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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Although altered vascular permeability and edema of the bronchial mucosa are associated with asthma attack&#44; their influence on its severity remains unknown&#46; We address this issue by comparing relative indices for the concentration of albumin &#40;RIAlb&#41; and &#945;<span class="elsevierStyleInf">2</span>-macroglobulin &#40;RI&#945;<span class="elsevierStyleInf">2</span>M&#41; in induced sputum and peripheral blood from patients with exacerbated asthma&#44; patients with stable asthma&#44; and control subjects&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Forty-six volunteers participated in the study&#58; 14 with exacerbated asthma &#40;forced expiratory volume in the first second &#91;FEV<span class="elsevierStyleInf">1</span>&#93; 74&#46;3&#37; &#91;SD&#44; 20&#46;8&#37;&#93; of reference&#41;&#44; 23 with stable asthma &#40;FEV<span class="elsevierStyleInf">1</span> 93&#46;6&#37; &#91;7&#46;5&#37;&#93;&#41;&#44; and 9 controls &#40;FEV<span class="elsevierStyleInf">1</span> 101&#46;1&#37; &#91;9&#46;9&#37;&#93;&#41;&#46; The concentrations of albumin and &#945;<span class="elsevierStyleInf">2</span>-macroglobulin were quantified by immunoturbidimetry and immunonephelometry&#44; respectively&#46; The relative index was then calculated by dividing the concentration in sputum supernatant by the concentration in peripheral blood&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The mean RIAlb was 1&#46;2 &#40;1&#46;1&#41; in the control group&#44; 2&#46;9 &#40;3&#46;1&#41; in the stable asthma group&#44; and 6&#46;0 &#40;6&#46;7&#41; in the exacerbated asthma group&#46; The RI&#945;<span class="elsevierStyleInf">2</span>M values were 11&#46;7 &#40;10&#46;9&#41;&#44; 11&#46;9 &#40;14&#46;7&#41;&#44; and 3&#46;2 &#40;3&#46;8&#41; for the control group and stable and exacerbated asthma groups&#44; respectively&#46; The increases in the RIAlb values between all groups&#44; and the decrease in the RI&#945;<span class="elsevierStyleInf">2</span>M value between the exacerbated asthma and control groups were statistically significant &#40;<span class="elsevierStyleItalic">P</span> &#60;&#46;05&#41;&#46; The percentage of neutrophils&#44; but not of eosinophils&#44; in sputum was correlated with the RIAlb &#40;r&#61;0&#46;39&#59; <span class="elsevierStyleItalic">P</span> &#61; &#46;008&#41; but not the RI&#945;<span class="elsevierStyleInf">2</span>M &#40;r&#61;-0&#46;035&#59; <span class="elsevierStyleItalic">P</span> &#61; &#46;82&#41;&#46; FEV<span class="elsevierStyleInf">1</span> displayed an inverse relationship with the RIAlb &#40;r&#61;-0&#46;43&#59; <span class="elsevierStyleItalic">P</span> &#61; &#46;009&#41; but not with the RI&#945;<span class="elsevierStyleInf">2</span>M &#40;r&#61;-0&#46;206&#59; <span class="elsevierStyleItalic">P</span> &#61; &#46;24&#41;&#46; No correlation was found between oxyhemoglobin saturation and either the RIAlb &#40;r&#61;-0&#46;33&#59; <span class="elsevierStyleItalic">P</span> &#61; &#46;19&#41; or the RI&#945;<span class="elsevierStyleInf">2</span>M &#40;r&#61;-0&#46;12&#59; <span class="elsevierStyleItalic">P</span> &#61; &#46;84&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Vascular permeability is altered during asthma exacerbations and appears to be correlated with the presence of neutrophils and the degree of bronchial