Increased Neutrophil Numbers and IL-8 Levels in Airway Secretions in Acute Severe Asthma: Clinical and Biologic Significance

作者：Claudia L. Ordoñez, Thomas E. Shaughnessy, Michael A. Matthay, JOHN V. FAHY · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2000 · DOI：10.1164/ajrccm.161.4.9812061 · 被引用次数：439 · 研究领域：Asthma and respiratory diseases、Respiratory Support and Mechanisms、Neonatal Respiratory Health Research

The inflammatory events in the airways at the time of acute respiratory failure from acute severe asthma are poorly understood. To determine the patterns of cellular inflammation in the airways in acute severe asthma, we analyzed tracheal aspirates collected within 12 h of intubation from patients intubated emergently for acute severe asthma (n = 10) and from patients intubated electively for nonpulmonary surgery (n = 14). The number of neutrophils in tracheal aspirates from asthma patients was 10 times higher than normal (4.2 [0.6 to 335.0] [median, range] versus 0.4 [0.009 to 9.4] x 10(6)/ml, p = 0.001), and there was a strong trend for a positive relationship between neutrophil number and duration of intubation (r(s) = 0.64, p = 0.06). Although eosinophil numbers were also significantly higher than normal (0.5 [0.0 to 23.3] versus 0.0 [0.0 to 0.1] x 10(6)/ml, p = 0.003), the numbers of eosinophils were 8-fold less than neutrophils, and there was no significant correlation between eosinophil number and duration of intubation (r(s) = 0.4, p = 0.26). Interleukin-8 (IL-8), a chemoattraction for neutrophils, was 19 times higher than normal in tracheal aspirates from asthmatic patients (75.0 [9.0 to 168.0] versus 4.0 [0.08 to 24.0] ng/ml, p < 0. 05) and correlated significantly with the neutrophil number (r(s) = 0.77, p = 0.03). Furthermore, the IL-8 levels correlated positively with the duration of mechanical ventilation (r(s) = 0.74, p = 0.03). Surprisingly, the number of neut...