确诊为中度及重度哮喘前血清中IL-5，IL-6，IL-8，IL-13和IL-17A水平的变化
2019/07/11
摘要
背景：支气管哮喘（BA）是一种以持续性气道炎症为特征的复杂疾病。呼出气一氧化氮（FeNO）和外周血嗜酸性粒细胞计数（b-Eos）是2型支气管哮喘的生物学标志物。
目的：分析中度及重度哮喘患者在通过外周血嗜酸粒细胞及FeNO确诊前血清中的白介素及总免疫球蛋白E。
方法：在30名健康对照（HC）组和80名成人哮喘患者中测定血清IL-5，IL-6，IL-8，IL-13和IL-17A（ELISA）水平。 BA患者分为4组，第1组：低FeNO /低b-Eos（n = 23; 28.8％）;第2组：低FeNO /高b-Eos（n = 17; 21.3％）;第3组：高FeNO /低b-Eos（n = 15; 18.8％）;第4组：高FeNO /高b-Eos（n = 25; 31.3％）。
结果：与HC相比，BA患者的所有白细胞介素及总IgE都显着升高。 IL-5水平在第2组中最高（p <0.05）。与HC相比，第2,3和4组的IL-6，IL-13和IL-17A水平升高（p <0.05）。IL-8水平升高与当时吸烟状态相关。在频繁发作的2型哮喘组中发现IL-17A水平最高，并且大多数是难控制哮喘和重症哮喘。根据人口学、临床表现、功能指标、免疫学特点及炎症特点为基础，发现每组独一无二的特点。
结论：FeNO和b-Eos可用于确定频繁发作的重症2型哮喘亚组。 IL-5，IL-6，IL-13和IL-17A参与中度及重度哮喘中持续性的2型免疫反应。我们已经在真实临床实践中确定了难治性、重度2型/高 IL-17A水平型支气管哮喘特征。
Serum levels of IL-5, IL-6, IL-8, IL-13 and IL-17A in pre-defined
groups of adult patients with moderate and severe bronchial asthma.
Dimitrova D, Youroukova V, Ivanova-Todorova E, Tumangelova-Yuzeir K, Velikova T.
Abstract
BACKGROUND: Bronchial asthma (BA) is a complex disease characterised by persistent inflammation. Exhaled nitric oxide (FeNO) and blood eosinophil count (b-Eos) are biomarkers for type 2 endotype of BA.
OBJECTIVE: To analyse a panel of serum interleukins and total IgE in predefined by FeNO and b-Eos groups of moderate and severe BA patients.
METHODS: Serum levels of IL-5, IL-6, IL-8, IL-13 and IL-17A (ELISA) were measured in 30 healthy controls (HC) and 80 adult BA patients. BA patients were split into 4 groups. Group 1:Low FeNO/Low b-Eos (n = 23; 28.8%); Group 2:Low FeNO/High b-Eos (n = 17; 21.3%); Group 3:High FeNO/Low b-Eos (n = 15; 18.8%); Group 4:High FeNO/High b-Eos (n = 25; 31.3%).
RESULTS:All interleukins and total IgE were significantly higher in patients with BA as compared with HC. IL-5 levels were highest in Group 2 (p < 0.05). IL-6, IL-13 and IL-17A levels were elevated in Groups 2, 3 and 4 as compared with HC (p < 0.05). Higher IL-8 levelswere associated with a pattern of current smokers. Highest IL-17A levels were found in type 2 high groups with frequent exacerbations, mostly uncontrolled and severe BA. We have found a distinct pattern for each group based on demographic, clinical, functional, immunological and inflammatory characteristics.
CONCLUSION:FeNO and b-Eos are useful in the identification of severe type 2 BA subgroups with frequent exacerbations. IL-5, IL-6, IL-13 and IL-17A are involved in the persistent type 2 immune response in moderate and severe BA. We have identified a pattern of refractory, severe type 2/IL-17A high BA in the real clinical practice.
