Airway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma

被引:98
作者
Gibson, PG [1 ]
Saltos, N [1 ]
Borgas, T [1 ]
机构
[1] John Hunter Hosp, Dept Resp Med, Airways Res Ctr, Newcastle, NSW 2310, Australia
基金
英国医学研究理事会;
关键词
asthma; sputum; eosinophil; mast cell; airway responsiveness; inflammation; corticosteroid;
D O I
10.1067/mai.2000.105319
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: The relationship between airway inflammation and asthma severity in corticosteroid-treated asthma is unclear. Objectives: Our purpose was to characterize the inflammatory cell profile of the airway lumen and epithelium in corticosteroid-treated asthma and to relate these findings to clinical and physiologic markers of asthma severity. Methods: Adults (n = 20) with asthma received standardized high-dose inhaled corticosteroid therapy with beclomethasone 2000 mu g per day For 8 weeks, Airway responsiveness to methacholine and hypertonic (4.5%) saline solution was then assessed, followed by sputum induction and, 1 week later, bronchoscopy with bronchoalveolar lavage and bronchial brush biopsy to assess inflammatory cells. Results: Clinical asthma severity was associated with airway hyperresponsiveness. Metachromatic cells were the main granulocyte present in bronchial blush biopsy specimens and correlated with airway responsiveness to saline solution (r = -0.75), methacholine (r = -0.74), peak flow variability (r = 0.59), and clinical asthma severity (r = 0.57). Eosinophils were the main granulocyte present in sputum and correlated with airway responsiveness to saline solution (r = -0.63) but not with other clinical markers of asthma severity. Bronchoalveolar lavage cell counts were not related to clinical asthma severity. Conclusions: In asthmatic patients treated with corticosteroids, the dominant inflammatory effector cell in the epithelium is the metachromatic cell, and in sputum it is the eosinophil. These cells correlate with the degree of airway hyperresponsiveness. Clinical asthma severity correlates with airway responsiveness and epithelial metachromatic cells. Induced sputum eosinophils and airway responsiveness to hypertonic saline solution may be useful markers of airway inflammation for clinical practice.
引用
收藏
页码:752 / 759
页数:8
相关论文
共 32 条
  • [1] Intranasal beclomethasone reduces allergen-induced symptoms and superficial mucosal eosinophilia without affecting submucosal inflammation
    Baroody, FM
    Rouadi, P
    Driscoll, PV
    Bochner, BS
    Naclerio, RM
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 157 (03) : 899 - 906
  • [2] IDENTIFICATION OF LYMPHOCYTES-T, MACROPHAGES, AND ACTIVATED EOSINOPHILS IN THE BRONCHIAL-MUCOSA IN INTRINSIC ASTHMA - RELATIONSHIP TO SYMPTOMS AND BRONCHIAL RESPONSIVENESS
    BENTLEY, AM
    MENZ, G
    STORZ, C
    ROBINSON, DS
    BRADLEY, B
    JEFFERY, PK
    DURHAM, SR
    KAY, AB
    [J]. AMERICAN REVIEW OF RESPIRATORY DISEASE, 1992, 146 (02): : 500 - 506
  • [3] A CD18/ICAM-1-dependent pathway mediates eosinophil adhesion to human bronchial epithelial cells
    Burke-Gaffney, A
    Hellewell, PG
    [J]. AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY, 1998, 19 (03) : 408 - 418
  • [4] Chanez P, 1998, EUR RESPIR J, V11, p26S
  • [5] CORRIGAN CJ, 1988, LANCET, V1, P1129
  • [6] MUCOSAL INFLAMMATION IN ASTHMA
    DJUKANOVIC, R
    ROCHE, WR
    WILSON, JW
    BEASLEY, CRW
    TWENTYMAN, OP
    HOWARTH, PH
    HOLGATE, ST
    [J]. AMERICAN REVIEW OF RESPIRATORY DISEASE, 1990, 142 (02): : 434 - 457
  • [7] EFFECT OF AN INHALED CORTICOSTEROID ON AIRWAY INFLAMMATION AND SYMPTOMS IN ASTHMA
    DJUKANOVIC, R
    WILSON, JW
    BRITTEN, KM
    WILSON, SJ
    WALLS, AF
    ROCHE, WR
    HOWARTH, PH
    HOLGATE, ST
    [J]. AMERICAN REVIEW OF RESPIRATORY DISEASE, 1992, 145 (03): : 669 - 674
  • [8] COMPARISON OF SAMPLES COLLECTED BY SPUTUM INDUCTION AND BRONCHOSCOPY FROM ASTHMATIC AND HEALTHY-SUBJECTS
    FAHY, JV
    WONG, H
    LIU, J
    BOUSHEY, HA
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1995, 152 (01) : 53 - 58
  • [9] ALTERED ADHESION MOLECULE EXPRESSION AND ENDOTHELIAL-CELL ACTIVATION ACCOMPANY THE RECRUITMENT OF HUMAN GRANULOCYTES TO THE LUNG AFTER SEGMENTAL ANTIGEN CHALLENGE
    GEORAS, SN
    LIU, MC
    NEWMAN, W
    BEALL, LD
    STEALEY, BA
    BOCHNER, BS
    [J]. AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY, 1992, 7 (03) : 261 - 269
  • [10] GIBSON PG, 1993, AM REV RESPIR DIS, V148, P80, DOI 10.1164/ajrccm/148.1.80