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Vol. 41. Issue 6.
Pages 328-333 (June 2005)
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Vol. 41. Issue 6.
Pages 328-333 (June 2005)
Original Articles
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Bronchial Exudate of Serum Proteins During Asthma Attack
J. Beldaa,
Corresponding author

Correspondence: Dr. J. Belda. Clínica d'Asma i Al·lèrgia. Departament de Pneumologia. Hospital de la Santa Creu i de Sant Pau. Antoni M. Claret, 167. 08025 Barcelona. España
, G. Margarita, C. Martínezb, P. Casana, F. Rodríguez-Jereza, M. Brufala, M. Torrejóna, C. Granela, J. Sanchisa
a Clínica d'Asma i Al-lérgia, Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Servei de Bioquímica, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Although altered vascular permeability and edema of the bronchial mucosa are associated with asthma attack, their influence on its severity remains unknown. We address this issue by comparing relative indices for the concentration of albumin (RIAlb) and α2-macroglobulin (RIα2M) in induced sputum and peripheral blood from patients with exacerbated asthma, patients with stable asthma, and control subjects.

Patients and methods

Forty-six volunteers participated in the study: 14 with exacerbated asthma (forced expiratory volume in the first second [FEV1] 74.3% [SD, 20.8%] of reference), 23 with stable asthma (FEV1 93.6% [7.5%]), and 9 controls (FEV1 101.1% [9.9%]). The concentrations of albumin and α2-macroglobulin were quantified by immunoturbidimetry and immunonephelometry, respectively. The relative index was then calculated by dividing the concentration in sputum supernatant by the concentration in peripheral blood.


The mean RIAlb was 1.2 (1.1) in the control group, 2.9 (3.1) in the stable asthma group, and 6.0 (6.7) in the exacerbated asthma group. The RIα2M values were 11.7 (10.9), 11.9 (14.7), and 3.2 (3.8) for the control group and stable and exacerbated asthma groups, respectively. The increases in the RIAlb values between all groups, and the decrease in the RIα2M value between the exacerbated asthma and control groups were statistically significant (P <.05). The percentage of neutrophils, but not of eosinophils, in sputum was correlated with the RIAlb (r=0.39; P = .008) but not the RIα2M (r=-0.035; P = .82). FEV1 displayed an inverse relationship with the RIAlb (r=-0.43; P = .009) but not with the RIα2M (r=-0.206; P = .24). No correlation was found between oxyhemoglobin saturation and either the RIAlb (r=-0.33; P = .19) or the RIα2M (r=-0.12; P = .84).


Vascular permeability is altered during asthma exacerbations and appears to be correlated with the presence of neutrophils and the degree of bronchial obstruction.

Key words:
Induced sputum
Crisis, asthmatic

La alteración de la permeabilidad vascular y el edema de la mucosa bronquial se asocian con las crisis de asma. Hay pocos datos publicados y adems no se conoce su relación con la gravedad de éstas. Así se propuso comparar los índices relativos de albúmina (IRAlb) y de macroglobulina α2 (IRMα2), entre esputo inducido y sangre periférica, de asmáticos agudizados (AA), asmáticos estables (AE) y controles.

Pacientes y métodos

Se estudió a 46 voluntarios: 14 del grupo AA (volumen espiratorio forzado en el primer segundo [FEV1]: 74,3 ± 20,8), 23 del AE (FEV1: 93,6 ± 7,5) y 9 controles (FEV1: 101,1 ± 9,9). Se cuantificó la concentración de albúmina (turbidimetría inmunoquímica) y de macroglobulina α2 (nefelometría inmunoquímica) en el sobrenadante del esputo y en sangre venosa periférica y se calcularon los índices relativos.


La media ± desviación estándar del IRAlb fue de 1,2 ± 1,1 en el grupo control, de 2,9 ± 3,1 en AE y de 6,0 ± 6,7 en AA. El IRMα2 fue 11,7 ± 10,9,11,9 ± 14,7 y 3,2 ± 3,8, respectivamente. El incremento del IRAlb entre los grupos AA, AE y control, y el descenso del IRMα2 entre AA y control fueron estadísticamente significativos (p < 0,05). Se relacionó el porcentaje de neutrófilos, y no el de eosinófilos, con el IRAlb (r = 0,39; p = 0,008), pero no con el IRMα2 (r = -0,035; p = 0,82). El FEV1 se relacionó inversamente con el IRAlb (r = -0,43; p = 0,009) y no con el IRM?2 (r = -0,206; p = 0,24), y tampoco se relacionó la saturación de oxihemoglobina con el IRAlb (r = -0,33; p = 0,19) o el IRMα2 (r = -0,12; p = 0,84).


La permeabilidad vascular está alterada en las agudizaciones de asma y parece relacionarse con la presencia de neutrófilos y el grado de obstrucción bronquial.

Palabras clave:
Macroglobulina α2
Esputo inducido
Crisis de asma
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This work was partially funded by a grant from Red Respira (RITC-Instituto de Salud Carlos III and the Spanish Society of Pulmonology and Thoracic Surgery [SEPAR]).

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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