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Background:We observed airway remodeling, which is the thickness of the susepithelial layer, in asthmatic patients and inhealthy subjects in order to determine its relationship with severity of disease, such as symptom, bronchial hyperresponsiveness, and degree of acute exacerbation. Moreover, for evaluation of factors contributing to airway remodeling, we analyzed the age, sex, presence of atopy, length of asthmatic history and degree of airway inflammation. Methods: Thirty-six patients with asthma and ten healthy controls were recruited for the study. The degree of asthma symptom severity was assessed using NIH criteria. Bronchial responsiveness to methacholine was expressed as provocative concentration of methacholine causing a 20% fall in FEV1. The degree of acute exacerbation was assessed by PaCO2 during acute exacerbation. Bronchoscopy, bronchoalveolar lavage(BAL), and bronchial biopsy were performed for all subjects; the total cell counts, differential cell counts and levels of ECP were measured inBAL fluid, and the basement membrane thickness and degree of epithelial shedding were measured in biopsy samples under light microscopy. Results: The mean values of basement membrane thickness were 7.8±0.6 ㎛ in asthmatics, and 4.1±0.5 ㎛ in healthy subjects (p$lt;0.05). Basement membrane thickness in patients with severe persistent asthma differed significantly from that of patients with mild intermittent asthma (11.8±1.0 ㎛ vs 6.5±0.7 ㎛ p$lt;0.05). A lower level of PC20 for methacholine was observed in asthma with thick basement membrane(±7.5 ㎛) compared to those with basement membrane less than 7.5㎛ (0.26±0.13 mg/ml vs. 0.74±0.16 mg/ml, p$lt;0.05). No difference was found between the degree of thickening in patients with different degree of acute exacerbation with age, sex, atopy and lengths of asthmatic history. The degree of thickening was positively correlated to degree of epithelial shedding (r=0.393, p$lt;0.05), but not to the degree of total cell counts, differential cell percentage nor ECP in BAL fluid. Conclusion: We confirmed that thickening of the basement membrane is a characteristic finding of asthma. We also demonstrated that it affects symptom severity and bronchial hyperresponsiveness, and is related to degree of epithelial damage rather than duration of asthma history.
Background and Objective : T cells play a pivotal role in initiating and orchestrating bronchial inflammation in asthma. However, little is known about changes in T cell subset in the airways. Our objective was to study whether the proportion of CD4+ or CD8+ T cells in the bronchoa1veolar lavage fluid (BALF) of bronchial asthma is different from normal subjects, and whether it is associated with clinical characteristics. Methods : We examined the percentage of CD4+ and CD8+ cells in the BALF of 37 patients with bronchial asthma and 14 normal controls by flow cytometry. Bronchial asthma was classified as mild, moderate and severe according to bronchial hyperresponsiveness. Skin prick test and pulmonary function tests were performed. Results : The percentage of CD4+ cells in BALF did not differ between asthmatics and controls, however, the percentage of CD8+ cells was significantly higher in asthmatics than contro1s, In asthmatics, the percentage of CD4+ cells and CD8+ cells did not differ between atopic and nonatopic asthmatics. The percentage of CD8+ cells in addition to CD4+ cells was correlated with the percentage of eosinophils in BALF, and the percentage of CD8+ cells also showed negative correlation with FEV₁and FEF_(25-75%) Conclusion : These results suggest that CD8+ cells as well as CD4+ cells are associated with airway inflammation in bronchial asthma.
Acute eosinophilic pneumonia(AEP) was first described in 1989 and represents a clinical entity distinct from chronic eosinophilic pneumonia. AEP is characterized by acute respiratory insufficiency, hypoxemia, fever, diffuse radiographic infiltrates, and eosinophilia in bronchoalveolar lavage fluid or lung biopsies in the absence of infection, atopy, or asthma. Rapid response to corticosteroids is characteristic. We experienced a 47-year-old metal driller presenting typical clinical and radiological characteristics of AEP. We confirmed eosinophilic pneumonia with brochoalveolar lavage analysis and transbronchial lung biopsy. We report a case of AEP diagnosed by clinical, radiographic, and histologic findings with a brief review of the literature.
