哮喘联盟

   摘要
   肥胖型哮喘以活化的巨噬细胞和肥大细胞浸润脂肪组织为特征。本研究旨在探索肥胖型哮喘年龄与性别对免疫代谢的影响。
   肥胖/非肥胖儿童及成人哮喘患者接受了以下检查：肺功能，用双能X线吸收仪测量体成分，以及血清可溶CD163 (soluble CD163，sCD163)，类胰蛋白酶，C反应蛋白(CRP)和其他脂肪细胞因子。
   血浆CRP（p < 0.01）和瘦素（p < 0.01）在肥胖型成人哮喘患者中升高，并且sCD163（p = 0.003）在肥胖型哮喘儿童中升高。与肥胖女性成人哮喘患者和肥胖男性儿童哮喘患者比较，肥胖女性儿童哮喘患者其sCD163水平更高；与肥胖男性儿童和肥胖男性成人哮喘患者比较，肥胖女性成人哮喘患者其CRP水平更高。血清类胰蛋白酶浓度在各年龄组间并无明显差异。在女性肥胖儿童哮喘患者（r = 0.70，p = 0.003）和女性肥胖成人哮喘（r = 0.65，p = 0.003）患者中，sCD163与腹周脂肪比例呈正相关。女性肥胖儿童哮喘患者中，sCD163与第一秒用力呼气量实预比（FEV1%）呈负相关（r = -0.55，p = 0.02），且与哮喘控制问卷（ACQ）呈正相关（r = 0.57，p = 0.02）。
   肥胖哮喘儿童具有性别特异的巨噬细胞活化，这可能导致哮喘控制水平更差以及肺功能更低。不同年龄和性别导致全身炎症反应具有异质性，这表明肥胖型哮喘在分子水平方面存在亚表型。

 

(李虹霖 张红萍 王刚  四川大学华西医院中西医结合科呼吸病组 610041 摘译)
（Eur Respir J. 2015; 45; 388–395）


 

Macrophage activation, age and sex effects of immunometabolism in obese asthma

Hashim A. Periyalil, Lisa G. Wood, Hayley A. Scott, Megan E. Jensen and Peter G. Gibson
Eur Respir J. 2015; 45; 388–395
 

ABSTRACT
Obese asthma is characterised by infiltration of adipose tissue by activated macrophages and mast cells. The aim of this study was to examine the age and sex effects of immunometabolism in obese asthma.
Obese and non-obese asthmatic children and adults underwent spirometry, body composition assessment by dual energy X-ray absorptiometry and measurement of serum soluble CD163 (sCD163), tryptase, C-reactive protein (CRP) and other adipocytokines.
Plasma CRP ( p<0.01) and leptin ( p<0.01) were elevated in obese asthmatic adults, and sCD163( p=0.003) was elevated in obese asthmatic children. We observed significantly higher sCD163 in obese female children compared to obese female adults and male children, and higher CRP in obese female adults compared to obese male children and adults. Serum tryptase concentrations were not significantly different across age groups. sCD163 positively correlated with the proportion of android fat in obese female children (r=0.70, p=0.003) and obese female adults (r=0.65, p=0.003). In obese female children, sCD163 was inversely associated with forced expiratory volume in 1 s % predicted (r=−0.55, p=0.02) and was positively associated with the Asthma Control Questionnaire (r=0.57, p=0.02).
Obese children with asthma have sex-specific macrophage activation, which may contribute to worse asthma control and lung function. The heterogeneous systemic inflammatory profile across age and sex suggests the existence of sub-phenotypes in obese asthma at the molecular level.