obstruction&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La alteraci&#243;n de la permeabilidad vascular y el edema de la mucosa bronquial se asocian con las crisis de asma&#46; Hay pocos datos publicados y adems no se conoce su relaci&#243;n con la gravedad de &#233;stas&#46; As&#237; se propuso comparar los &#237;ndices relativos de alb&#250;mina &#40;IRAlb&#41; y de macroglobulina &#945;<span class="elsevierStyleInf">2</span> &#40;IRM&#945;<span class="elsevierStyleInf">2</span>&#41;&#44; entre esputo inducido y sangre perif&#233;rica&#44; de asm&#225;ticos agudizados &#40;AA&#41;&#44; asm&#225;ticos estables &#40;AE&#41; y controles&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; a 46 voluntarios&#58; 14 del grupo AA &#40;volumen espiratorio forzado en el primer segundo &#91;FEV<span class="elsevierStyleInf">1</span>&#93;&#58; 74&#44;3 &#177; 20&#44;8&#41;&#44; 23 del AE &#40;FEV<span class="elsevierStyleInf">1</span>&#58; 93&#44;6 &#177; 7&#44;5&#41; y 9 controles &#40;FEV<span class="elsevierStyleInf">1</span>&#58; 101&#44;1 &#177; 9&#44;9&#41;&#46; Se cuantific&#243; la concentraci&#243;n de alb&#250;mina &#40;turbidimetr&#237;a inmunoqu&#237;mica&#41; y de macroglobulina &#945;<span class="elsevierStyleInf">2</span> &#40;nefelometr&#237;a inmunoqu&#237;mica&#41; en el sobrenadante del esputo y en sangre venosa perif&#233;rica y se calcularon los &#237;ndices relativos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La media &#177; desviaci&#243;n est&#225;ndar del IRAlb fue de 1&#44;2 &#177; 1&#44;1 en el grupo control&#44; de 2&#44;9 &#177; 3&#44;1 en AE y de 6&#44;0 &#177; 6&#44;7 en AA&#46; El IRM&#945;<span class="elsevierStyleInf">2</span> fue 11&#44;7 &#177; 10&#44;9&#44;11&#44;9 &#177; 14&#44;7 y 3&#44;2 &#177; 3&#44;8&#44; respectivamente&#46; El incremento del IRAlb entre los grupos AA&#44; AE y control&#44; y el descenso del IRM&#945;<span class="elsevierStyleInf">2</span> entre AA y control fueron estad&#237;sticamente significativos &#40;p &#60; 0&#44;05&#41;&#46; Se relacion&#243; el porcentaje de neutr&#243;filos&#44; y no el de eosin&#243;filos&#44; con el IRAlb &#40;r &#61; 0&#44;39&#59; p &#61; 0&#44;008&#41;&#44; pero no con el IRM&#945;<span class="elsevierStyleInf">2</span> &#40;r &#61; -0&#44;035&#59; p &#61; 0&#44;82&#41;&#46; El FEV<span class="elsevierStyleInf">1</span> se relacion&#243; inversamente con el IRAlb &#40;r &#61; -0&#44;43&#59; p &#61; 0&#44;009&#41; y no con el IRM&#63;<span class="elsevierStyleInf">2</span> &#40;r &#61; -0&#44;206&#59; p &#61; 0&#44;24&#41;&#44; y tampoco se relacion&#243; la saturaci&#243;n de oxihemoglobina con el IRAlb &#40;r &#61; -0&#44;33&#59; p &#61; 0&#44;19&#41; o el IRM&#945;<span class="elsevierStyleInf">2</span> &#40;r &#61; -0&#44;12&#59; p &#61; 0&#44;84&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La permeabilidad vascular est&#225; alterada en las agudizaciones de asma y parece relacionarse con la presencia de neutr&#243;filos y el grado de obstrucci&#243;n bronquial&#46;</p>"
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Vol. 41. Issue 6.
Pages 328-333 (June 2005)
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Vol. 41. Issue 6.
Pages 328-333 (June 2005)
Original Articles
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Bronchial Exudate of Serum Proteins During Asthma Attack
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J. Beldaa,
Corresponding author
jbelda@hsp.santpau.es

