维持吸入糖皮质激素对哮喘患者SARS-CoV-2受体ACE2的上调作用
2021/07/28
摘要
背景：SARS-CoV-2感染的第一步是病毒与气道上皮血管紧张素转换酶2(ACE2)的结合。哮喘影响了全球超3亿人，其中许多人可能会感染SARS-CoV-2。流行病学数据表明，被感染的哮喘患者患更严重疾病的风险可能会增加。
目的：我们的目的是评估哮喘的主要治疗方法——维持吸入糖皮质激素(ICS)是否与哮喘患者气道ACE2表达有关。
方法：采用微阵列技术对维持吸入糖皮质激素治疗的哮喘患者(ICS+)、未接受ICS治疗的哮喘患者(ICS-)和健康对照组(对照组)的大气道上皮(LAE)中ACE2和其他冠状病毒感染相关基因的表达进行分析。
结果：作为一个组，所有哮喘患者与对照组 LAE ACE2 表达无差异。相反，亚组分析显示，哮喘患者 ICS +中的 LAE ACE2 表达高于ICS-，男性 ICS+中的ACE2 表达高于女性 ICS+和任一性别的ICS-。在ICS-或ICS+中，ACE2的表达与血清IgE、绝对嗜酸性粒细胞水平或FEV1对支气管扩张剂的反应均无相关性。
结论：长期使用ICS治疗的哮喘患者气道ACE2的表达增加，在评估大流行期间吸入性皮质类固醇的使用时应考虑这一观察结果。
Up-regulation of ACE2, the SARS-CoV-2 receptor, in asthmatics on maintenance inhaled corticosteroids
Sarah L O'Beirne, Jacqueline Salit, Robert J Kaner, Ronald G Crystal, Yael Strulovici-Barel
Abstract
BACKGROUND:The first step in SARS-CoV-2 infection is binding of the virus to angiotensin converting enzyme 2 (ACE2) on the airway epithelium. Asthma affects over 300 million people world-wide, many of whom may encounter SARS-CoV-2. Epidemiologic data suggests that asthmatics who get infected may be at increased risk of more severe disease.
OBJECTIVE:Our objective was to assess whether maintenance inhaled corticosteroids (ICS), a major treatment for asthma, is associated with airway ACE2 expression in asthmatics.
METHODS: Large airway epithelium (LAE) of asthmatics treated with maintenance ICS (ICS+), asthmatics not treated with ICS (ICS-), and healthy controls (controls) was analyzed for expression of ACE2 and other coronavirus infection-related genes using microarrays.
RESULTS:As a group, there was no difference in LAE ACE2 expression in all asthmatics vs controls. In contrast, subgroup analysis demonstrated that LAE ACE2 expression was higher in asthmatics ICS+ compared to ICS‾ and ACE2 expression was higher in male ICS+ compared to female ICS+ and ICS‾ of either sex. ACE2 expression did not correlate with serum IgE, absolute eosinophil level, or change in FEV1 in response to bronchodilators in either ICS- or ICS+.
CONCLUSION:Airway ACE2 expression is increased in asthmatics on long-term treatment with ICS, an observation that should be taken into consideration when assessing the use of inhaled corticosteroids during the pandemic.
背景：SARS-CoV-2感染的第一步是病毒与气道上皮血管紧张素转换酶2(ACE2)的结合。哮喘影响了全球超3亿人，其中许多人可能会感染SARS-CoV-2。流行病学数据表明，被感染的哮喘患者患更严重疾病的风险可能会增加。
目的：我们的目的是评估哮喘的主要治疗方法——维持吸入糖皮质激素(ICS)是否与哮喘患者气道ACE2表达有关。
方法：采用微阵列技术对维持吸入糖皮质激素治疗的哮喘患者(ICS+)、未接受ICS治疗的哮喘患者(ICS-)和健康对照组(对照组)的大气道上皮(LAE)中ACE2和其他冠状病毒感染相关基因的表达进行分析。
结果：作为一个组，所有哮喘患者与对照组 LAE ACE2 表达无差异。相反，亚组分析显示，哮喘患者 ICS +中的 LAE ACE2 表达高于ICS-，男性 ICS+中的ACE2 表达高于女性 ICS+和任一性别的ICS-。在ICS-或ICS+中，ACE2的表达与血清IgE、绝对嗜酸性粒细胞水平或FEV1对支气管扩张剂的反应均无相关性。
结论：长期使用ICS治疗的哮喘患者气道ACE2的表达增加，在评估大流行期间吸入性皮质类固醇的使用时应考虑这一观察结果。
(中日友好医院呼吸与危重症医学科 王静茹 摘译 林江涛 审校)
(Respir Res. 2021 Jul 7;22(1):200. doi: 10.1186/s12931-021-01782-0.)
(Respir Res. 2021 Jul 7;22(1):200. doi: 10.1186/s12931-021-01782-0.)
Up-regulation of ACE2, the SARS-CoV-2 receptor, in asthmatics on maintenance inhaled corticosteroids
Sarah L O'Beirne, Jacqueline Salit, Robert J Kaner, Ronald G Crystal, Yael Strulovici-Barel
Abstract
BACKGROUND:The first step in SARS-CoV-2 infection is binding of the virus to angiotensin converting enzyme 2 (ACE2) on the airway epithelium. Asthma affects over 300 million people world-wide, many of whom may encounter SARS-CoV-2. Epidemiologic data suggests that asthmatics who get infected may be at increased risk of more severe disease.
OBJECTIVE:Our objective was to assess whether maintenance inhaled corticosteroids (ICS), a major treatment for asthma, is associated with airway ACE2 expression in asthmatics.
METHODS: Large airway epithelium (LAE) of asthmatics treated with maintenance ICS (ICS+), asthmatics not treated with ICS (ICS-), and healthy controls (controls) was analyzed for expression of ACE2 and other coronavirus infection-related genes using microarrays.
RESULTS:As a group, there was no difference in LAE ACE2 expression in all asthmatics vs controls. In contrast, subgroup analysis demonstrated that LAE ACE2 expression was higher in asthmatics ICS+ compared to ICS‾ and ACE2 expression was higher in male ICS+ compared to female ICS+ and ICS‾ of either sex. ACE2 expression did not correlate with serum IgE, absolute eosinophil level, or change in FEV1 in response to bronchodilators in either ICS- or ICS+.
CONCLUSION:Airway ACE2 expression is increased in asthmatics on long-term treatment with ICS, an observation that should be taken into consideration when assessing the use of inhaled corticosteroids during the pandemic.
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基层医疗中哮喘和COPD客观检测的障碍和促成因素：一项使用理论领域框架的系统综述
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定义重症哮喘超级应答者：基于德尔菲法的发现
