Airway inflammation in elderly patients with bronchial asthma. Different airway inflammatory cell response related to disease severity.

Cellular composition of bronchoalveolar lavage (BAL) fluid was examined in 11 elderly asthmatics over the age of 70, and the results were compared with those of 11 younger asthmatics under the age of 50. In the subjects with mild asthma, the proportion of BAL cells in the elderly subjects was 86.2% macrophages, 11.0% lymphocytes, 1.9% neutrophils, 0.9% eosinophils and 0.08% basophilic cells. The proportion of neutrophils and eosinophils in the BAL fluid was slightly higher in younger subjects with mild asthma compared with that in elderly subjects, although no significant difference was found between the two groups. In subjects with severe asthma, the proportions of lymphocytes, neutrophils, eosinophils and basophilic cells were more increased in both younger and older patients compared to those with mild asthma, and a significant increase in the number of BAL eosinophils was found in younger subjects with severe asthma compared to those with mild asthma (p < 0.05). However, no significant difference was present in the proportion of BAL cells between younger and older patients with severe asthma. The results reveal that BAL cells are more increased in subjects with suvere asthma than in those with mild asthma in both younger and older subjects, and show the possibility that this increase is more predominant in neutrophils in older subjects and in eosinophils in younger subjects.

70才以上の老年者気管支喘息11例(平均年齢71.4才)を対象に,重症度と気道細胞反応との関連について検討を加えた｡なお,対照として50才以下の喘息症例11例(平均年齢33.5才)を選んだ｡1.老年者の軽症型喘息における気管支肺胞洗浄(BAL)液中の出現細胞の頻度は,マクロファージが86.2%,リンパ球が11.0%,好中球が1.9%,好酸球が0.9%,好塩基性細胞が0.08%であった｡BAL液中の好中球,好酸球の頻度は若青年症例でやや高い傾向が見られたが,両群間に有意の差は見られなかった｡重症例では,老年症例,若青年症例とも,軽症例に比べリンパ球,好中球,好酸球などのBAL細胞の出現頻度が増加しており,特に好酸球では若青年症例の重症例で軽症例に比べ有意に高い頻度が観察された｡これらの結果は, リンパ球,好中球,好酸球などのBAL細胞は,軽症例に比べ重症例で増加してくること,そして,その増加は老年症例では好中球,若青年症例では好酸球の増加が特徴的であることを示唆しているものと考えられた｡