Background: Th2-like cells are thought to play a crucial role in the recruitment and activation of eosinophil in bronchial asthma. In contrast to Th2 cytokine, Thl cytokine IFN-γdecreases eosinophil recruitment. Previous studies have shown that IL-12 promotes differentiation of Th0 into Thl and enhances production of Thl cytokine. IL-12 also prevents differentiation of Th0 into Th2 during primary immune response. Its effect on established Th2 cell, however, is well known. Objective: The objective of aur study was focused on whether IL-12 prevents recruitment of eosinophil and expression of Th2 cytokine in murine model for bronchial asthma, and whether its effect differs according to timing of dosage. Methods: Administration of IL-12 was tested in the 3 different time-frames; 1) allergic sensitization (early dosage) 2) allergic challenge (late doaage) or 3) both. The number of eosinophil in the bronchoalveolar lavage(BAL) fluid and tissue was examined for change of airway inflammation. The effect on cytokine expression was assessed by measuring cytokine in bronchoalveolar lavage fluid (ELISA) and mRNA in peribronchial lymph node (RT-PCR) Results: Early dosage of IL-12, and the combination of early and late dosages, strikingly decreased the numbers of eosinophil in both BAL fluid and tissue(p$lt;0.05). Late dosage of IL-12 decreased tissue eosinophilia, while the number of eosinophil in BAL fluid remained unchanged. IL-12 increased IL-4 and IL-5 levels, and decreased IL-2 and I~FN-γlevels. There were no dif- ferences in Thl/Th2 cytokine regulation among the three dosage times. Early dosage of IL-12, and the combination of early and late dosages, increased IL-10 level, but late dosage had no effect on IL-10. Conclusion: These results demonstrate that depending upon whether IL-12 is administered during sensitization or during subsequent allergen exposure, Thl/Th2 cytokine regulation by IL -12 shows no difference because it seems that difference of inhibition of eosinophil recruitment by IL-12 might be related with the other factors, such as IL-10.
Efects of α-chymotrypsin modification ondegre of hydrolysis (DH), solubility, emulsifying capacitytein isolate (SPI) using a lipoxygenase-defected soybean(Jinpum-kong) and commercial soy protein isolate (Supro500E) were compared. SPIs were hydrolyzed by α-chy-motrypsin at pH 7.8 and 37oC for 30 min. DHs of Supro50E and Jinpum-kong SPI were increased by α-chymot-rypsin modification, and DH of Supro 500E was higherthan that of Jinpum-kong SPI. DH of α-chymotrypsintreated Jinpum-kong SPI was similar with untreatedest. Solubility, emulsifying capacity and thermal aggrega-tion of SPIs were increased by α-chymotrypsin modification,and these changes were highly related to changes in DH.Functional properties of Supro 500E were higher thanJinpum-kong SPI in both of untreated and α-chymot-rypsin treated SPIs.
Background:Cysteinyl leukotrienes are important inflammatory mediators in bronchial asthma because they enhance microvascular permeability, increase nonspecific bronchial hyperresponsiveness, and are potent bronchoconstrictor agents. Leukotriene E₄ is a major metabolite of cysteinyl leukotriene excreted in urine and its concentration of urine can be a reliable marker of the overall leukotriene production in the body. Objective : To determine whether clinical parameters of bronchial asthma are associated with production of cysteinyl leukotrienes, expressed by urinary leukotriene E₄. Method: We measured the urinary concentration of leukotriene E₄ in bronchial asthma(127 patients) and normal control(15 persons) group by ELISA method. Pulmonary function test, allergic skin test, measurement of peripheral eosinophil count and eosinophil cationic protein were undertaken in bronchial asthma patients. Results: The concentrations of urinary leukotriene E₄ were significantly higher in bronchial asthma patients than ormal controls (p$lt;0.05). The increased concentrations of leukotriene E4 had a significant correlation with FEV1/FVC or methacholine PC20(p$lt;0.05). However, the concentration of leukotriene E4 did not have any correlation with the presence of atopy, peripheral blood eosinophil count, and eosinophil cationic protein level. Conclusion : The concentration of urinary leukotriene E₄ that represents the overall leukotriene production in the body is correlated with the degree of airway obstruction and airway hyperres- ponsiveness. So, the concentration of urinary leukotriene E₄ may be used as an adjunctive parameter of airway obstruction and hyperresponsiveness in bronchial asthma.
Background:Airway hyperresponsiveness is expressed as the provocative dose or concentration of the stimulus required to achieve bronchoconstriction, a 20% fall in FEV1 (PD20 and PC20, respectively). A decrease in PC_(20) may be due to a steeper dose-response curve (hyperreactivity) or to a shift in the curve to the left (hypersensitivity), or both. It has been suggested that many factors, such as genetic factor, airway inflammation, epithelial damage or airway remodeling, are involved in the airway hyperresponsiveness in asthma. Objective: In this study, we analyzed the relationship of airway sensitivity and reactivity with bronchial inflammation and structural change in asthmatics. Method: The PC_(20) for methacholine, as the airway sensitivity parameter, and the slope between PC_(20) and PC_(40), as the airway reactivity parameter, were measured. Total cell counts and differential cell counts in BAL fluid, percentage of epithelial shedding (ES), basement membrane thickness (BMT) and depth of submucosal collagen depoition (SMC) on bronchial tissue were measured. The patients (n=27) were divided into two groups by median values of ES, BMT, or SMC (32%, 7.3㎛, 68㎛, respectively). Results: The PC_(20) showed a significant correlation with baseline FEV1% (r=0.498, p$lt;0.05), and was significantly lower in patients with over 32% of ES than in those with under 32% of ES (2.89±1.05 ㎎/㎖ vs 5.70±3.70 ㎎/㎖, p$lt;0.05). The slope was significantly steeper in patients with thicker BMT or SMC. Conclusion: These results suggest that airway hypersensitivity is affected by airway caliber, and airway hyperreactivity is affected by bronchial remodeling in asthma.