摘要

背景:目前的哮喘管理指南提倡除轻微疾病外，对所有哮喘患者使用抗炎治疗。他们根据临床标准，如肺功能和症状来定义疾病控制。然而，该病的临床控制与气道炎症之间的关系尚不清楚。因此，我们进行了一项横断面研究，以调查吸入类固醇治疗哮喘患者的气道炎症、临床控制措施和支气管高反应性之间的关系。方法:26名患有轻度至中度哮喘(基线1秒用力呼气量(FEV1) >或= 50%预测，组胺浓度导致FEV1下降20% (PC20) 0.02-7.6 mg/ml)的特应性成年人(19-45岁)进入研究，常规使用吸入类固醇治疗。在进行乙酰胆碱激发试验和支气管镜检查前两周的日记卡记录被用来确定峰值流量变化率、症状评分和使用β - 2激动剂。活检标本由纤维支气管镜从右下、中叶隆突和主隆突取。用抗:嗜酸性粒细胞阳离子蛋白(EG1, EG2)、肥大细胞胰蛋白酶(AA1)、CD45、CD22、CD3、CD4、CD8、CD25和CD45RO的单克隆抗体对冷冻切片进行免疫组化染色。利用交互显示系统计算两次固有层阳性染色细胞数。结果:活检标本采集的三个部位的细胞数量没有差异。 The PC20 for methacholine was inversely related to the average number of total leucocytes, EG1+, and EG2+ cells, mast cells, CD8+, and CD45RO+ cells in the lamina propria. These relationships were similar for each of the biopsy sites. Symptom scores, beta 2 agonist usage, FEV1, and peak flow variability were not related to any of the cell counts. CONCLUSIONS: Infiltration of inflammatory cells in the lamina propria of the airways seems to persist in asthmatic outpatients despite regular treatment with inhaled steroids. The number of infiltrating leucocytes such as mast cells, (activated) eosinophils, CD8+, and CD45RO+ cells in bronchial biopsy specimens from these patients appears to be reflected by airway hyperresponsiveness to methacholine, but not by symptoms or lung function. These findings may have implications for the adjustment of anti-inflammatory treatment of patients with asthma.