Correspondence: Dr. J. Belda. Clínica d'Asma i Al·lèrgia. Departament de Pneumologia. Hospital de la Santa Creu i de Sant Pau. Antoni M. Claret, 167. 08025 Barcelona. España
, G. Margarita, C. Martínezb, P. Casana, F. Rodríguez-Jereza, M. Brufala, M. Torrejóna, C. Granela, J. Sanchisa
a Clínica d'Asma i Al-lérgia, Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Servei de Bioquímica, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Objective

Although altered vascular permeability and edema of the bronchial mucosa are associated with asthma attack, their influence on its severity remains unknown. We address this issue by comparing relative indices for the concentration of albumin (RIAlb) and α2-macroglobulin (RIα2M) in induced sputum and peripheral blood from patients with exacerbated asthma, patients with stable asthma, and control subjects.

Patients and methods

Forty-six volunteers participated in the study: 14 with exacerbated asthma (forced expiratory volume in the first second [FEV1] 74.3% [SD, 20.8%] of reference), 23 with stable asthma (FEV1 93.6% [7.5%]), and 9 controls (FEV1 101.1% [9.9%]). The concentrations of albumin and α2-macroglobulin were quantified by immunoturbidimetry and immunonephelometry, respectively. The relative index was then calculated by dividing the concentration in sputum supernatant by the concentration in peripheral blood.

Results

The mean RIAlb was 1.2 (1.1) in the control group, 2.9 (3.1) in the stable asthma group, and 6.0 (6.7) in the exacerbated asthma group. The RIα2M values were 11.7 (10.9), 11.9 (14.7), and 3.2 (3.8) for the control group and stable and exacerbated asthma groups, respectively. The increases in the RIAlb values between all groups, and the decrease in the RIα2M value between the exacerbated asthma and control groups were statistically significant (P <.05). The percentage of neutrophils, but not of eosinophils, in sputum was correlated with the RIAlb (r=0.39; P = .008) but not the RIα2M (r=-0.035; P = .82). FEV1 displayed an inverse relationship with the RIAlb (r=-0.43; P = .009) but not with the RIα2M (r=-0.206; P = .24). No correlation was found between oxyhemoglobin saturation and either the RIAlb (r=-0.33; P = .19) or the RIα2M (r=-0.12; P = .84).

Conclusions

Vascular permeability is altered during asthma exacerbations and appears to be correlated with the presence of neutrophils and the degree of bronchial obstruction.

Key words:
Albumin
α2-macroglobulin
Induced sputum
Eosinophils
Neutrophils
Crisis, asthmatic
Objetivo

La alteración de la permeabilidad vascular y el edema de la mucosa bronquial se asocian con las crisis de asma. Hay pocos datos publicados y adems no se conoce su relación con la gravedad de éstas. Así se propuso comparar los índices relativos de albúmina (IRAlb) y de macroglobulina α2 (IRMα2), entre esputo inducido y sangre periférica, de asmáticos agudizados (AA), asmáticos estables (AE) y controles.

Pacientes y métodos

Se estudió a 46 voluntarios: 14 del grupo AA (volumen espiratorio forzado en el primer segundo [FEV1]: 74,3 ± 20,8), 23 del AE (FEV1: 93,6 ± 7,5) y 9 controles (FEV1: 101,1 ± 9,9). Se cuantificó la concentración de albúmina (turbidimetría inmunoquímica) y de macroglobulina α2 (nefelometría inmunoquímica) en el sobrenadante del esputo y en sangre venosa periférica y se calcularon los índices relativos.

Resultados

La media ± desviación estándar del IRAlb fue de 1,2 ± 1,1 en el grupo control, de 2,9 ± 3,1 en AE y de 6,0 ± 6,7 en AA. El IRMα2 fue 11,7 ± 10,9,11,9 ± 14,7 y 3,2 ± 3,8, respectivamente. El incremento del IRAlb entre los grupos AA, AE y control, y el descenso del IRMα2 entre AA y control fueron estadísticamente significativos (p < 0,05). Se relacionó el porcentaje de neutrófilos, y no el de eosinófilos, con el IRAlb (r = 0,39; p = 0,008), pero no con el IRMα2 (r = -0,035; p = 0,82). El FEV1 se relacionó inversamente con el IRAlb (r = -0,43; p = 0,009) y no con el IRM?2 (r = -0,206; p = 0,24), y tampoco se relacionó la saturación de oxihemoglobina con el IRAlb (r = -0,33; p = 0,19) o el IRMα2 (r = -0,12; p = 0,84).

Conclusiones

La permeabilidad vascular está alterada en las agudizaciones de asma y parece relacionarse con la presencia de neutrófilos y el grado de obstrucción bronquial.

Palabras clave:
Albúmina
Macroglobulina α2
Esputo inducido
Eosinófilos
Neutrófilos
Crisis de asma
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This work was partially funded by a grant from Red Respira (RITC-Instituto de Salud Carlos III and the Spanish Society of Pulmonology and Thoracic Surgery [SEPAR]).

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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