嗜酸粒细胞性哮喘与非嗜酸粒细胞哮喘中穿透素水平
2018/08/16
摘要
背景：先天性免疫被认为与哮喘发病机制有关。作为可溶性模式识别分子的穿透素在体液先天免疫中起重要作用。哮喘是气道的异质性炎性疾病，分为嗜酸性粒细胞性或非嗜酸性粒细胞性哮喘。
目的：调查嗜酸性粒细胞性哮喘与非嗜酸性粒细胞性哮喘患者的穿透素水平是否不同。此外，评估穿透素水平对区分哮喘炎症表型的预测能力。
方法：80名哮喘患者和24名健康对照受试者在研究纳入时进行了痰诱导。对选定的痰进行白细胞分类计数。通过酶联免疫吸附测定法测定血浆C-反应蛋白（CRP），血清淀粉样蛋白P（SAP），穿透素3（PTX3）和痰SAP，PTX3，IL-8水平。
结果：与嗜酸性粒细胞性哮喘和健康对照者相比，非嗜酸性哮喘患者的穿透素水平显着升高，中位数（四分位数间距）血浆CRP水平分别为0.86（0.28-2.07），0.26（0.14-0.85）和0.15（0.09-0.45）mg/L（P <0.001），血浆SAP水平分别为33.69（19.79-58.39），19.76（16.11-30.58）和20.06（15.68-31.11）mg/L（P = .003）和痰PTX3水平分别为4.9（1.35-18.72），0.87（0.30-2.07）和1.08（0.31-4.32）ng/mL（P <0.001）。相反，嗜酸性粒细胞性哮喘患者的痰SAP浓度（中位数，21.49ng/mL；IQR，6.86-38.79ng/mL）显着高于非嗜酸性粒细胞患者（中位数，8.15ng/mL；IQR，2.82-18.01ng/mL）和健康对照（中位数，8.79ng/mL; IQR，2.00-16.18ng/mL）。血浆CRP（P = .004）、SAP（P = .005）和痰PTX3水平（P <0.001）较高的哮喘患者痰嗜酸性粒细胞百分比显着降低。痰PTX3水平对哮喘患者非嗜酸性粒细胞性气道炎症有着最好的预测能力（11.18倍，P <0.001）。
总结：非嗜酸性粒细胞性哮喘和嗜酸性粒细胞性哮喘患者的穿透素水平有显著差异。此外，升高的穿透素表达可预测哮喘患者的非嗜酸性粒细胞性气道炎症水平。
Pentraxin levels in noneosinophilic versus eosinophilic asthma.
Gao P,et al. Clin Exp Allergy. 2018 May 13.
Abstract
Background：Innate immunity has been thought to be involved in asthma pathogenesis. Pentraxins, acting as soluble pattern recognition molecules, play an important role in humoral innate immunity. Asthma is a heterogeneous inflammatory disease of airways and can be classified as eosinophilic or noneosinophilic asthma.
Objective：To investigate whether pentraxin levels differ in subjects with eosinophilic versus noneosinophilic asthma. Furthermore, to access the predictive performance of pentraxin levels for discriminating asthma inflammatory phenotypes.
Methods：80 asthmatic patients and 24 healthy control subjects underwent sputum induction at study inclusion. Differential leukocyte counts were performed on selected sputum. Plasma C-reactive protein (CRP), serum amyloid P (SAP), pentraxin 3 (PTX3), and sputum SAP, PTX3, IL-8 levels were determined by enzyme-linked immunosorbent assay.
Results：Subjects with noneosinophilic asthma had significantly increased pentraxin levels compared with those with eosinophilic asthma and healthy controls, with median (interquartile range) plasma CRP levels of 0.86 (0.28-2.07), 0.26 (0.14-0.85), and 0.15 (0.09-0.45)mg/L (P < 0.001), respectively, plasma SAP levels of 33.69 (19.79-58.39), 19.76 (16.11-30.58), and 20.06 (15.68-31.11)mg/L (P = .003), respectively, and sputum PTX3 levels of 4.9 (1.35-18.72), 0.87 (0.30-2.07), and 1.08 (0.31-4.32)ng/mL (P < 0.001), respectively. Conversely, sputum SAP concentrations of eosinophilic asthmatics (median, 21.49ng/mL; IQR, 6.86-38.79ng/mL) were significantly higher than those of noneosinophilic patients (median, 8.15ng/mL; IQR, 2.82-18.01ng/mL) and healthy controls (median, 8.79ng/mL; IQR, 2.00-16.18ng/mL). Asthma patients with high plasma CRP (P = .004), SAP (P = .005), and sputum PTX3 levels (P < 0.001) also had significantly lower sputum eosinophil percentages. Sputum PTX3 levels had the best power (11.18-fold, P < 0.001) to predict noneosinophilic airway inflammation in asthma patients.
