血清IL-17水平和诱导痰中性粒细胞百分比的升高与成人严重的早发型哮喘相关
2021/07/28
摘要
背景:成年严重早发和晚发哮喘患者之间的差异尚未得到充分研究。
目的:确定严重哮喘患者发病年龄的表型差异。
方法:本研究纳入32例严重早发型哮喘患者(发病年龄12岁)。严重哮喘的定义是根据全球哮喘倡议的标准。收集临床、肺活量和实验室参数进行组间比较。
结果:纳入64例患者(平均年龄46.22±13.90岁;预测1秒用力呼气量(FEV1)的平均百分比为68.43±20.55%。重度早发性哮喘患者较重度晚发性哮喘患者年龄更小、哮喘持续时间更长、家族史发生率更高、小气道功能(MEF25%和MMEF75/25%)更好。严重早发型哮喘患者血清IL-17水平和痰中性粒细胞百分比显著升高(P=0.016、0.033)。多因素logistic回归分析显示，血清IL-17水平升高(比值比=1.065,P=0.016)与严重早发型哮喘独立相关。结合血清IL-17和痰中性粒细胞百分比，鉴别严重早期哮喘患者的敏感性为80.0%，特异性为86.7%。
结论:严重早发型哮喘患者血清IL-17水平和痰中性粒细胞百分比升高，提示其可能与严重早发型哮喘的发病机制有关。
Increased levels of serum IL-17 and induced sputum neutrophil percentage are associated with severe early-onset asthma in adults
Chen D, Zhang Y, Yao C, et al.
Abstract
BACKGROUND:Differences between adult patients with severe early-onset and late-onset asthma have not been well studied.
OBJECTIVE: To determine the phenotypic distinction regarding age at onset in patients with severe asthma.
METHODS: The present study enrolled thirty-two patients with severe early-onset (onset age 12 years) asthma. Severe asthma was defined according to Global Initiative for Asthma criteria. The clinical, spirometric, and laboratory parameters were collected for group comparisons.
RESULTS:Among the 64 patients included (mean age, 46.22±13.90 years; 53.1% male), the mean percent of predicted forced expiratory volume in 1 s (FEV1) was 68.43±20.55%. Patients with severe early-onset asthma had a younger age, longer duration of asthma, higher rate of family history, and better small-airway function (MEF25% and MMEF75/25%) compared with severe late-onset asthma. Furthermore, levels of serum IL-17 and sputum neutrophil percentage were significantly higher for patients with severe early-onset asthma (P=0.016, 0.033, respectively). Multiple logistic regression analysis revealed that increased serum IL-17 (odds ratio=1.065, P=0.016) was independently associated with severe early-onset asthma. The combination of serum IL-17 and sputum neutrophil percentage yielded a sensitivity of 80.0% and a specificity of 86.7% for identifying patients with severe early-onset asthma.
CONCLUSIONS: Patients with severe early-onset asthma exhibit elevated levels of serum IL-17 and sputum neutrophil percentage, suggesting a potential role in the pathogenesis of severe early-onset phenotype.
背景:成年严重早发和晚发哮喘患者之间的差异尚未得到充分研究。
目的:确定严重哮喘患者发病年龄的表型差异。
方法:本研究纳入32例严重早发型哮喘患者(发病年龄12岁)。严重哮喘的定义是根据全球哮喘倡议的标准。收集临床、肺活量和实验室参数进行组间比较。
结果:纳入64例患者(平均年龄46.22±13.90岁;预测1秒用力呼气量(FEV1)的平均百分比为68.43±20.55%。重度早发性哮喘患者较重度晚发性哮喘患者年龄更小、哮喘持续时间更长、家族史发生率更高、小气道功能(MEF25%和MMEF75/25%)更好。严重早发型哮喘患者血清IL-17水平和痰中性粒细胞百分比显著升高(P=0.016、0.033)。多因素logistic回归分析显示，血清IL-17水平升高(比值比=1.065,P=0.016)与严重早发型哮喘独立相关。结合血清IL-17和痰中性粒细胞百分比，鉴别严重早期哮喘患者的敏感性为80.0%，特异性为86.7%。
结论:严重早发型哮喘患者血清IL-17水平和痰中性粒细胞百分比升高，提示其可能与严重早发型哮喘的发病机制有关。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Allergy Asthma Clin Immunol, 2021, 17(1): 64.）
（Allergy Asthma Clin Immunol, 2021, 17(1): 64.）
Increased levels of serum IL-17 and induced sputum neutrophil percentage are associated with severe early-onset asthma in adults
Chen D, Zhang Y, Yao C, et al.
Abstract
BACKGROUND:Differences between adult patients with severe early-onset and late-onset asthma have not been well studied.
OBJECTIVE: To determine the phenotypic distinction regarding age at onset in patients with severe asthma.
METHODS: The present study enrolled thirty-two patients with severe early-onset (onset age 12 years) asthma. Severe asthma was defined according to Global Initiative for Asthma criteria. The clinical, spirometric, and laboratory parameters were collected for group comparisons.
RESULTS:Among the 64 patients included (mean age, 46.22±13.90 years; 53.1% male), the mean percent of predicted forced expiratory volume in 1 s (FEV1) was 68.43±20.55%. Patients with severe early-onset asthma had a younger age, longer duration of asthma, higher rate of family history, and better small-airway function (MEF25% and MMEF75/25%) compared with severe late-onset asthma. Furthermore, levels of serum IL-17 and sputum neutrophil percentage were significantly higher for patients with severe early-onset asthma (P=0.016, 0.033, respectively). Multiple logistic regression analysis revealed that increased serum IL-17 (odds ratio=1.065, P=0.016) was independently associated with severe early-onset asthma. The combination of serum IL-17 and sputum neutrophil percentage yielded a sensitivity of 80.0% and a specificity of 86.7% for identifying patients with severe early-onset asthma.
CONCLUSIONS: Patients with severe early-onset asthma exhibit elevated levels of serum IL-17 and sputum neutrophil percentage, suggesting a potential role in the pathogenesis of severe early-onset phenotype.
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成年患者自我相关依从性、哮喘相关生活质量与哮喘控制的相关性
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中重度哮喘患者发作病史对dupilumab临床疗效的影响
