気管支喘息患者における白血球ロイコトリエン産生能に対する不飽和脂肪酸食の効果に影響する因子

Dietary supplementation with perilla seed oil, a vegetable oil rich in α -lin- olenic acid, inhibits the generation of leukotrienes(LTs) by leucocytes in patients with bronchial asthma. We examined the factors that affect the suppression of LT generation by leucocytes with perilla seed oil-rich supplementation in patients with asthma, by comparing the clinical features of patients with asthma, whose generation of leukotriene (LT) C4 was suppressed by dietary supplementation with perilla seed oil (n-3 fatty acids) (group A), with those of patients who showed no suppression of LTC4 generation (group B). Group A showed a significant increase in the generation of LTB4 and L TC4 by leucocytes after corn oil-rich supplementation (n-6 fatty acids), and a significant decrease in the generation of LTB4 and LTC4 after perilla seed oil-rich supplementation (n-3 fatty acid). However, this was not observed in group B. The level of serum IgE and peak expiratory flow (PEF) in group A were significantly higher than in group B. Furthermore, the serum levels of LDL-cholesterol, β-lipoprotein and　phospholipid were significantly lower in group A than in group B. These results suggest that the clinical features differ between these two asthmatic populations with respect to suppression of LTB4 and LTC4 generation by n-3 fatty acids in perilla seed oil-rich supplementation.a-リノレン酸の豊富なエゴマ油の食事は気管支喘息患者の白血球ロイコトリエン(LT)産生能を抑制する｡気管支喘息患者の内,エゴマ油食によりLTC4の産生が抑制された群(A群)と抑制されない群(B群)の臨床データを比較することにより,気管支喘息患者の白血球ロイコトリエン産生能に影響する因子を検討した｡A群はコーン油(n-6系脂肪酸)の豊富な食事後,白血LTB4,LTC4の産生能が増加し,エゴマ油(n-3系脂肪酸)の豊富な食事後LTB4,LTC4の産生能が減少した｡これらの変化はB群では認められなかった｡A群のIgE値,ピークフロー(PEF)値はB群に比し,有意に高値であった｡またLDL-コレステロール,β-リポ蛋白,リン脂質はA群ではB群に比し,有意に低値であった｡これらの結果はエゴマ油の豊富な食事のn-3系脂肪酸によるLTB4,LTC4の産生能の抑制に関して2群の気管支喘息患者群間に臨床データの相違があることを示唆している

気管支喘息症例における末梢血白血球のロイコトリエンC4産生能とロイコトリエン受容体括抗薬プランルカストの効果に関する検討

The correlation between the efficacy of 4-weeks administration with pranlukast, leukotriene receptor antagonist, and LTs generation by peripheral leukocytes were evaluated in 18 patients with mild-persistent asthma. The efficacy of pranlukast administration was assessed by symptom, morning PEF and pulmonary function. Pranlukast were effective in 12/18(67%) patients. In those patients, LTC4 generation before pranlukast administration was significantly high, compared with that in pranlukast-ineffective patients. LTC4 generation decreased after 4-weeks administration with pranlukast in effective patients. In ineffective patients, however, LTC4 generation increased after 4-weeks administration. LTB4 had shown no significant difference between effective and ineffective patients before administration, and LTB4 decreased after 4-weeks in both groups. Proport ion of peripheral eosinophi Is in effective patients were higher than that in ineffective patients, however not significant. After 4-weeks, proportion of eosinophi Is was decreased in effective patients and increased in ineffective patients. These findings suggest that pranlukast is effective for patients with high LTC4 generation and has the effect to suppress the accumulation of eosinophils in such patients.軽症気管支喘息18例にロイコトリエン受容体桔抗薬プランルカストを4週間投与し，その効果と末梢血白血球からのLTC4，LTB4産生能の関係を検討した．プランルカストの効果は臨床症状，起床時ピークフロー値，肺機能の変化によって判定し，効果群，非効果群の2群に分類した．18例中12例（67％）の症例がプランルカスト投与により，臨床症状の軽減，ピークフロー値の増加，肺機能の改善が認められた．効果群におけるプランルカスト投与前のLTC4値は，非効果群のLTC4値に比較して有意に高値であった．4週間の投与後には 効果群ではLTC4値は減少し，非効果群では増加した．両群のLTB4値はプランルカスト投与前で有意な差は認められず，投与後には両群で減少した．投与前の好酸球分画は，効果群において非効果群に比べ高値であったが，有意な差は認められなかった．4週間の投与後，効果群においては好酸球は減少し，非効果群においては増加した．以上の結果より，プランルカストは末梢血白血球のLTC4産生能が高い症例において効果的であり，好酸球集積を抑制する作用を有すると考えられる

