Avtor/Urednik		Šuškovič, Stanislav; Košnik, Mitja; Kern, Izidor; Fležar, Matjaž; Kopač, Matjaž; Mušič, Ema; Šorli, Jurij
Naslov		Inducirani sputum in bronhialna preodzivnost pri bolnikih z astmo
Prevedeni naslov		Induced sputum and bronchial hyperresponsiveness in patients with asthma
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 69, št. 12
Leto izdaje		2000
Obseg		str. 803-7
Jezik		slo
Abstrakt		Background. Airway inflammation is considered to be the primary event leading to airway hyperresponsiveness, airway obstruction, and symptoms of asthma. Analysis of induced sputum allowes the direct measurement of airway inflammation in asthma. However the interrelations between sputum biochemical and cytological profiles and clinical or functional parameters in asthma are not fully known. Methods. We measured cellular and biochemical elements in induced sputum. In the analysis were included 17 patients with asthma and 11 clinicaly healthy subjects. We measured blood and sputum concentrations of eosinophilic cationic protein (ECP) and of tryptase. Expectoration of sputum was induced wiyh inhalations of 4.5% NaCl. In sputum were measured relative concentrations of eosinophils (EOS), neutrophils (NEU), lymphocytes and macrophages (MCF). Levels of bronchial responsiveness to inhaled hypertonic NaCl (BHR) in asthmatic patients were compared to cellular and biochemical findings of induced sputum. Results. Concentrations of ECP in blood of asthmatics (15.7 micro g/L, SD 9.2 micro g/L) compared to healthy subjects (8.2 micro g/L, SD 3.09 micro g/L) as well as ECP concentrations in induced sputum of asthmatics (110.7 micro g/L, SD 24.4 micro g/L) differed significantly (p = 0.02 and p = 0.0002 respectively). Asthmatic and healthy subjects differed significantly regarding to EOS (13.0% versus 1.o%, p = 0.03), but no to other cellular components of induced sputum. There were positive correlations between EOS and BHR (r = 0.54, p < 0.05) and negative correlation between MCF and BHR (r = -0.50, p < 0.05). Conclusions. Our analysis confirmed the importance of eosinophils in asthmatic inflammation of airways. We confirmed the role of NEU in the activation of EOS. It appears, that MCF could inhibit BHR to inhaled hypertronic saline.
Izvleček		Izhodišča. Vnetje bronhijev je odgovorno za simptome astme, zaporo bronhijev in bronhialno preodzivnost pri bolnikih z astmo. Ocenjevanje vnetja je pomembno zaradi pravilne umestitve bolnika z astmo, predpisa zdravljenja ter ocene učinka zdravljenja astme. Metode. Pri 17 bolnikih z astmo in pri 11 zdravih prostovoljcih smo preučevati celične in topne elemente induciranega sputuma. V krvi in v sputumu smo merili koncentracije eozinofilnega kationskega proteina (ECP) ter triptaze. Ocenjevali smo količino in celično koncentracijo induciranega sputuma. Izločanje sputuma smo spodbudili z inhalacijami 4,5% NaCl. Ocenjevali smo relativne vrednosti eozinofilcev, nevtrofilcev, limfocitov ter makrofagov. Rezultate smo primerjali z velikostjo bronhialne odzivnosti za 4,5% NaCl (BO). Rezultati.. Koncentracije ECP v krvi astmatikov (15,7 mikro g/L, SD 9,2 mikro g/L) in zdravih (8,2 mikro g/L, SD 3,09 mikro g/L) in koncentracije ECP v sputumu bolnikov z astmo (110,7 mikro g/L, SD 67,7 mikro g/L) ali zdravih (20,7 mikro g/L, SD 24,4 mikro g/L) so se pomembno ločile (p = 0.02 in p = 0,0002). Po relativnem številu celic v induciranem sputumu so se astmatiki in zdravi ločili le po eozinofilcih (13,0% oziroma 1,0%, p = 0,03). Bolnikom z astmo smo z inhalacijo 4,5% NaCl spodbudili izločanje pomembno večje količine sputuma (12,7 ml, SD 6,9 ml) kot pri zdravih (5,2 ml, SD 3,8 ml, p = 0,002). Našli smo statistično pomembni pozitivni korelaciji med eozinofilci v sputumu in BO (r = 0,56, p < 0,05), med ECP in nevtrofilci v sputumu (r = 0,54, p < 0,05) ter statistično pomembno negativno korelacijo med makrofagi v sputumu in BO (r= - 50, p < 0,05). Zaključki. Analiza induciranega sputuma pri 17 bolnikih z astmo potrjuje pomembnost eozinofilnega vnetja pri astmi. Potrdili smo vlogo nevtrofilcev pri aktivaciji eozinofilcev. Zdi se, da makrofagi pri nekaterih bolnikih z blago astmo zavirajo astmatsko vnetje bronhijev.
Deskriptorji		ASTHMA BRONCHIAL HYPERREACTIVITY SPUTUM EOSINOPHILS NEUTROPHILS MACROPHAGES LYMPHOCYTES