Læknablaðið - 15.04.2000, Síða 21

FRÆÐIGREINAR / KRANSÆÐAVÍKKANIR Á ÍSLANDI
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Nýr doktor í læknisfræði
Þann 17. september síðastliðinn lauk Dóra Lúð-
víksdóttir doktorsprófi í læknisfræði frá Uppsalahá-
skóla. Doktorsritgerðin ber titilinn Airway Respon-
siveness and Exhaled Nitric Oxide. Studies in asthma
and Sjögren's syndrome. Ritgerðin fjallar um loft-
vegabólgu og berkjuauðreitni hjá sjúklingum með
astma og einstaklingum með heilkenni Sjögrens.
Rannsökuð voru tengsl berkjuauðreitni og köfnunar-
efnisoxíðs (NO) í útöndunarlofti við loftvegaein-
kenni og bólguþætti í blóði. Agrip af ritgerðinni fer
hér á eftir.
In this thesis, four different types of provoca-
tion agents: methacholine, adenosine 5'-mono-
phosphate (AMP), cold air and dry powder
mannitol were used to study different aspects of
the airway responsiveness profile in asthma and
Sjögren's syndrome. Exhaled nitric oxide (NO)
and markers of eosinophil activation, serum eosi-
nophil peroxidase (S-EPO) and serum eosinophil
cationic protein (S-ECP) were measured.
The main findings of this research are that
atopic patients with asthma were significantly
more hyperresponsive to AMP than nonatopic
asthmatic subjects and patients with Sjögren's
syndrome. In atopic subjects with asthma, the air-
way responsiveness to AMP was correlated with
markers of eosinophil activation S-EPO and S-
ECP. Furthermore, hyperresponsiveness to cold
air was more common in atopic asthmatics com-
pared with patients with Sjögren's syndrome.
Exhaled NO was almost twice as high in
patients with Sjögren's syndrome and atopic asth-
matics compared with healthy controls. In atopic
asthmatics exhaled NO was significantly correla-
ted with airway responsiveness to methacholine
and was due to an increased NO flux from the
airways but not the alveoli. After inhalation of dry
powder mannitol the levels of exhaled NO de-
creased in asthmatics, but increased in healthy
individuals.
In conclusion, atopic and nonatopic subjects
with asthma and patients with Sjögren's syndrome
have different airway responsiveness profiles for
AMP and cold air. Exhaled NO is elevated in
patients with Sjögren's syndrome and in atopic
asthmatic subjects while nonatopic asthmatics
have normal levels. Using a new bronchial provo-
cation test with dry powder mannitol we showed
that healthy subjects can release NO after manni-
tol provocation, wheras asthmatics can not. More
than one type of bronchial provocation may be
required to detect different aspects of the airway
hyperresponsiveness profile.
Dóra starfar sem sérfræðingur við lungnalækn-
ingaskor lyflækningasviðs Landspítala Vífilsstöð-
um.
Dr. Dóra Lúðvíksdóttir.
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