胆碱补充能否成为老年哮喘的治疗措施？
2016/03/22
摘要
背景：老年哮喘因较少受到研究者关注，其机制远未阐明。ＤＮＡ甲基化可影响哮喘易感基因的表达。甲基基团可以通过胆碱依赖的途径产生。已经证实哮喘患者血清胆碱水平降低。我们研究目的为探讨胆碱补充对老年哮喘的作用及可能机制。
方法：这是一项双盲，安慰剂对照，交叉研究。入组30例65岁以上患者，分别在基线和3，6，9，12周后进行评价 。他们随机接受胆碱310 mg和安慰剂胶囊，每日2次，共6 周。
结果：90％的研究对象是过敏性和97%的人使用吸入糖皮质激素。与安慰剂相比，胆碱补充不影响ＡＣＴ（哮喘控制测试）评分，肺功能测定值，嗜酸性粒细胞计数、血清总IgE（所有的比较P > 0.86）。在低的ＡＣＴ（≤20），低FEV1 （＜60 %），或高嗜酸性粒细胞计数（≥0.6）的受试者，胆碱组和安慰剂组之间无显著差异（P＞0.63 ）。我们没有发现IgE和嗜酸性粒细胞计数等参数在基线具有明显的相关性，包括那些低ＡＣＴ或更高的吸入性类固醇剂量（P > 0.09）的病人。女性哮喘患者相对于男性具有更低的ＡＣＴ评分（P = 0.02 ）。
结论：在这项老年哮喘患者研究中，6周的胆碱补充并未影响ＡＣＴ评分、肺功能指标、外周血嗜酸性粒细胞和血清总IgE。本结论将需要更大的研究和更长期的研究来证实。注册临床试验nct02371993
Asthma in the elderly: the effect of choline supplementation.
Columbo M1, Rohr AS1.
Abstract
BACKGROUND:Asthma in the elderly is poorly understood as very few studies have included these patients. DNA methylation can affect the expression of asthma susceptibility genes. Methyl groups can be produced through a choline dependent pathway. Asthmatics have decreased serum choline. We studied the effect of choline supplementation in elderly asthmatics and associations between different parameters at baseline.
METHODS:This is a double-blind, placebo-controlled, cross-over study. Thirty asthmatics 65 years old and older were evaluated at baseline and 3, 6, 9, and 12 weeks later. They randomly received choline bitartrate 310 mg and placebo capsules twice daily for 6 weeks.
RESULTS:Ninety percent of the study subjects were atopic and 97 % of them were using inhaled corticosteroids. Choline supplementation did not affect ACT (asthma control test), spirometric values, eosinophil counts or total serum IgE vs. placebo (p > 0.86 for all comparisons). In subjects with lower ACT (≤20), lower FEV1 % (<60 %), or higher eosinophil counts (≥0.6), there was similarly no difference between choline and placebo (p > 0.63). We found no significant association between eosinophil counts and IgE and the other parameters at baseline including in subjects with lower ACT or on higher inhaled steroid doses (p > 0.09). Asthmatic women had lower baseline ACT scores compared to men (p = 0.02).
CONCLUSIONS:In this study of elderly asthmatics, choline supplementation for 6 weeks did not affect ACT scores, spirometric values, peripheral blood eosinophils, or total serum IgE. These results will require confirmation in larger and longer studies. Trial registration ClinicalTrials.gov NCT02371993
Allergy Asthma Clin Immunol. 2016 Mar 11;12:15. doi: 10.1186/s13223-016-0121-5. eCollection 2016.
背景：老年哮喘因较少受到研究者关注，其机制远未阐明。ＤＮＡ甲基化可影响哮喘易感基因的表达。甲基基团可以通过胆碱依赖的途径产生。已经证实哮喘患者血清胆碱水平降低。我们研究目的为探讨胆碱补充对老年哮喘的作用及可能机制。
方法：这是一项双盲，安慰剂对照，交叉研究。入组30例65岁以上患者，分别在基线和3，6，9，12周后进行评价 。他们随机接受胆碱310 mg和安慰剂胶囊，每日2次，共6 周。
结果：90％的研究对象是过敏性和97%的人使用吸入糖皮质激素。与安慰剂相比，胆碱补充不影响ＡＣＴ（哮喘控制测试）评分，肺功能测定值，嗜酸性粒细胞计数、血清总IgE（所有的比较P > 0.86）。在低的ＡＣＴ（≤20），低FEV1 （＜60 %），或高嗜酸性粒细胞计数（≥0.6）的受试者，胆碱组和安慰剂组之间无显著差异（P＞0.63 ）。我们没有发现IgE和嗜酸性粒细胞计数等参数在基线具有明显的相关性，包括那些低ＡＣＴ或更高的吸入性类固醇剂量（P > 0.09）的病人。女性哮喘患者相对于男性具有更低的ＡＣＴ评分（P = 0.02 ）。
结论：在这项老年哮喘患者研究中，6周的胆碱补充并未影响ＡＣＴ评分、肺功能指标、外周血嗜酸性粒细胞和血清总IgE。本结论将需要更大的研究和更长期的研究来证实。注册临床试验nct02371993
（南方医科大学南方医院 赵海金 ）
Allergy Asthma Clin Immunol. 2016 Mar 11;12:15. doi: 10.1186/s13223-016-0121-5. eCollection 2016.
Allergy Asthma Clin Immunol. 2016 Mar 11;12:15. doi: 10.1186/s13223-016-0121-5. eCollection 2016.
Asthma in the elderly: the effect of choline supplementation.
Columbo M1, Rohr AS1.
Abstract
BACKGROUND:Asthma in the elderly is poorly understood as very few studies have included these patients. DNA methylation can affect the expression of asthma susceptibility genes. Methyl groups can be produced through a choline dependent pathway. Asthmatics have decreased serum choline. We studied the effect of choline supplementation in elderly asthmatics and associations between different parameters at baseline.
METHODS:This is a double-blind, placebo-controlled, cross-over study. Thirty asthmatics 65 years old and older were evaluated at baseline and 3, 6, 9, and 12 weeks later. They randomly received choline bitartrate 310 mg and placebo capsules twice daily for 6 weeks.
RESULTS:Ninety percent of the study subjects were atopic and 97 % of them were using inhaled corticosteroids. Choline supplementation did not affect ACT (asthma control test), spirometric values, eosinophil counts or total serum IgE vs. placebo (p > 0.86 for all comparisons). In subjects with lower ACT (≤20), lower FEV1 % (<60 %), or higher eosinophil counts (≥0.6), there was similarly no difference between choline and placebo (p > 0.63). We found no significant association between eosinophil counts and IgE and the other parameters at baseline including in subjects with lower ACT or on higher inhaled steroid doses (p > 0.09). Asthmatic women had lower baseline ACT scores compared to men (p = 0.02).
CONCLUSIONS:In this study of elderly asthmatics, choline supplementation for 6 weeks did not affect ACT scores, spirometric values, peripheral blood eosinophils, or total serum IgE. These results will require confirmation in larger and longer studies. Trial registration ClinicalTrials.gov NCT02371993
Allergy Asthma Clin Immunol. 2016 Mar 11;12:15. doi: 10.1186/s13223-016-0121-5. eCollection 2016.
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关于母亲体重指数、孕期体重增加和后代哮喘的纵向研究
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通过切除喉神经进行手术治疗支气管哮喘