背景：支气管哮喘（BA）是一种以持续性气道炎症为特征的复杂疾病。呼出气一氧化氮（FeNO）和外周血嗜酸性粒细胞计数（b-Eos）是2型支气管哮喘的生物学标志物。
目的：分析中度及重度哮喘患者在通过外周血嗜酸粒细胞及FeNO确诊前血清中的白介素及总免疫球蛋白E。
方法：在30名健康对照（HC）组和80名成人哮喘患者中测定血清IL-5，IL-6，IL-8，IL-13和IL-17A（ELISA）水平。 BA患者分为4组，第1组：低FeNO /低b-Eos（n = 23; 28.8％）;第2组：低FeNO /高b-Eos（n = 17; 21.3％）;第3组：高FeNO /低b-Eos（n = 15; 18.8％）;第4组：高FeNO /高b-Eos（n = 25; 31.3％）。
结果：与HC相比，BA患者的所有白细胞介素及总IgE都显着升高。 IL-5水平在第2组中最高（p <0.05）。与HC相比，第2,3和4组的IL-6，IL-13和IL-17A水平升高（p <0.05）。IL-8水平升高与当时吸烟状态相关。在频繁发作的2型哮喘组中发现IL-17A水平最高，并且大多数是难控制哮喘和重症哮喘。根据人口学、临床表现、功能指标、免疫学特点及炎症特点为基础，发现每组独一无二的特点。
结论：FeNO和b-Eos可用于确定频繁发作的重症2型哮喘亚组。 IL-5，IL-6，IL-13和IL-17A参与中度及重度哮喘中持续性的2型免疫反应。我们已经在真实临床实践中确定了难治性、重度2型/高 IL-17A水平型支气管哮喘特征。
（中日友好医院呼吸与危重症医学科 张鑫 摘译 林江涛 审校）
（Respir Med. 2019 Jun 26;154:144-154）
（Respir Med. 2019 Jun 26;154:144-154）
Serum levels of IL-5, IL-6, IL-8, IL-13 and IL-17A in pre-defined
groups of adult patients with moderate and severe bronchial asthma.
Dimitrova D, Youroukova V, Ivanova-Todorova E, Tumangelova-Yuzeir K, Velikova T.
Abstract
BACKGROUND: Bronchial asthma (BA) is a complex disease characterised by persistent inflammation. Exhaled nitric oxide (FeNO) and blood eosinophil count (b-Eos) are biomarkers for type 2 endotype of BA.
OBJECTIVE: To analyse a panel of serum interleukins and total IgE in predefined by FeNO and b-Eos groups of moderate and severe BA patients.
METHODS: Serum levels of IL-5, IL-6, IL-8, IL-13 and IL-17A (ELISA) were measured in 30 healthy controls (HC) and 80 adult BA patients. BA patients were split into 4 groups. Group 1:Low FeNO/Low b-Eos (n = 23; 28.8%); Group 2:Low FeNO/High b-Eos (n = 17; 21.3%); Group 3:High FeNO/Low b-Eos (n = 15; 18.8%); Group 4:High FeNO/High b-Eos (n = 25; 31.3%).
RESULTS:All interleukins and total IgE were significantly higher in patients with BA as compared with HC. IL-5 levels were highest in Group 2 (p < 0.05). IL-6, IL-13 and IL-17A levels were elevated in Groups 2, 3 and 4 as compared with HC (p < 0.05). Higher IL-8 levelswere associated with a pattern of current smokers. Highest IL-17A levels were found in type 2 high groups with frequent exacerbations, mostly uncontrolled and severe BA. We have found a distinct pattern for each group based on demographic, clinical, functional, immunological and inflammatory characteristics.
CONCLUSION:FeNO and b-Eos are useful in the identification of severe type 2 BA subgroups with frequent exacerbations. IL-5, IL-6, IL-13 and IL-17A are involved in the persistent type 2 immune response in moderate and severe BA. We have identified a pattern of refractory, severe type 2/IL-17A high BA in the real clinical practice.
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儿童期和成人期哮喘的遗传结构区别
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