Effect Of Mycobacterium Nebulization On Bronchial Asthma Patients

Objective:To explore the role and mechanism of mycobacterium phlei F.U.36 nebulization in the prevention and treatment of bronchial asthma.Methods:44 patients with light-moderate persistent asthma were divided into group A(control group)and group B(aerosol inhalation group)in a randomized study,group A conventional inhalation of Salmeterol and Fluticasone propionate powder aerosol twice a day for 5 days(50/100μg),and group B inhalation Mycobacterium 1.72μg/mL×2 with 3 mL normal saline for 5 days.The patients' clinic synthesis indexes were evaluated before and after treatment,including lung function and airway reactivity,ACT(Asthma Control Test)scores.The percentage ofγdT cells,IFN-γpositiveγdT lymphocyte cells, IL-4⁺ positiveγdT lymphocyte cells in peripheral blood lymphocytes were detected by flow cytometry before and after therapy.The percentage of CD8⁺ T lymphocytes in peripheral blood lymphocytes and its' apoptotic rate were also detected by flow cytometry before and after therapy.Results:(1)Comprehensive Clinical Evaluation Indicators:The scores of ACT about group B significantly improved better than before treatment (22.63±2.28 VS 14.94±3.11,P＜0.05).Compared with group A,group B has a significant difference after treatment(P＜0.05).Average numbers of spray inhalation Ventolin in week of group B were reduced significantly after treatment than before treatment(1.17±0.51 VS 4.00±2.45,P＜0.05),and there has a difference between group A and group B after treatment(P＜0.05).The FEV1 significantly increased in group B after treatment compare with before (82.99±16.42 VS 73.93±11.45,P＜0.05).Compared with group A(72.30±19.48), group B has no significant difference after treatment.The PEF in group B also significantly increased compare with before(83.88±26.60 VS 76.35±20.77, P＜0.05),and there has no difference between group A and group B after treatment.After treatment,the negative rate of bronchial provocation test(81.82%)in group B increased than that of group A(P＜0.01),and there has a significant difference between the two groups after treatment.The cumulant of methacholine(PD₂₀-FEV1)in both groups increased markedly,and there have a significant difference in group B and group A before and after therapy[(1.89±1.08)mg VS(0.59±0.88)mg,P＜0.05].Compared with group A, group B has a significant difference after treatment(P＜0.05).(2)The percentage ofγdT cells in peripheral blood lymphocytes in group B and group A has no differences before and after treatment(4.88±2.98 VS 5.22±2.88,6.41±3.12 VS 5.84±3.52),but the rate of IFN-γ⁺γdT cells/IL-4⁺γdT cells(Th1/Th2)increased markedly in group B(0.74±0.46 vs 2.95±0.11,P＜0.05),and there has significant change between group A and group B after treatment.(3)The apoptosis rate of CD8⁺ T lymphocytes has no changes before and after treatment in group B(1.76±0.84 VS 1.37±0.77,P＞0.05),and the proportion of CD8⁺ lymphocytes in leucocytes in peripheral blood also have no obvious change in both groups.Compared with group A,there was no significant difference.Conclusions:The mycobacterium phlei F.U.36 nebulization can reduce the airway hyperresponsiveness and enhance the patients' lung function, and it also can prevent or reduce asthma attack within a certain period time.A significant shift from a Th2 to a Th1 response ofγdT cells in peripheral blood was observed.It is imply thatγdT cells are playing an important role during the treatment response.The effect of Mycobacterium nebulization on CD8⁺T lymphocyte in peripheral blood of patients with asthma is not obvious in a short time.