Study The Role And Machanism In Preventing And Treating Bronchial Asthma By Aerosol Inhalation Of Deactived Mycobacterium Phlei

Objectives:To observe the effect of atomization inhalation of deactivated mycobacterium phlei to prevent and treat bronchial asthma and explore the mechanism for it.Materials and methods:44 patients in persistent period of bronchial asthma,who fited the diagnostic criteria of mild to moderate asthma, participated in this experiment and were divided into group A(for control observation,normally treated)and group B(for experimental treatment, treated by atomizating inhalation)respectively at random.In group A, patients were being treated with Salmcterol Xinafimte and Fluticasone Propionate Powder for inhalation(SXFP;50/100μg twice daily)normally according to conventional therapy.While in group B,two tubes of F.U.36 parenteral solution containing 1.72μg/mL deactivation mycobacterium phlei were added into 3ml normal saline to make up a new therapeutic solution and all patients received atomizating inhalation of this kind of solution in 5L/min oxo-fluence,once in every morning,for continuous 5 days.These indexes were detected as followed in before treatment and after 5-day treatment:(1)Clinical synthesis index evaluation which cantains asthma control test(ACT)which estimated before treatment and in a month after treatment,pulmonary function,determination of airway responsiveness, intake of ventolin in every week,and untoward reaction.(2)The percentage ofγδT cells in total leukomonocytes and levels of the IL-4 & IFN-γsecreted in peripheral blood were detected by flow cytometry.(3)CD4⁺ T-lymphocytic apoptosis ratio detection deployed by triad-colour fluorescent labelling of lymphocytic subpopulation marker,Annexin-â…¤and propidium iodide,flow cytometry.Results:(1)Cinical comprehend index evaluation:The control test scores(CTSs)of patients in group B after treatment were significantly higher than that before treatment(22.63±2.28 VS 14.94±3.11,P＜0.05),and were also statistically different from that in group A after treament(22.63±2.28 VS 21.00±2.71,P＜0.05).And the intake of ventolin in group B decreased remarkably after treatment(1.17±0.51 VS 4.00±2.45,P＜0.05),and was also less than that in group A(3.67±1.72)obviously(P＜0.05).When compared by FEV₁,increasing results could be found in group B between prior-treatment and post-treatment(82.99±16.42 VS 73.93±11.45,P＜0.05). And PEF of all patients in both groups were obviously improved after treatment,and group B had a great increase after treament(83.88±26.60 VS 76.35±20.77,P＜0.05).While there was no significant difference between group B and group A on both FEV₁ and PEF after treatment.Moreover, more cases of the patients in group B(81.82%)than group A had turned negative(P＜0.01).Moreover,there was no untoward reaction but only transcient mult-expectoration after atomization in group B.Furthermore, accumulative amount of methacholine had an obvious increase in group B after treatment(1.89±1.08mg VS 0.59±0.88mg,P＜0.05),and group B had obvious superiority,compared with group A(0.81±1.07 mg)on this index.(2)Detection index ofγδT cells in peripheral blood:The ratio ofγδT cells in total lymphocyte had no statistical changes between experimental group and control group at the stage of both prior-treatment and post-treatment(P＞0.05).And the ratio of IFN-γ⁺γδTcells to IL-4⁺γδT cells had a great increase after treatment in group B(2.95±0.11 VS 0.74±0.46,P＜0.05),and there was difference between group B and group A by different treatments(P＜0.05).(3)Detection index of CD4⁺T cells in peripheral blood:There was no difference between prior-treatment and post-treatment in group B on the rate of CD4⁺T lymphocytic apoptosis.The same result also existed between group B and group A.While the mean value of group A had an increasing tendency after treatment but this difference had no statistical significance(2.48±0.32 VS 1.95±0.07,P＞0.05).In addition,the percent of CD4⁺ T-leukomonocytes in total leukocytes had no statistical difference between experimental group and control group at the stage of both prior-treatment and post-treatment(P＞0.05)and had no change caused by treatments(P＞0.05).Conclusions:(1)Atomizating inhalation of deactivation mycobacterium phlei parenteral solution can decrease airway hyperresponsiveness of asthmatic subjects and improve their pulmonary function,prevent and decrease the asthmatic attack.(2)The patients'γδT cells can change from Th2-dominance to Th1-dominance after atomizating inhalation of deactivation mycobacterium phlei parenteral solution,which implicates thatγδT cells may take an important role in the treatment action.(3)The rate of CD4⁺T-leukomonocytic apoptosis and the quantity of CD4⁺T cells in peripheral blood have no changes after 5 days of atomizating inhalation, probably not have been influnenced.