上皮细胞因子与老年哮喘临床表型的关系
2019/01/09
摘要
目的：老年人的哮喘具有不同的临床特征，包括更严重的表型和更多的合并症。已知上皮细胞在哮喘患者气道中引起先天/适应性免疫应答。在成人哮喘患者的横断面队列中，我们研究了老年哮喘患者的临床特征及上皮细胞因子水平，并与非老年哮喘患者相比，以进一步了解其致病机制。
方法：共有1,452名成人哮喘患者从一家三级医院入组，分为2组，一组为234名老年人（初诊时≥60岁）和另一组为1,218名非老年人（初诊时<60岁）哮喘患者。比较两组哮喘相关的临床参数。通过酶联免疫吸附测定法测量血清上皮细胞来源细胞因子水平，包括白细胞介素IL-31、IL-33、IL-8，嗜酸性粒细胞趋化因子-2，转化生长因子β1（TGF-β1）和骨膜素。
结果：与非老年哮喘患者相比（为P <0.05），老年哮喘患者的晚发哮喘（发病年龄≥40岁）及重症哮喘的患病率明显较高，特应性、血液/痰嗜酸性粒细胞计数、血清总IgE及嗜酸性粒细胞阳离子蛋白水平较低。FEV1水平往往较低（P = 0.07）。此外，老年哮喘患者血清IL-33和IL-31水平较低，而血清IL-8、嗜酸性粒细胞趋化因子-2、TGF-β1及骨膜素水平无明显差异。 在老年哮喘患者中，重症哮喘患者的FEV1值较低，但血清嗜酸性粒细胞趋化因子-2和TGF-β1的水平明显高于非重症哮喘患者（P <0.05）。
结论：此研究结果表明，上皮细胞来源细胞因子年龄相关改变可能影响老年哮喘患者的临床表型及严重程度：IL-33和IL-31水平降低可能减弱Th2表型表达，然而嗜酸性粒细胞趋化因子-2和TGF-β水平升高可能增加其严重程度。
Association Between Epithelial Cytokines and Clinical Phenotypes of Elderly Asthma.
Ulambayar B, Lee SH.
Abstract
PURPOSE: Asthma in the elderly has different clinical features including more severe phenotypes with higher comorbidities. Epithelial cells are known to initiate innate/adaptive immune responses in asthmatic airways. We investigated clinical features and epithelial derived cytokine levels in elderly asthmatics compared to non-elderly asthmatics in a cross-sectional cohort of adult asthmatics in order to further understand its pathogenic mechanisms.
METHODS: A total of 1,452 adult asthmatics were enrolled from a single tertiary hospital and were classified into 2 groups: 234 elderly (≥ 60 years at initial diagnosis) and 1,218 non-elderly (< 60 years at initial diagnosis) asthmatics. Asthma-related clinical parameters were compared between the 2 groups. Serum levels of epithelial cell-derived cytokines including interleukin (IL)-31, IL-33, IL-8, eotaxin-2, transforming growth factor beta 1 (TGF-β1) and periostin were measured by enzyme-linked immunosorbent assay.
RESULTS: Significantly higher prevalence rates of late-onset asthma (onset age ≥ 40 years) and severe asthma, as well as the lower rate of atopy, blood/sputum eosinophil counts, total immunoglobulin E and eosinophil cationic protein levels were noted in elderly asthmatics compared to non-elderly asthmatics (P < 0.05, respectively). The forced expiratory volume in 1 second (FEV1, % predicted) level tended to be lower in elderly asthmatics (P = 0.07). In addition, serum IL-33 and IL-31 levels were significantly lower in elderly asthmatics, while no differences were found in the serum level of IL-8, eotaxin-2, TGF-β1 or periostin. Among elderly asthmatics, subjects with severe asthma had lower FEV1 (% predicted) value, but showed significantly higher serum levels of eotaxin-2 and TGF-β1, than those with non-severe asthma (P < 0.05 for each).
CONCLUSIONS: These findings suggest that age-related changes of epithelial cell-derived cytokines may affect clinical phenotypes and severity of elderly asthma: decreased levels of IL-33 and IL-31 may contribute to less Th2 phenotype, while increased levels of eotaxin-2 and TGF-β1 may contribute to severity.
