Effect On B7 Molecules Expressions Of Monocyte By Inhaled Inactivated-Mycobacterium Phlei In Asthmatic Subjects

Objectives:To investigate the effect on the patients with bronchial asthma by inhalation of inactivated-mycobacterium phlei.Methods:The lung ventilation function,airway reactivity and CD80,CD86 expressions on monocyte in both peripheral blood and induced sputum were detected in group A (control group). 27 subjects with mild to moderate persistent asthma and dust mite allergy were randomly divided into group B(normally treated) and group C(nebulization group). Both groups were treated with 50/100μg Salmeterol Xinafimte and Fluticasone Propionate twice daily for 30 days and nebulization of 3.44μg inactivated-mycobacterium phlei once a day for 5 days respectively. At the 1st, 6th, 31th days, the percentage of CD80 positive monocyte and CD86 positive monocyte in both peripheral blood and induced sputum was detected by flow cytometry. Meanwhile, the therapeutic efficacy was assessed by lung ventilation fuction, airway responsiveness, ventolin dosage per week, asthma control test(ACT), classes of asthma control and the adverse effects. Results:(1) During one month, scores of ACT in group C were higher than that of group B(23.36±2.37VS20.27±3.66, P<0.05); and the ventolin dosage per week was less in group C than in group B(1.11±0.76VS2.05±0.72, P<0.05). As to the lung ventilation function, group C, both at the 6th and the 31th days, was statistically increased after nebulization (FEV1: 88.37±6.12VS79.86±5.17, P<0.01; 92.32±11.24VS79.86±5.17, P<0.05; PEF: 89.45±8.30 VS 77.92±6.34, P<0.01; 90.59±12.32 VS 77.92±6.34, P<0.05); compared with group B, only at the 31th day, the lung ventilation function was improved ( FEV1: 89.37±5.55 VS 79.40±5.17, P<0.01; PEF: 89.57±6.44 VS 76.25±8.01, P<0.01). The cumulant of methacholin was obviously increased in group C, both at the 6th and the 31th days(2.40±0.33VS0.34±0.56, P<0.01; 2.26±0.61VS0.34±0.56, P<0.01), while only at the 31th day in group B(2.37±0.38VS0.48±0.59, P<0.01). At the 6th day, the negative rate of methacholine inhalation challenge in group C was much higher than that of group B(85.71%VS18.18%, P<0.05), and there was no difference between the two groups at the 31th day.(2) In peripheral blood, CD80 expression on monocyte of both treated group were much higher than that of control group (group B: 1.61±0.56 VS 0.90±0.18, P<0.05; group C: 0.90±0.18 VS2.08±0.97, P<0.05); and compared to the 6th day, the percentage of CD80 positive monocyte in both groups at the 31th day was markedly lower than before treatment (group B 0.90±0.18 VS 1.61±0.56, P<0.05; group C 0.90±0.18 VS2.08±0.97, P<0.05). No differences between CD86 expression were showed in both groups during treatment.(3) The expressions of CD80 and CD86 in induced sputum monocyte of asthmatic subjects were still remarkably higher than the healthy(group B: 1.63±0.58VS0.86±0.21, P<0.05; 1.66±0.52VS0.82±0.19, P<0.05; group C: 2.38±1.21 VS 0.86±0.21, P<0.05; 2.05±0.96 VS 0.82±0.19, P<0.05). As for CD80 and CD86 expressions, both groups, at the 31th day, were significantly reduced after therapy(group B: 0.91±0.18 VS 1.63±0.58, P<0.05; 1.28±0.41 VS 1.66±0.52, P<0.05; group C: 1.06±0.21 VS 2.38±1.21, P<0.05; 1.00±0.16 VS2.05±0.96, P<0.05); while at the 6th day, only group C was decreased(CD80: 1.02±0.31VS2.38±1.21, P<0.05; CD86: 0.95±0.17VS2.05±0.96, P<0.05).(4) The increased co-stimulatory molecules expressions on monocyte in both peripheral blood and induced sputum significantly correlated negatively with lung ventilation function(P<0.01).Conclusions:(1)The B7 molecules expressions on monocyte in induced sputum, which correlated negatively with lung ventilation function, were increased in allergic asthmatic subjects, compared with control group. (2) The increased expression of B7 molecules in induced sputum may be downregulated by nebulization of inactivated-mycobacterium phlei, this may be one of the mechanisms of controlling asthma by inhaled inactivated-mycobacterium phlei. (3) Nebulization of inactivated-mycobacterium phlei can decrease airway responsiveness and improve lung ventilation function in asthmatic sufferers, then can control asthma partially or even completely.