哮喘急性发作期间外周血Th2细胞标记物升高
2020/08/20
摘要
背景;过敏性哮喘是一种Th2型炎症反应。已知重症哮喘和急性发作哮喘患者Th2型炎症反应增强。然而，尚不清楚Th2型免疫反应增强是否会引起哮喘急性发作。本研究的目的是确定因哮喘急性发作急诊就诊的患者Th2型免疫指标水平，并分析这些指标与临床及生理指标的相关性。
方法：签署知情同意后，共计16名因哮喘急性发作急诊就诊的患者入组。10名患者两周后返回随访。两次访问期间均收集生理参数、哮喘控制情况（ACQ6）、哮喘生活质量问卷（AQLQ）及静脉血。利用全血流式细胞术进行免疫细胞谱分析：CD4+ T细胞、Th2细胞（CD4+ CRTh2 + T细胞数目和表达CRTh2占CD4 + T细胞百分比），嗜酸性粒细胞和固有淋巴细胞（ILC2）。
结果：在急性发作期间，外周血Th2细胞数量与ACQ6及AQLQ评分具有相关性，而与ILC2及嗜酸性粒细胞数量无相关性。 与随访者相比，急性加重患者表达CRTh2的CD4 + T细胞百分比较高，FEV1较差。 在随访期间观察到的表达CRTh2的CD4 + T细胞百分比的降低与肺功能改善水平具有相关性。
结论：这些数据表明，外周血中的Th2细胞可以作为哮喘急性发作患者症状加重的敏感指标，同时可以作为哮喘急性发作的生物标志物。
Th2 cell markers in peripheral blood increase during an acute asthma exacerbation
Nami Shrestha Palikhe , Yingqi Wu , Emily Konrad , Vivek Dipak Gandhi , Brian H Rowe , Harissios Vliagoftis , Lisa Cameron
Abstract
Background: Allergic asthma is characterized by type 2 inflammation. We have shown the presence of increased type 2 inflammation in patients with severe asthma and those with frequent exacerbations. However, it is not known whether increased type 2 inflammation drives asthma exacerbations. This study aims to determine Th2 immune parameters in patients presenting to the emergency department (ED) with an acute asthma exacerbation and correlate these parameters with clinical and physiological measures of asthma.
Methods: Sixteen adults presenting to the ED with acute asthma exacerbations were recruited after giving informed consent. Ten patients returned two weeks later for follow-up. Physiological parameters, asthma control (ACQ6), asthma quality of life (AQLQ) questionnaires, and venous blood were collected during both visits. An immune cell profiling was performed by whole blood flow cytometry: CD4+ T cells, Th2 cells (CD4+ CRTh2+ T cells and % of CD4+ T cells expressing CRTh2), eosinophils and innate lymphoid cells (ILC2).
Results: During exacerbation, peripheral blood Th2 cell numbers correlated with ACQ6 and AQLQ scores, while ILC2 and eosinophil numbers did not. Subjects had higher % of CD4+ T cells expressing CRTh2 and worse FEV1 during exacerbation compared to the follow-up. The decrease in the % of CD4+ T cells expressing CRTh2 seen during the follow up visit correlated with the improvement in lung function.
Conclusions: These data suggest that Th2 cells in peripheral blood may be a sensitive measure of increasing symptoms in patients with asthma exacerbations and may serve as a biomarker of an asthma exacerbation
背景;过敏性哮喘是一种Th2型炎症反应。已知重症哮喘和急性发作哮喘患者Th2型炎症反应增强。然而，尚不清楚Th2型免疫反应增强是否会引起哮喘急性发作。本研究的目的是确定因哮喘急性发作急诊就诊的患者Th2型免疫指标水平，并分析这些指标与临床及生理指标的相关性。
方法：签署知情同意后，共计16名因哮喘急性发作急诊就诊的患者入组。10名患者两周后返回随访。两次访问期间均收集生理参数、哮喘控制情况（ACQ6）、哮喘生活质量问卷（AQLQ）及静脉血。利用全血流式细胞术进行免疫细胞谱分析：CD4+ T细胞、Th2细胞（CD4+ CRTh2 + T细胞数目和表达CRTh2占CD4 + T细胞百分比），嗜酸性粒细胞和固有淋巴细胞（ILC2）。
结果：在急性发作期间，外周血Th2细胞数量与ACQ6及AQLQ评分具有相关性，而与ILC2及嗜酸性粒细胞数量无相关性。 与随访者相比，急性加重患者表达CRTh2的CD4 + T细胞百分比较高，FEV1较差。 在随访期间观察到的表达CRTh2的CD4 + T细胞百分比的降低与肺功能改善水平具有相关性。
结论：这些数据表明，外周血中的Th2细胞可以作为哮喘急性发作患者症状加重的敏感指标，同时可以作为哮喘急性发作的生物标志物。
（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. 2020 Aug 4. doi: 10.1111/all.14543. Online ahead of print.）
（Allergy. 2020 Aug 4. doi: 10.1111/all.14543. Online ahead of print.）
Th2 cell markers in peripheral blood increase during an acute asthma exacerbation
Nami Shrestha Palikhe , Yingqi Wu , Emily Konrad , Vivek Dipak Gandhi , Brian H Rowe , Harissios Vliagoftis , Lisa Cameron
Abstract
Background: Allergic asthma is characterized by type 2 inflammation. We have shown the presence of increased type 2 inflammation in patients with severe asthma and those with frequent exacerbations. However, it is not known whether increased type 2 inflammation drives asthma exacerbations. This study aims to determine Th2 immune parameters in patients presenting to the emergency department (ED) with an acute asthma exacerbation and correlate these parameters with clinical and physiological measures of asthma.
Methods: Sixteen adults presenting to the ED with acute asthma exacerbations were recruited after giving informed consent. Ten patients returned two weeks later for follow-up. Physiological parameters, asthma control (ACQ6), asthma quality of life (AQLQ) questionnaires, and venous blood were collected during both visits. An immune cell profiling was performed by whole blood flow cytometry: CD4+ T cells, Th2 cells (CD4+ CRTh2+ T cells and % of CD4+ T cells expressing CRTh2), eosinophils and innate lymphoid cells (ILC2).
Results: During exacerbation, peripheral blood Th2 cell numbers correlated with ACQ6 and AQLQ scores, while ILC2 and eosinophil numbers did not. Subjects had higher % of CD4+ T cells expressing CRTh2 and worse FEV1 during exacerbation compared to the follow-up. The decrease in the % of CD4+ T cells expressing CRTh2 seen during the follow up visit correlated with the improvement in lung function.
Conclusions: These data suggest that Th2 cells in peripheral blood may be a sensitive measure of increasing symptoms in patients with asthma exacerbations and may serve as a biomarker of an asthma exacerbation
上一篇：
一项产前维生素D平喘试验的六年随访
下一篇：
控制良好的哮喘降级治疗期间作为哮喘发作预测因子的2型气道炎症生物标志物：长效β受体激动剂降级研究（LASST）
