The Effect Of Aminophylline And Glucocorticoid On Eosinophil Cell Ultrastructure In Apoptosis

The pathogenesis of bronchial asthma is so complicated that it is not completely clarified now. Bronchial asthma is a kind of disease that reactivity of trachea-bronchus to the antigen or non-antigen stimulation increases excessively. In pathology, it is defined as a chronic inflammatory disease characterized by eosinophil infiltration and involved by many kinds of cells, such as lymph cell, mast cell and neutrophil. Eosinophil is activated as the major effected cell and lead to tissue injury in bronchial asthma. In recent years, it is demonstrated that the key point of treatment of bronchial asthma is to control apoptosis of eosinophil, clear eosinophils gathered in airway and relieve airway inflammation.Nowadays, cell apoptosis, also called program cell death, is considered as an active cell death process after accepting certain signal or stimulus and involved in interaction of some apoptosis-related gene. It is a kind of mechanism to maintain the stability of body. The injured, aging and prominent cells are eliminated by apoptosis in order to maintain balance of tissue. Apoptosis of eosinophil is the major pathway of eosinophil elimination when bronchial asthma lessens. Apoptosis of eosinophil can not only avoid injury of epithelium of airway, but also be identified and phagocytized by macrophages and other phagocytic cells.In morphology, cell apoptosis is mainly characterized by shrinkage of cellular and nuclear membrane, decreased cell size, nuclear debris formation after breakage of condensated chromatin which is known as DNA fragmentation phenomenon, clearage of cytoskeleton, sprouting membrane and formation of dense apoptotic body parceled by membrane.This study is designed to observe the change of lung function and ultrastructure change of eosinophil apoptosis before and after treatment with theophyline, glucocorticoid and combined treatment for bronchial asthma patient.Methods: 30 cases of patients with bronchial asthma (diagnosed according to the diagnostic criteria by Chinese medical association of respiratory diseases branch asthma study group; no infectious factor; no smoking history ; no medication with other bronchodilator drugs; positive allergic source) were randomly divided into three groups: treatment group with aminophyline, treatment group with glucocorticoid and combined treatment group with aminophyline and glucocorticoid. Measure change of pulmonary function by statistics analysis before and after treatment. Observe ultrasturcture change of eosinophil apoptosis by collecting sputum, centrifugating and abstracting eosinophil. Result:When the patients with bronchial asthma treated by aminophylline, glucocorticoid and combination therapy, FEV1 and FEV1(%) of patient was significantly increased, the positive Eos of trypan blue stain in sputum was also significantly increased, and the number of Eos was significantly decreased. The Eos was apoptosis in morphology by transmission electron microscope.Conclusion: The infiltration of Eos is the notable pathological feature in patients with bronchial asthma. The apoptosis of Eos is the main pathway for patients with bronchial asthma to lessen the airway spasm. Aminophylline and glucocorticoid can improve the Eos apoptosis. The combination therapy has the synergistic action on apoptosis of Eos.