The role of airway neurogenic inflammation in gastro-esophageal reflux induced cough
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES
- Issue:
- 8
- DOI:
- 10.3760/j:issn:1001-0939.2005.08.005
- Key Word:
- 胃食管反流;慢性咳嗽;气道炎症;神经肽;发病机制
Abstract： 目的探讨气道神经源性炎症在胃食管反流性咳嗽(GERC)发病中的作用.方法 20例GERC患者(GERC组),与10名正常人(正常对照组)和8例其他病因咳嗽伴有胃食管反流(GERD)患者(GERD组)分别作对比分析,观察GERC患者治疗前、后气道黏膜与分泌物中神经肽的变化.用酶联免疫吸附测定(ELISA)法测定痰上清液P物质(SP)、神经肽A(NKA)、神经肽B(NKB)的含量;用放射免疫法测定痰上清液降钙素基因相关肽(CGRP)的浓度.用免疫组化法检测气道黏膜、诱导痰细胞SP、NKA及SP受体(NK-1)的表达,结果用半定量病理学方法表示.结果 GERC组患者痰上清液SP、CGRP含量[(266±207)ng/L、(180±83)ng/L]显著高于正常对照组[(143±36)ng/L、(105±64)ng/L,P分别＜0.05、＜0.01]和GERD组[(130±11)ng/L、(89±16)ng/L,P分别＜0.05、＜0.01],NKA、NKB的含量各组间比较差异无统计学意义(P均＞0.05);GERC组痰细胞SP、NK-1和NKA的表达显著高于正常对照组(P分别＜0.01、＜0.05,＜0.05)和GERD组(P均＜0.05);GERC组气道黏膜SP的表达也显著高于GERD组(P＜0.01).治疗后,诱导痰细胞SP、NK-1、NKA的表达较治疗前显著降低(P＜0.01,＜0.01或＜0.05),痰上清液CGRP的含量也较治疗前显著降低(P＜0.05).结论 GERC患者气道存在明显的神经源性炎症,治疗后神经肽趋于正常,提示神经源性炎症与GERC的发病密切相关.
- [1]刘春丽,赖克方,陈如冲,等.胃食管反流性咳嗽的临床特征与诊断探讨[J].2005,(6).
- [2]O'Connell F,Springall D R,Moradoghli-Haftvani A,etc.Abnormal intraepithelial airway nerves in persistent unexplained cough?[J].1995.
- [3]L, Jayaram,K, Parameswaran,M R, Sears,etc.Induced sputum cell counts: their usefulness in clinical practice.[J].2000,16(1).
- [4]K, Sekizawa,Y X, Jia,T, Ebihara,etc.Role of substance P in cough.[J].1900,9(5-6).
- [5]L P A McGarvey,L G Heaney,J T Lawson,etc.Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol[J].1998,53(9).
- [6]J, Hamamoto,H, Kohrogi,O, Kawano,etc.Esophageal stimulation by hydrochloric acid causes neurogenic inflammation in the airways in guinea pigs.[J].1997,82.