目的：老年人的哮喘具有不同的临床特征，包括更严重的表型和更多的合并症。已知上皮细胞在哮喘患者气道中引起先天/适应性免疫应答。在成人哮喘患者的横断面队列中，我们研究了老年哮喘患者的临床特征及上皮细胞因子水平，并与非老年哮喘患者相比，以进一步了解其致病机制。
方法：共有1,452名成人哮喘患者从一家三级医院入组，分为2组，一组为234名老年人（初诊时≥60岁）和另一组为1,218名非老年人（初诊时<60岁）哮喘患者。比较两组哮喘相关的临床参数。通过酶联免疫吸附测定法测量血清上皮细胞来源细胞因子水平，包括白细胞介素IL-31、IL-33、IL-8，嗜酸性粒细胞趋化因子-2，转化生长因子β1（TGF-β1）和骨膜素。
结果：与非老年哮喘患者相比（为P <0.05），老年哮喘患者的晚发哮喘（发病年龄≥40岁）及重症哮喘的患病率明显较高，特应性、血液/痰嗜酸性粒细胞计数、血清总IgE及嗜酸性粒细胞阳离子蛋白水平较低。FEV1水平往往较低（P = 0.07）。此外，老年哮喘患者血清IL-33和IL-31水平较低，而血清IL-8、嗜酸性粒细胞趋化因子-2、TGF-β1及骨膜素水平无明显差异。 在老年哮喘患者中，重症哮喘患者的FEV1值较低，但血清嗜酸性粒细胞趋化因子-2和TGF-β1的水平明显高于非重症哮喘患者（P <0.05）。
结论：此研究结果表明，上皮细胞来源细胞因子年龄相关改变可能影响老年哮喘患者的临床表型及严重程度：IL-33和IL-31水平降低可能减弱Th2表型表达，然而嗜酸性粒细胞趋化因子-2和TGF-β水平升高可能增加其严重程度。
(中日友好医院呼吸与危重症医学科 张鑫 摘译 林江涛 审校)
(Allergy Asthma Immunol Res. 2019 Jan;11(1):79-89)
(Allergy Asthma Immunol Res. 2019 Jan;11(1):79-89)
Association Between Epithelial Cytokines and Clinical Phenotypes of Elderly Asthma.
Ulambayar B, Lee SH.
Abstract
PURPOSE: Asthma in the elderly has different clinical features including more severe phenotypes with higher comorbidities. Epithelial cells are known to initiate innate/adaptive immune responses in asthmatic airways. We investigated clinical features and epithelial derived cytokine levels in elderly asthmatics compared to non-elderly asthmatics in a cross-sectional cohort of adult asthmatics in order to further understand its pathogenic mechanisms.
METHODS: A total of 1,452 adult asthmatics were enrolled from a single tertiary hospital and were classified into 2 groups: 234 elderly (≥ 60 years at initial diagnosis) and 1,218 non-elderly (< 60 years at initial diagnosis) asthmatics. Asthma-related clinical parameters were compared between the 2 groups. Serum levels of epithelial cell-derived cytokines including interleukin (IL)-31, IL-33, IL-8, eotaxin-2, transforming growth factor beta 1 (TGF-β1) and periostin were measured by enzyme-linked immunosorbent assay.
RESULTS: Significantly higher prevalence rates of late-onset asthma (onset age ≥ 40 years) and severe asthma, as well as the lower rate of atopy, blood/sputum eosinophil counts, total immunoglobulin E and eosinophil cationic protein levels were noted in elderly asthmatics compared to non-elderly asthmatics (P < 0.05, respectively). The forced expiratory volume in 1 second (FEV1, % predicted) level tended to be lower in elderly asthmatics (P = 0.07). In addition, serum IL-33 and IL-31 levels were significantly lower in elderly asthmatics, while no differences were found in the serum level of IL-8, eotaxin-2, TGF-β1 or periostin. Among elderly asthmatics, subjects with severe asthma had lower FEV1 (% predicted) value, but showed significantly higher serum levels of eotaxin-2 and TGF-β1, than those with non-severe asthma (P < 0.05 for each).
CONCLUSIONS: These findings suggest that age-related changes of epithelial cell-derived cytokines may affect clinical phenotypes and severity of elderly asthma: decreased levels of IL-33 and IL-31 may contribute to less Th2 phenotype, while increased levels of eotaxin-2 and TGF-β1 may contribute to severity.
上一篇：
谷胱甘肽S-转移酶M1、T1及P1基因与早期烟雾暴露对青少年肺功能的影响
下一篇：
DNA甲基化和儿童哮喘的表观基因组Meta分析
