血清sST2水平可预测哮喘的重度急性发作
2018/11/13
摘要
背景：中性粒细胞炎症与哮喘控制不佳有关。血清sST2(可溶性IL-33受体)水平在中性粒细胞性肺病中增加。我们假设，处于稳定期的哮喘患者血清sST2水平高预示着短期内病情加重。
方法：这项前瞻性观察研究评估了104名哮喘患者的血清sST2水平，这些患者均接受了肺部疾病专家的治疗，随访周期3个月。
结果：血清中高水平sST2(>18ng/ml)预测3个月内可能发生重度哮喘急性发作。血清sST2水平与哮喘严重程度(治疗级别)、气道H2O2水平、血清IL-8水平呈正相关。高水平sST2和血中性粒细胞升高(> 6000 /μl)是哮喘急性发作的独立预测指标。我们将高水平sST2和中性粒细胞结合在一起，定义了一个急性发作风险评分，并据此将患者分为4组。。在受试者工作特征曲线分析中该评分预测急性加重的曲线下面积为0.91。评分最高的患者表型最严重，有85.7%的患者表现为急性发作、气流受限和糖皮质激素不敏感。
结论：高水平sST2可预测一般哮喘患者的急性发作，它与血中性粒细胞水平相结合可作为急性加重风险评分准确预测3个月内病情急性加重的风险。
Serum sST2 levels predict severe exacerbation of asthma
Watanabe M, Nakamoto K, et al. Respir Res. 2018 Sep 3
Abstract
BACKGROUND：Neutrophilic inflammation is associated with poorly controlled asthma. Serum levels of sST2, a soluble IL-33 receptor, increase in neutrophilic lung diseases. We hypothesized that high serum sST2 levels in stable asthmatics are a predictor for exacerbation within a short duration.
METHODS：This prospective observational study evaluated the serum sST2 levels of 104 asthmatic patients who were treated by a lung disease specialist with follow-ups for 3 months.
RESULTS：High serum sST2 levels (> 18 ng/ml) predicted severe asthma exacerbation within 3 months. Serum sST2 levels correlated positively with asthma severity (treatment step), airway H2O2 levels, and serum IL-8 levels. High serum sST2 levels and blood neutrophilia (> 6000 /μl) were independent predictors of exacerbation. We defined a post-hoc exacerbation-risk score combining high serum sST2 level and blood neutrophilia, which stratified patients into four groups. The score predicted exacerbation-risk with an area under curve of 0.91 in the receiver operating characteristic curve analysis. Patients with the highest scores had the most severe phenotype, with 85.7% showing exacerbation, airflow limitation, and corticosteroid-insensitivity.
CONCLUSIONS：High serum sST2 levels predicted exacerbation within the general asthmatic population and, when combined with blood neutrophil levels, provided an exacerbation-risk score that was an accurate predictor of exacerbation occurring within 3 months.
背景：中性粒细胞炎症与哮喘控制不佳有关。血清sST2(可溶性IL-33受体)水平在中性粒细胞性肺病中增加。我们假设，处于稳定期的哮喘患者血清sST2水平高预示着短期内病情加重。
方法：这项前瞻性观察研究评估了104名哮喘患者的血清sST2水平，这些患者均接受了肺部疾病专家的治疗，随访周期3个月。
结果：血清中高水平sST2(>18ng/ml)预测3个月内可能发生重度哮喘急性发作。血清sST2水平与哮喘严重程度(治疗级别)、气道H2O2水平、血清IL-8水平呈正相关。高水平sST2和血中性粒细胞升高(> 6000 /μl)是哮喘急性发作的独立预测指标。我们将高水平sST2和中性粒细胞结合在一起，定义了一个急性发作风险评分，并据此将患者分为4组。。在受试者工作特征曲线分析中该评分预测急性加重的曲线下面积为0.91。评分最高的患者表型最严重，有85.7%的患者表现为急性发作、气流受限和糖皮质激素不敏感。
结论：高水平sST2可预测一般哮喘患者的急性发作，它与血中性粒细胞水平相结合可作为急性加重风险评分准确预测3个月内病情急性加重的风险。
（复旦大学附属中山医院呼吸与危重症医学科 魏婷婷 摘译 毕晶 审校）
（Respir Res. 2018 Sep 3）
（Respir Res. 2018 Sep 3）
Serum sST2 levels predict severe exacerbation of asthma
Watanabe M, Nakamoto K, et al. Respir Res. 2018 Sep 3
Abstract
BACKGROUND：Neutrophilic inflammation is associated with poorly controlled asthma. Serum levels of sST2, a soluble IL-33 receptor, increase in neutrophilic lung diseases. We hypothesized that high serum sST2 levels in stable asthmatics are a predictor for exacerbation within a short duration.
METHODS：This prospective observational study evaluated the serum sST2 levels of 104 asthmatic patients who were treated by a lung disease specialist with follow-ups for 3 months.
RESULTS：High serum sST2 levels (> 18 ng/ml) predicted severe asthma exacerbation within 3 months. Serum sST2 levels correlated positively with asthma severity (treatment step), airway H2O2 levels, and serum IL-8 levels. High serum sST2 levels and blood neutrophilia (> 6000 /μl) were independent predictors of exacerbation. We defined a post-hoc exacerbation-risk score combining high serum sST2 level and blood neutrophilia, which stratified patients into four groups. The score predicted exacerbation-risk with an area under curve of 0.91 in the receiver operating characteristic curve analysis. Patients with the highest scores had the most severe phenotype, with 85.7% showing exacerbation, airflow limitation, and corticosteroid-insensitivity.
CONCLUSIONS：High serum sST2 levels predicted exacerbation within the general asthmatic population and, when combined with blood neutrophil levels, provided an exacerbation-risk score that was an accurate predictor of exacerbation occurring within 3 months.
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重症哮喘患者气道中的骨膜蛋白能否区分T2内型哮喘？
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