哮喘患者诱导痰嗜酸性细胞阳离子蛋白、嗜酸细胞趋化因子的改变及其意义

The changes and signif icances of ECP and eotaxin levels in induced sputum from asthmatic patients

目的:探讨嗜酸性细胞阳离子蛋白(ECP)、嗜酸细胞趋化因子(eotaxin)在嗜酸细胞性气道炎症和气流阻塞发生中的作用。方法:收集单纯型慢性支气管炎(A组)、支气管哮喘(B组)急性发作期患者各30例和健康对照者(C组)20名,分别给予肺功能检测和痰诱导检查。用荧光免疫法和酶联免疫法(ELISA)分别测定诱导痰上清液中ECP、eotaxin浓度。结果:B组[(22.5±10.3)%]诱导痰嗜酸细胞占白细胞百分比(EOS/Leu%)分别与A组[(12.3±8.6)%]、C组[(1.4±0.9)%]比较,差异有显著性(P均<0.05);B组eotaxin浓度[(0.286±0.136)g/L]与A组[(0.142±0.018)g/L]、C组[(0.028±0.043)μg/l]比较,差异有显著性(P均<0.05);B组ECP浓度[(248.1±102.3)μg/l]与A组[(123.6±87.9)g/L]、C组[(30.9±18.5)μg/l]比较,差异有显著性(P均<0.05)。B组EOS/Leu%、eotaxin浓度和ECP浓度与一秒钟用力呼气容积占预计值百分比(FEV1%)均呈负相关(r分别=-0.769、-0.658、-0.524,P<0.001或0.005);B组ECP浓度与eotaxin浓度呈正相关(r=0.785,P<0.001),与EOS/Leu%呈正相关(r=0.614,P<0.001),eotaxin浓度与EOS/Leu%呈正相关(r=0.569,P<0.02)。结论:eotaxin可能通过对EOS的选择性趋化作用使其释放ECP等一系列炎性介质参与了嗜酸细胞性气道炎症和气流阻塞的发生机制。

Objective:Investigate the roles of ECP(eosinophil cationic protein) and eotaxin(chemotactic factor of eosinophils) in pathogenesis of eosinophilic airway inflammation and airflow obstruction.Methods:60 patients in exacerbations with chronic bronchitis(A group) and bronchial asthma(B group)(30 cases respectively) and 20 healthy volunteers as controls(C group) have participated in lung function test and sputum induction.The concentration of ECP and eotaxin was measured respectively with immuno-CAP system and sandwich enzymelinked immunosorbent assay(ELISA).Results:The differences of the eosinophil(EOS)/leukocyte(Leu) % in the three groups,A group[(12.3±8.6)%],B group[(22.5±10.3)%],C group[(1.4±0.9)%] are signif icant(P<0.05);The differences of the ECP and eotaxin in the three groups,A group [(123.6±87.9) g/L,(0.142±0.018)g/ L],B group[(248.1±102.3)μg/l,(0.286±0.136)g/L],C group[(30.9± 18.5)μg/l,(0.028±0.043) μg/l] are also signifi cant(P<0.05);The EOS/Leu%,the level of eotaxin,the level of ECP are significantly inversely correlated with the percentage of the fi rst second forced expiratory volume/predicted value(FEV1%) in B group(r=-0.769、-0.658、-0.524,P<0.001 or P<0.005).The level of eotaxin is signif icantly positively correlated with the level of ECP in B group(r=0.785,P<0.001).The level of eotaxin and the level of ECP in induced sputum are respectively signif icantly positively correlated with the EOS/Leu% in B group(r=0.569,P<0.02;r=0.785,P<0.001).Conclusion:Eotaxin possiblely particulates in eosinophilic airway inflammation and airflow obstruction in asthmatic patients by selective chemotactic activity on eosinophil,and eosinophil release a series of inflammation medium that induce the exacerbation of asthma.