モノクローナル抗体を利用した急性白血病に対する自家骨髄移植療法

金沢大学医学部研究課題/領域番号:58571024, 研究期間(年度):1983出典：研究課題「モノクローナル抗体を利用した急性白血病に対する自家骨髄移植療法」課題番号58571024（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-58571024/）を加工して作

各種疾患における免疫不全状態の解析とその臨床的応用に関する研究

金沢大学医学部研究課題/領域番号:X00210----077152, 研究期間(年度):1975出典：「各種疾患における免疫不全状態の解析とその臨床的応用に関する研究」研究成果報告書　課題番号：X00210----077152（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-X00210----077152/）を加工して作

腰椎MRI画像と腰痛の関係

The purpose of this study was to examine the potential role of magnetic resonance imaging (MRI) in the evaluation of low back pain (LBP). The study group, 19 patients with low back pain (2 subjects aged 32-39 years and 17 aged 59-78), underwent MRI of the lumbar spine. Disc degeneration at L4/5 was the most common finding (68.4%). Overall in present study, all patients with LBP had abnormalities around the lumbar spine (evidence of disc degeneration, deformity of lumbar spine, disc bulging or protrusion, facet hypertrophy, nerve root compression and so on).この研究の目的は腰痛評価におけるMRIの役割を検討することであった｡対象は腰痛を訴え腰椎MRIを受けた19名(32歳から39歳2名,59歳から78歳17名)であった｡椎間板変成はL4/5levelで最も多く認められた(68.4%)｡本研究において腰痛を有する全患者に腰椎の異常(椎間板変性,disc bulging, protrusion, facet hypertrophy,神経根圧迫,腰椎変形など)を認めた

気管支喘息症例における気道過敏性と鼻腔･副鼻腔疾患の関係に関する検討

Pathological changes of nasosinus occur often in subjects with bronchial asthma. Coexisting nasosinus lesion may affect pathophysiology of lower respiratory tract in asthmatics. The extent of nasal and sinus lesion was quantified in 17 patients with bronchial asthma, and their relationships to atopic status, asthma severity and bronchial hyperresponsiveness were evaluated in this study. Opacification degree of maxillary sinuses and nasal mucosa thickening were quantified using CT scans. The opacification degree was evaluated as (total opacification area)/(total maxillary sinus area). Although the opacification degree of maxillary sinuses in atopic patients showed no significant difference compared with that in non-atopic patients, maximum nasal mucosa thickening in atopic patients had a significant difference compared with that in non-atopic patients (p=0.028). In severe asthmatics, the opacification degree of maxillary sinuses was significantly more prominent compared with those in moderate and mild asthmatics (p=0.0005, p=0.036, respectively). Significantly marked nasal mucosa thickening was recognized in mild asthmatics compared with that in moderate asthmatics (p=0.0462). Regarding bronchial hyperresponsiveness, a significant correlation between Dmin and the opacification degree of maxillary sinuses was observed (rs= -0.551, p=0.0276). Nasal mucosa thickening had no correlation with bronchial hyperresponsiveness. The results suggest that sinusitis may affect bronchial hyperresponsiveness and asthma severity. Treatment of sinusitis may lead to improvement of asthma symptoms.鼻腔･副鼻腔疾患はしばしば気管支喘息症例に合併が認められ,喘息症例の下気道病態に影響を及ぼしている可能性が考えられる｡今回,気管支喘息17例において,CTを用いて上顎洞の不透明化率･鼻腔粘膜肥厚を計測し,アトピー性の有無,喘息の重症度,気道過敏性との関係を検討した｡上顎洞不透明化率は全上顎洞面積の総計に対する不透明化領域面積総計として計算を行った｡上顎洞不透明化率はアトピー性の有無で差は認められなかったが,鼻腔粘膜はアトピー性喘息症例で有意に肥厚していた｡重症気管支喘息における上顎 洞不透明化率は,中等症および軽症喘息症例に比べ有意に高値であった｡鼻腔粘膜肥厚は中等症喘息症例に比べ,軽症症例で有意に肥厚していた｡気道過敏性(Dmin)は上顎洞不透明化率とのあいだに弱い負の相関が認められた(rs=-0.551,p=0.0276).鼻粘膜肥厚と気道過敏性は相関が認められなかった｡今回の結果から副鼻腔病変が気道過敏性･喘息重症度に影響を及ぼしている可能性が考えられ.副鼻腔疾患の治療により喘息症状の改善に繋がる可能性が考えられた

