| Objectives: (1) To compare the variations of inflammatory cells and cytokines in both sputum induced (SI) and bronchoalveolar lavage fluid (BAL) in asthmatic children in order to evaluate the usefulness of SI as an non-invasive way in monitoring of airway inflammation in patients with asthma. (2) To investigate the apoptosis of eosinophil in vivo in children with asthma. Method: (1) Collecting the SI and BAL in 11 children (7-14 years) with stable asthmatics(SA) for the measurement and comparison of the changes of inflammatory markers. (2) By combining the techniques of dNTP and immunohistochemistry, apoptotic EGi^cell was calculated in SI, BAL ,biopsy specimens and peripheral blood in above the 11 cases with SA and in other 20 kids (3.5-14years) with exacerbated asthmatics(EA) and 17 kinds with lower respiratory infection as control. Their expressions of Bcl-2 in bronchial biopsy specimens33were measured by using the immunohistochemistry specific mAbs. Their IL-5 and ECP in SI, BAL and blood were measured . Result: (1) The numbers of total cells, PMN, EOS, EG2+cell in the SA, were higher in SI than that in BAL(/><0.001, PO.001, PO.01, PO.01, respectivrly). The percentages of EOS and EG2+cell in SI had a closer correlation with in BAL. The concentrations of IL-5 and ECP in SI were higher than in BAL. But they did not show significant correlation between them (P>0.05). (2) Before the inhalation of glucocorticoid (GC), the apoptotic EG2+cells in SI of EA group were significantly lower than that in control group(P<0.01) and SA group (P<0.05) , and the numbers of EOS and EG2+cell in SI of EA group were significantly higher than that in control group (P<0.001) and SA group(P <0.05) . After the GC treatment the apoptotic EG2+cells in SI of EA and SA groups were increased (P<0.001 P<0.01, respectively), and the numbers of EOS and EG2+cell in SI of EA and SA groups were decreased (/><0.01 ~P<0.05), and coupled with the increase of FEV, % pre (P <0.05). (3) Before the inhalation of GC, the apoptotic EG2+cells in airway submucosa and BAL of SA group were lower than that in control group (P O.01), the number of EG2+cell was34higher than that in control group(/)<0.001), and number of BcL-2+cell in airway submucosa was higher than that in control group (P<0.05). After the treatment the apoptosis of EG2+cells was increased (P<0.01), EG2+cell decreased (P <0.01), BcL-2+cell did not change. (4) Before and after GC treatment the percentages of apoptotic eosinophils in peripheral blood in SA group had not significant changes compared with those in control subjects (P>0.05). But after GC treatment the numbers of eosinophil in peripheral blood in SA and EA groups were decreased (PO.01). (5) Before the treatment the levels of ECP in sputum and serum of EA group were higher than that in control CP0.05), the levels of IL-5 in sputum and serum of EA group were higher than that of control (PO.001, P<0.01, respectively) and SA group (PO.05). After the treatment the levels of ECP in sputum and serum of EA and SA groups were decreased (P<0.01~P<0.05), and the levels of IL-5 were decreased (P<0.01~P<0.05). (6) There were the negative correlations between apoptosis of EG2+ cell and ECP in sputum and BAL (PO.05) ,there were negative correlations between apoptosis of EG2+ cell in sputum , BAL and airway submucosa and FEV]%pre(P<0.05). Conclusion:35(1) SI was a reliable clinical practical way in studying and monitoring the changes of inflammatory cells and cytokines in asthmatics. (2)Apoptosis of EGj* cell was decreased in respiratory tract of asthmatics, one of the important roles of inhalation of GC was promoting the apoptotic EOS. (3) The numbers of apoptoptic ?2* cell and EG2+ cell in respiratory tract, the levels of IL-5 and ECP in SI, BAL and serum, were usefulness to determine the respiratory inflammation. (4) Decrease of apoptoptic eosinophil of asthmatics may only occur in respiratory tract but not in the peripheral blood.
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