Conclusion：Pentraxin levels differed significantly between patients with noneosinophilic asthma and those with eosinophilic asthma. Furthermore, elevated pentraxin expressions may predict noneosinophilic airway inflammation in asthmatic patients
背景：先天性免疫被认为与哮喘发病机制有关。作为可溶性模式识别分子的穿透素在体液先天免疫中起重要作用。哮喘是气道的异质性炎性疾病，分为嗜酸性粒细胞性或非嗜酸性粒细胞性哮喘。
目的：调查嗜酸性粒细胞性哮喘与非嗜酸性粒细胞性哮喘患者的穿透素水平是否不同。此外，评估穿透素水平对区分哮喘炎症表型的预测能力。
方法：80名哮喘患者和24名健康对照受试者在研究纳入时进行了痰诱导。对选定的痰进行白细胞分类计数。通过酶联免疫吸附测定法测定血浆C-反应蛋白（CRP），血清淀粉样蛋白P（SAP），穿透素3（PTX3）和痰SAP，PTX3，IL-8水平。
结果：与嗜酸性粒细胞性哮喘和健康对照者相比，非嗜酸性哮喘患者的穿透素水平显着升高，中位数（四分位数间距）血浆CRP水平分别为0.86（0.28-2.07），0.26（0.14-0.85）和0.15（0.09-0.45）mg/L（P <0.001），血浆SAP水平分别为33.69（19.79-58.39），19.76（16.11-30.58）和20.06（15.68-31.11）mg/L（P = .003）和痰PTX3水平分别为4.9（1.35-18.72），0.87（0.30-2.07）和1.08（0.31-4.32）ng/mL（P <0.001）。相反，嗜酸性粒细胞性哮喘患者的痰SAP浓度（中位数，21.49ng/mL；IQR，6.86-38.79ng/mL）显着高于非嗜酸性粒细胞患者（中位数，8.15ng/mL；IQR，2.82-18.01ng/mL）和健康对照（中位数，8.79ng/mL; IQR，2.00-16.18ng/mL）。血浆CRP（P = .004）、SAP（P = .005）和痰PTX3水平（P <0.001）较高的哮喘患者痰嗜酸性粒细胞百分比显着降低。痰PTX3水平对哮喘患者非嗜酸性粒细胞性气道炎症有着最好的预测能力（11.18倍，P <0.001）。
总结：非嗜酸性粒细胞性哮喘和嗜酸性粒细胞性哮喘患者的穿透素水平有显著差异。此外，升高的穿透素表达可预测哮喘患者的非嗜酸性粒细胞性气道炎症水平。
（复旦大学附属中山医院呼吸内科 包晨 摘译 杨冬 审校）
（Gao P,et al. Clin Exp Allergy. 2018 May 13.）
（Gao P,et al. Clin Exp Allergy. 2018 May 13.）
Pentraxin levels in noneosinophilic versus eosinophilic asthma.
Gao P,et al. Clin Exp Allergy. 2018 May 13.
Abstract
Background：Innate immunity has been thought to be involved in asthma pathogenesis. Pentraxins, acting as soluble pattern recognition molecules, play an important role in humoral innate immunity. Asthma is a heterogeneous inflammatory disease of airways and can be classified as eosinophilic or noneosinophilic asthma.
Objective：To investigate whether pentraxin levels differ in subjects with eosinophilic versus noneosinophilic asthma. Furthermore, to access the predictive performance of pentraxin levels for discriminating asthma inflammatory phenotypes.
Methods：80 asthmatic patients and 24 healthy control subjects underwent sputum induction at study inclusion. Differential leukocyte counts were performed on selected sputum. Plasma C-reactive protein (CRP), serum amyloid P (SAP), pentraxin 3 (PTX3), and sputum SAP, PTX3, IL-8 levels were determined by enzyme-linked immunosorbent assay.
Results：Subjects with noneosinophilic asthma had significantly increased pentraxin levels compared with those with eosinophilic asthma and healthy controls, with median (interquartile range) plasma CRP levels of 0.86 (0.28-2.07), 0.26 (0.14-0.85), and 0.15 (0.09-0.45)mg/L (P < 0.001), respectively, plasma SAP levels of 33.69 (19.79-58.39), 19.76 (16.11-30.58), and 20.06 (15.68-31.11)mg/L (P = .003), respectively, and sputum PTX3 levels of 4.9 (1.35-18.72), 0.87 (0.30-2.07), and 1.08 (0.31-4.32)ng/mL (P < 0.001), respectively. Conversely, sputum SAP concentrations of eosinophilic asthmatics (median, 21.49ng/mL; IQR, 6.86-38.79ng/mL) were significantly higher than those of noneosinophilic patients (median, 8.15ng/mL; IQR, 2.82-18.01ng/mL) and healthy controls (median, 8.79ng/mL; IQR, 2.00-16.18ng/mL). Asthma patients with high plasma CRP (P = .004), SAP (P = .005), and sputum PTX3 levels (P < 0.001) also had significantly lower sputum eosinophil percentages. Sputum PTX3 levels had the best power (11.18-fold, P < 0.001) to predict noneosinophilic airway inflammation in asthma patients.
Conclusion：Pentraxin levels differed significantly between patients with noneosinophilic asthma and those with eosinophilic asthma. Furthermore, elevated pentraxin expressions may predict noneosinophilic airway inflammation in asthmatic patients
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