correlated with the PC 20 ( r = -0 66), however ,the sVCAM 1 did not have significant correlation with the basophil count or with the PC 20 Conclusion The quantity and activity of eosinophils in asthmatics with remission at least 3 years are droped to the normal level, but the expression of VCAM 1 ,quantity of basophils were still higher than normal The airway responsiveness had negative correlation with the basophil count