No abstract

Blood phagocytes from patients with asthma have an increased capacity to produce reactive oxygen metabolites. We studied whether whole blood luminol-dependent chemiluminescence could detect this phenomenon in patients with a normal spirometry but bronchial hyperreactivity as determined with a methacholine bronchial challenge test. Whole blood chemiluminescence, serum eosinophilic cationic protein (ECP), and serum myeloperoxidase (MPO) were determined from 50 patients referred for a methacholine challenge due to prolonged cough and/or dyspnoea. The chemiluminescence results were compared to those from 15 healthy persons. The hyperreactive patients (n = 18) had significantly higher phorbol 12-myristate 13-acetate (PMA)-induced whole blood chemiluminescence values (mean 18.8 mV.min-1; 95% confidence limits (C.L.) 16.3-21.3 mV.min-1) than the normoreactive patients (mean 14.2 mV.min-1; 95% C.L. 13.0-15.5 mV.min-1;) and the healthy controls (mean 12.8 mV.min-1; 95% C.L. 11.7-13.9 mV.min-1). There was no significant difference in PMA-induced chemiluminescence between the normoreactive patients and the controls. The hyperreactive patients had higher serum ECP values than the normoreactive patients, but there was no correlation between whole blood chemiluminescence and serum ECP levels or total eosinophil count. There was no significant difference in monocyte reactive oxygen metabolite production or serum MPO values between the normoreactive and the hyperreactive patients. We suggest that the increased PMA-induced whole blood chemiluminescence in bronchial hyperreactivity is due mainly to an activation of neutrophils, and that the assay might be useful as a systemic inflammatory marker in patients with pulmonary inflammatory processes resulting in bronchial hyperreactivity.

Mononuclear leukocytes were isolated from the peripheral blood of 15 patients with malignant pulmonary diseases, 17 patients with pulmonary infections, 18 patients with chest film abnormalities of non‐malignant, non‐infectious etiology, and 15 healthy persons. The cells were exposed to zymosan yeast, BCG vaccine, quartz, or chrysotile asbestos, and the subsequent production of reactive oxygen species (ROS) was measured by luminol‐dependent chemiluminescence. All the stimulants caused significantly higher ROS production in the patient groups than in the healthy control group, and the asbestos‐induced ROS production was significantly more pronounced in the cancer group than in the two non‐cancer patient groups combined. After one‐year follow‐up, 5 of the 15 cancer patients were alive, and these patients had significantly lower mineral dust‐induced ROS responses at the time of diagnosis than were found in the patients who died. This result was verified in a subsequent study comprising 19 patients with malignant pulmonary disorders (6 alive after one year). In conclusion, monocytes from patients with malignant diseases seem to be primed for an increased ROS production, and high ROS responses seem to correlate with a poor one‐year survival of the patients.

Bacillus Calmette‐Guerin (BCG) was added simultaneously with known NADPH oxidase stimulants to suspensions of human mononuclear leukocytes, and the subsequent production of reactive oxygen metabolites (ROMs) was studied by luminol‐dependent chemiluminescence. BCG significantly amplified the ROM responses induced by zymosan, phorbol myristate acetate (PMA), and quartz, but not by concanavalin A and asbestos fibers. The stimulatory effect occurred rapidly when BCG was added to cells already phagocytosing zymosan, and vanished rapidly when extracellular BCG was removed from adherent monocyte cultures by washing prior to the addition of zymosan. The stimulatory effect of BCG could not be reproduced with recombinant interferon‐γ, tuberculin PPD, muramyl dipeptide, nor with the apathogenic Mycobacterium tuberculosis strain RV37. BCG and zymosan or PMA that had been incubated together prior to addition to the mononuclear cell suspensions caused ROM production with faster kinetics than if the reagents were added separately without preincubation. In conclusion, the synergy between BCG and some of the NADPH oxidase stimulants seems to be due to an interaction between BCG and the NADPH oxidase stimulants rather than to an interaction between BCG and the ROM‐producing cells. Such interactions between mycobacteria and NADPH oxidase stimulants may be of importance as a factor affecting the individual susceptibility to tissue damage in tuberculosis, for example in silicotuberculosis.