MPO?IL-8 Levels In Chronic Persistent Of Patients With Neutrophilic Asthma And Changes After Inhalation Treatment

Objectives To investigate MPO,IL-8,ECP's roles in the pathogenesis of neutrophilic asthma and examined the changes after salmeterol and fluticasone propionate power inhalation.Methods 37 chronic persistent of asthmatics without using any corticosteroids were divided into two groups:neutrophilic asthma group(NA group)(n=13)and non-neutrophilic asthma group(NNA group)(n=24)according to induced sputum cytology.Before treatment,all asthmatics underwent lung function tests?sputum induction and were detected Peripheral blood eosinophils?neutrophils?eosinophil percentage?neutrophil percentage?Serum and sputum supernatant inflammatory factors(MPO?IL-8?ECP).After 1 month treatment,all asthmatics underwent sputum induction and were detected Serum and sputum supernatant inflammatory factors(MPO?IL-8?ECP).Peripheral blood eosinophils?neutrophils?eosinophil percentage and neutrophil percentage were measured by Hematology analyzer.Serum and sputum supernatant MPO?IL-8?ECP were measured by ELISA.Results 1.There was no difference in ACT scores between NA group and NNA group,no matter before or after treatment(P>0.05).However,both of ACT scores of the two groups had elevated after treatment(P<0.05).2.The total induced sputum cells count?neutrophil percentage and neutrophils in NA group were higher,but the sputum eosinophil percentage were lower than that of NNA group(all P<0.05).However the number of induced sputum eosinophils between of them had no statistically difference(P>0.05).After 1 month treatment,The total induced sputum cells count?neutrophil percentage and neutrophils in NA group were lower,however,the eosinophil percentage was higher than before(all P<0.05).However the number of induced sputum eosinophils between them had no statistically difference(P>0.05).The total induced sputum cells count?neutrophil percentage?neutrophils eosinophil percentage?eosinophils in NNA group had no statistically difference than before(P>0.05).Neutrophil percentage and neutrophils in NA group,after 1 month treatment,were also higher than that of NNA group(all P<0.05).However,the total induced sputum cells count?eosinophil percentage and eosinophils between of them had no statistically difference(P>0.05).After 1 month treatment,some NA and NNA can interconvert each other.There are 3(23.08%)in NA and 4(16.67%)in NNA interconvert each other.The total cells count?neutrophil percentage?neutrophils?eosinophil percentage and eosinophils in peripheral blood,no matter before treatment or after treatment,had no statistically difference between NA and NNA group(P>0.05).There were also no statistically difference in NA or NNA group,after treatment(P>0.05).3.The MPO?IL-8 levels were higher but the ECP levels had no statistically difference in sputum supernatant in NA group than NNA group before treatment.After 1 month treatment,The MPO?IL-8?ECP levels,in sputum supernatant,in NA group and the MPO?IL-8 levels in NNA group had no statistically difference than before(P>0.05).However,the ECP levels,in sputum supernatant,in NNA group was lower than before(P<0.05).Before treatment and after 1 month treatment,The MPO?IL-8?ECP levels in NA group,in peripheral blood,had no statistically difference compared to NNA group.After 1 month treatment,There had no statistically difference in NA or NNA group.4.FEV1%?FEV1/FVC%and MMEF75/25%in NA group were lower than them of NNA group before treatment.After treatment,FEV1%were higher and FEV1/FVC%and MMEF75/25%had Rising trend,but no statistically difference in NA group than before.However,FEV1%?FEV1/FVC%or MMEF75/25%had no statistically difference in NNA group than before.FEV1%.FEV1/FVC%?MMEF75/25%had no statistically difference in NA and NNA group.5.In NA group,eosinophil percentage?eosinophils and MPO were positively correlated with ECP,eosinophils was negatively correlated with IL-8 in sputum supernatant(r=0.594,p<0.05;r=0.554,p<0.05;r=0.574,p<0.05;r=-0.565,p<0.05).However,the others in sputum supernatant of NA group was no correlated with each other.In NNA group,neutrophils and eosinophils was positively correlated with IL-8(r=0.651,p<0.05;r=0.751,p<0.05).Eosinophil percentage was positively correlated with ECP(r=0.735,p<0.05).the others in sputum supernatant of NNA group was no correlated with each other.In NA group,neutrophil percentage and neutrophils was positively correlated with MPO and ECP(r=0.757,p<0.05;r=0.812,p<0.05),eosinophil percentage was negatively correlated with MPO(r=-0.604,p<0.05),MPO was positively correlated,with ECP(r=0.757,p<0.05)in Peripheral blood.In NNA group,IL-8 and eosinophils in Peripheral blood was positively correlated with ECP(r=0.475,p<0.05;r=0.470,p<0.05),the others was no correlated with each other.In NA group,FEV1%was positively correlated with ECP in sputum supernatant(r=0.623,p<0.05),the others was no correlated with each other.In NNA group,FEV1%?FEV1/FVC%and MMEF75/25%were negatively correlated with neutrophil percentage in induced sputum(r=-0.624,p<0.05;r=-0.718,p<0.05;r=-0.569,p<0.05),the others were no correlated with each other.Conclusion:1.MPO,IL-8 may participate in the Airway inflammation of neutrophilic asthma duration.2.The lung function of Chronic neutrophilic asthma duration in patients was obstructive ventilation dysfunction and the airway obstruction was more severity than chronic non-neutrophilic asthma duration.3.Standardized treatment of ICS + LABA had a certain effect on neutrophilic asthma.4.Some neutrophilic asthma and non-neutrophilic asthma,after normalization treatment,can be interconvert to each other.The Mechanism is unclear.