首页 >  专业园地 >  文献导读 >  临床观察 > 正文

重度哮喘“T2高”与血嗜酸性粒细胞、呼出的一氧化氮和血清骨膜蛋白有关

2019/01/09

   摘要             
   背景:气道上皮细胞(AEC)中的2型免疫应答将轻中度哮喘分为T2高表达型。我们检验了目前可用的临床生物标记物是否能够预测U-BIOPRED队列中AEC定义的T2高表达型。           
   方法:对103例哮喘患者和44名健康对照者毛刷所得到的AECs进行转录谱分析,利用IL-13暴露的AECs标记行基因组变异分析,以确定T2型哮喘的相对表达评分。           
   结果:应用AEC基因表达检测,37%的哮喘患者(45%的非吸烟型重度哮喘,n=49,33%吸烟或戒烟型重度哮喘,n=18,28%的轻中度哮喘,n=36)T2表达曾高。呼出气一氧化氮(FeNO)和血液及痰嗜酸性粒细胞(血清IgE或骨膜蛋白)水平越高,则症状越明显。痰嗜酸性粒细胞增多与T2高信号相关性最好。FeNO(≥30ppb)和嗜酸性粒细胞(≥300/L)可作为T2高表达哮喘的中度预测指标。痰中IL-4、IL-5、IL-13水平与基因表达无关。         
   结论:从FeNO、血和痰嗜酸性粒细胞计数的增加,可以一定程度上预测T2高危型哮喘,但血清IgE或血清骨膜蛋白对T2高危型哮喘的预测较差。需要更好的床旁生物标记物来检测T2高表达。


(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(Eur Respir J. 2018 Dec 21. pii: 1800938. doi: 10.1183/13993003.00938-2018.)
 
 
 
"T2-high" in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin.
 
Pavlidis S, Takahashi K, Kwong FNK, Xie J, Hoda U, Sun K, Elyasigomari V, Agapow P, Loza , Baribaud F, Chanez P, Fowler SJ, Shaw DE, Fleming LJ, Howarth PH, Sousa AR, Corfield J, Auffray C, De Meulder B, Knowles R, Sterk PJ, Guo Y, Adcock IM, Djukanovic R, Chung KF; U-BIOPRED study group.

Abstract
BACKGROUND: Type-2 (T2) immune responses in airway epithelial cells (AECs) classifies mild-moderate asthma into a T2-high phenotype. We examined whether currently-available clinical biomarkers can predict AEC-defined T2-high phenotype within U-BIOPRED cohort.
METHODS: The transcriptomic profile of AECs obtained from brushings of 103 patients with asthma and 44 healthy controls was obtained and gene set variation analysis used to determine the relative expression score of T2 asthma using a signature from IL-13-exposed AECs.
RESULTS: 37% of asthmatics (45% non-smoking severe asthma, n=49, 33% of smoking or ex-smoking severe asthma, n=18 and 28% mild-moderate asthma, n=36) were T2-high using AEC gene expression. They were more symptomatic with higher levels of nitric oxide in exhaled breath (FeNO) and of blood and sputum eosinophils but not of serum IgE or periostin. Sputum eosinophilia correlated best with the T2-high signature. FeNO (≥30 ppb) and blood eosinophils (≥300/µL) gave a moderate prediction of T2-high asthma. Sputum IL-4, IL-5 and IL-13 protein levels did not correlate with gene expression.
CONCLUSION: T2-high severe asthma can be predicted to some extent from raised levels of FeNO, blood and sputum eosinophil counts, but serum IgE or serum periostin were poor predictors. Better bedside biomarkers are needed to detect T2-high.




上一篇: 基于学校的远程医疗哮喘强化管理项目(SB-TEAM)对哮喘病情的影响一项随机临床试验
下一篇: 重症哮喘患者血液嗜酸性粒细胞的变异性

用户登录