気管支喘息における複合温泉療法と気道炎症反応

Efficacy of complex spa therapy was studied in 55 patients with bronchial asthma. Complex spa therapy was effective in 47 (85.5%) of the 55 patients with bronchial asthma : marked efficacy was observed in 15 (27.3%), moderate in 32 (58.2%), slight in 6 (10.9%) and no efficacy in 2 patients (3.6%). Improvement of clinical symptoms and findings by complex spa therapy was more clearly observed in patients with an increased proportion of BAL lymphocytes, neutrophils and eosinophils. These findings suggest that complex spa therapy more affects cell infiltration in the airways than bronchoconstriction induced by chemical mediators. Improvement of ventilatory function represented by FEV1.0% value was higher in patients with a low proportion of BAL neutrophils, suggesting that patients with increased number of BAL neutrophils require longer complex spa therapy than those without BAL neutrophilia.気管支喘息55例を対象に,複合温泉療法(温泉プール水泳訓練+ヨードゾル吸入+鉱泥湿布療法)を試み,その臨床効果と気道炎症反応との関連について,若干の検討を加えた｡1.複合温泉療法の臨床効果では,著効15例(27.3%),有効32例(58.2%),やや有効6例,無効2例であり,明らかに有効と判断された症 例は,55例中47例(85.5%)であった｡2.複合温泉療法は,気管支肺胞洗浄液(BALF)中の細胞成分(リンパ球,好中球,好酸球など)が多い症例,すなわち気道炎症反応がより強い症例により有効であった｡このことは,複合温泉療法が,単純性の(化学伝達物質による)気管支攣縮よりも,気道炎症反応をともなった病態により強く影響を及ぼすことを示している｡3.複合温泉療法による換気機能の改善(1秒量)は,BAL液中の好中球数が少ない症例においてより高度であった｡このことは,BAL液中に高度な好中球増多が見られる症例に対しては,より長期的な複合温泉療法が必要であることを示しているものと考えられた

ステロイド依存性重症難治性喘息における気道反応の特徴

Characteristics of airway response in steroid-dependent intractable asthma (SDIA) were examined in 86 asthma patients (43 with SDIA and 43 with non-SDIA) divided into three age groups: 20-39, 40-59 and 60+ years, by observing cellular composition of bronchoalveolar lavage (BAL) fluid and ventilatory function. 1. The level of serum cortisol was significantly lower in patients with SDIA than in those with non-SDIA in all age groups. 2. The proportion of lymphocytes in BAL fluid was significantly decreased in patients with SDIA compared to results in non-SDIA patients in the age between 40-59, and over 60+ years, While BAL neutrophils were significantly increased in SDIA patients compared to results in non-SDIA patients in the age group over 60 years. 3. Of ventilatory parameters, the values of % FVC, FEV(1.0%), % MMF and % V(25) were significantly lower in SDIA patients over the age of 60 compared with non-SDIA subjects of the same age group. These results show that in SDIA patients the proportion of BAL lymphocytes decreases and the proportion of BAL neutrophils increases with aging, and that ventilatory function in SDIA patients also decreases with aging compared to non-SDIA patients.年齢により3群(20-39才,40-59才,60才以上)に分類された気管支喘息86例(ステロイド依存性重症難治性喘息:SDIA;43例,非SDIA;43例)を対象に,気管支肺胞洗浄液(BALF)中の細胞成分および換気機能よりSDIAにおける気 道反応の特徴を検討した｡1.血清コーチゾ-ル値は,SDIA症例において, 非SDIA症例に比べいずれの年齢層においても有意の低値を示した｡2.BALF中リンパ球頻度は,40-59才および60才以上のSDIA症例において,同年齢の非SDIA症例に比べ有意の低値を示した｡一方,BALF中好中球頻度は,60才以上のSDIA症例で,同年齢層の非SDIA症例に比べ有意に高い値を示 した｡また,BALF中好酸球頻度は,いずれの年齢層においても,SDIAと非SDIA症例の間に有意の差は見られなかった｡3.換気機能では,% FVC, FEV1.0%,% MMF, % V(25)などの換気パラメーターは,60才以上の SDIA症例において,同年齢層の非SDIA症例に比べて有意の低値を示した｡ これらの結果は,40-59才あるいは60才以上のSDIA症例では,非SDIA症例に比べ,BALF中リンパ球頻度の低下,好中球頻度の増加,換気パラメーター値の低下などがより高度に見られることを示している

気管支喘息における血清免疫グロブリン値,末梢血リンパ球数と気管支肺胞洗浄液中の細胞成分との関連

Changes in airway inflammation by glucocorticoids were examined in 26 patients with bronchial asthma, divided into two age groups ; 20-59 and 60+ years, in relation to serum immunoglobulin levels and peripheral lymphocyte count. 1. The levels of IgG, IgA and IgM were significantly lower in patients with steroid-dependent intractable asthma (SDIA) of age over 60 years than in those with non-SDIA of the same age group. In patients between the ages of 20 and 59, only serum IgG level was significantly lower in SDIA than in non-SDIA patients. 2. Peripheral lymphocyte count was significantly decreased in SDIA patients than in non-SDIA patients in age group over 60, but not in age group between 20 and 59. 3. Number of lymphocytes in bronchoalveolar lavage (BAL) fluid was significantly lower and number of BAL neutrophils was significantly higher in SDIA patients than in non-SDIA patients in age group over 60, but not in age group between 20 and 59. These results suggest that levels of IgG, IgA and IgM, and peripheral lymphocyte count were significantly suppressed in SDIA patients of age over 60, accompanied with decrease of BAL lymphocytes and increase of BAL neutrophils.気管支喘息26例(ステロイド依存性重症難治性喘息,SDIA 13例,非SDIA 13例)を対象に,血清免疫グロブリン,IgG,IgAおよびIgM値,および末梢血リンパ球数との関連のもとに,副腎皮質ホルモン長期投与による気道炎症細胞の出現頻度の変化について検討を加えた｡なお,年齢による影響を観察する目的で,SDIAおよび非SDIA各13例を,20-59才と60才以上の2群に分けて,それ ぞれのグループの特徴について検討した｡1.血清IgG,IgAおよびIgM値は,60才以上の症例において,いずれも非SDIA症例に比べ,SDIA症例で有意に低い値を示した｡一方,20-59才の症例群においては,IgG値のみSDIA症例で有意の低下傾向が見られた｡2.末梢血リンパ球数は,60才以上の症例では,SDIA症例で,非SDIA症例に比べ有意の低値を示したが,20-59才の症例では両群間に有意の差は見られなかった｡3.気管支肺胞洗浄(BAL)液中のリンパ球数 は,60才以上のSDIA症例で,非SDIA症例に比べ有意に少なく,また同時にこれらの症例ではBAL液中好中球が有意に多い傾向が観察された｡しかし,20-59才の症例群では,SDIAと非SDIAの間にいずれも有意の差は見られなかっ た｡これらの結果より,60才以上の症例では,20-59才の症例群に比べ,副腎皮質ホルモンの長期投与により,血清IgG,IgAおよびIgM値,末梢血リンパ球数の減少とともに,BAL液中のリンパ球減少,好中球増加をきたしやすいことが明らかにされた

気管支喘息における末梢血白血球および気管支肺胞洗浄液中の細胞からのヒスタミンおよびロイコトリエンC(4),B(4)遊離と気道過敏性

The proportions of cells in bronchoalveolar lavage (BAL) fluid, the release of histamine, leukotrienes C(4) and B(4) from leucocytes and BAL cells, and bronchial reactivity to methacholine were examined in 40 patients with asthma in relation to patient age. 1. The proportions of lymphocytes and neutrophils in BAL fluid were higher in older patients over age 60 than in younger patients between 20 and 49. The proportions of eosinophils and basophilic cells in BAL fluid were higher in younger patients than in older patients, and the difference in the proportion of BAL basophilic cells was significant between the two groups (p<0.05). 2. The release of histamine from BAL cells was significantly higher in younger patients than in older patients (p<0.001). The release of LTC(4) from BAL cells was higher in older patients compared to younger patients. 3. Bronchial reactivity to methacholine was higher in younger patients than in older patients. The number of patients reactive to low concentration of methacholine (390μg/mℓ or less) was larger in younger patients (12/16 ; 75.0%) than in older patients (5/14 ; 35.7%). These results suggest that bronchial hyperresponsiveness changes with aging, accompanied by changes in the release of chemical mediators from BAL cells and in the proportion of BAL cells.気管支喘息を対象に,気管支肺胞洗浄(BAL)液中の細胞の出現頻度,末梢血白血球およびBAL細胞からのヒスタミン,ロイコトリエンC(4),B(4)遊離,気道過敏性などについて,患者年齢との関連のもとに検討を加えた｡1.BAL液中のリンパ球および好中球頻度は,60才以上の老齢症例で,20-49才の若青年症例に比べやや高い傾向が見られたが,推計学的には有意の差は見られなかった｡BAL液中の好酸球,好塩基細胞の頻度は,若青年症例で,老年症例に比べて高く,特に好塩基性細胞の頻度には両症例群間に有意の差が見られ(P<0.05)｡ 2.BAL細胞からのヒスタミン遊離は,若青年症例で,老年症例に比べ有意に多い傾向が見られた(P<0.001)｡一方,BAL細胞からのロイコトリエンC(4)遊離は,若青年症例に比べ,老年症例で多い傾向が見られたが,両症例群間に有意の差は見られなかった｡3.メサコリンに対する気道の反応性は,全般的に若青年症例で,老年症例に比べより強い傾向を示した｡そして,390μg/mℓまたはそれ以下の低濃度のメサコリンに反応を示す症例は,若青年症例では16例中12例(75.0%),老年症例では14例中5例(35.7%)であった｡以上の結果より,気道過敏性は,BAL細胞からの化学伝達物質遊離の変化やBAL細胞の頻度の変化とともに,加齢の影響を受けることが明らかとなった