体力活动在哮喘学龄前儿童哮喘控制中的作用及其免疫调节作用
2021/09/24
摘要
背景：体力活动对免疫反应的影响是运动免疫学研究的热点，但涉及哮喘儿童的研究较少。
目的：我们的目的是检验在体力活动水平和每日看电视次数方面是否存在任何差异，评估其在哮喘控制和对各种免疫刺激物的免疫反应方面的作用。
方法：每周体力活动和每天看电视次数从Predicta研究纳入的问卷中获得。用植物血凝素(PHA)、R848、PolyI：C和酵母多糖刺激PBMC培养物。使用基于发光多重免疫荧光珠的测定法测量和量化细胞培养上清液中的一组细胞因子。
结果：哮喘学龄前儿童每天看电视的次数明显多于健康儿童(每天1-3h，58.6% vs 41.5%；≤每天1h,仅25.7% vs 47.2%)，哮喘控制不佳与较少的体力活动(PA)相关(不活动或偶尔活动，未控制组75% vs对照组20%；≥每周3次，25% vs 62%)。PA增加的哮喘患者对多克隆刺激物的反应表现出较高的细胞因子水平，这表明与PA低和看电视次数多的受试者相比，循环免疫细胞已经准备好释放1型、2型和17型细胞因子。这也可能代表了高PA哮喘儿童的促炎状态。低体力活动和高看电视率与促炎细胞因子的减少有关。哮喘儿童的体外免疫反应中促炎症细胞因子之间存在相关性，但在健康对照组中不存在，这种相关性在有久坐行为的儿童中更为明显。
结论：哮喘儿童比健康受试者表现出更多的久坐行为，而哮喘控制不佳与体力活动显著减少有关。我们的结果表明，哮喘儿童可能会从定期锻炼中受益，因为在刺激条件下细胞因子水平的升高，表明免疫系统已经准备好在不同类型的感染情况下做出强烈反应。然而，必须考虑，高PA的高炎症状态可能对哮喘儿童不利。
Physical activity in asthma control and its immune modulatory effect in asthmatic preschoolers
Debbie J Maurer, Chengyao Liu, Paraskevi Xepapadaki, Barbara Stanic, Claus Bachert, Susetta Finotto, Ya-Dong Gao, Anna Graser, Tuomas Jartti, Walter Kistler, Marek Kowalski, Heikki Lukkarinen, Maria Pasioti, Ge Tan, Michael Villiger, Luo Zhang, Nan Zhang, Mübeccel Akdis, Nikolaos G Papadopoulos, Cezmi A Akdis
Abstract
BACKGROUND:The impact of physical activity on immune response is a hot topic in exercise immunology, but studies involving asthmatic children are scarce.
OBJECTIVE:Our aims were to examine whether there were any differences in the level of physical activity and daily TV attendance, to assess its role on asthma control and immune responses to various immune stimulants.
METHODS:Weekly physical activity and daily television attendance were obtained from questionnaires at inclusion of the PreDicta study. PBMC cultures were stimulated with phytohemagglutinin (PHA), R848, poly I:C and zymosan. A panel of cytokines was measured and quantified in cell culture supernatants using luminometric multiplex immunofluorescence beads-based assay.
RESULTS:Asthmatic preschoolers showed significantly more TV attendance than their healthy peers (58.6% vs. 41.5% 1-3h daily and only 25.7% vs. 47.2% ≤ 1h daily) and poor asthma control was associated with less frequent physical activity (PA) (75% no or occasional activity in uncontrolled vs. 20% in controlled asthma; 25% ≥ 3 times weekly vs. 62%). Asthmatics with increased PA exhibited elevated cytokine levels in response to polyclonal stimulants, suggesting a readiness of circulating immune cells for type 1, 2 and 17 cytokine release compared to subjects with low PA and high TV attendance. This may also represent a proinflammatory state in high PA asthmatic children. Low physical activity and high TV attendance were associated with a decrease in proinflammatory cytokines. Proinflammatory cytokines were correlating with each other in in vitro immune responses of asthmatic children, but not healthy controls, this correlation was more pronounced in children with sedentary behavior.
CONCLUSION:Asthmatic children show more sedentary behavior than healthy subjects, while poor asthma control is associated with a substantial decrease in physical activity. Our results suggest that asthmatic children may profit from regular exercise, as elevated cytokine levels in stimulated conditions indicate an immune system prepared for responding strongly in case of different types of infections. However, it has to be considered that a hyperinflammatory state in high PA may not be beneficial in asthmatic children.
背景：体力活动对免疫反应的影响是运动免疫学研究的热点，但涉及哮喘儿童的研究较少。
目的：我们的目的是检验在体力活动水平和每日看电视次数方面是否存在任何差异，评估其在哮喘控制和对各种免疫刺激物的免疫反应方面的作用。
方法：每周体力活动和每天看电视次数从Predicta研究纳入的问卷中获得。用植物血凝素(PHA)、R848、PolyI：C和酵母多糖刺激PBMC培养物。使用基于发光多重免疫荧光珠的测定法测量和量化细胞培养上清液中的一组细胞因子。
结果：哮喘学龄前儿童每天看电视的次数明显多于健康儿童(每天1-3h，58.6% vs 41.5%；≤每天1h,仅25.7% vs 47.2%)，哮喘控制不佳与较少的体力活动(PA)相关(不活动或偶尔活动，未控制组75% vs对照组20%；≥每周3次，25% vs 62%)。PA增加的哮喘患者对多克隆刺激物的反应表现出较高的细胞因子水平，这表明与PA低和看电视次数多的受试者相比，循环免疫细胞已经准备好释放1型、2型和17型细胞因子。这也可能代表了高PA哮喘儿童的促炎状态。低体力活动和高看电视率与促炎细胞因子的减少有关。哮喘儿童的体外免疫反应中促炎症细胞因子之间存在相关性，但在健康对照组中不存在，这种相关性在有久坐行为的儿童中更为明显。
结论：哮喘儿童比健康受试者表现出更多的久坐行为，而哮喘控制不佳与体力活动显著减少有关。我们的结果表明，哮喘儿童可能会从定期锻炼中受益，因为在刺激条件下细胞因子水平的升高，表明免疫系统已经准备好在不同类型的感染情况下做出强烈反应。然而，必须考虑，高PA的高炎症状态可能对哮喘儿童不利。
(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)
(Allergy.2021 Sep 21.doi: 10.1111/all.15105.)
(Allergy.2021 Sep 21.doi: 10.1111/all.15105.)
Physical activity in asthma control and its immune modulatory effect in asthmatic preschoolers
Debbie J Maurer, Chengyao Liu, Paraskevi Xepapadaki, Barbara Stanic, Claus Bachert, Susetta Finotto, Ya-Dong Gao, Anna Graser, Tuomas Jartti, Walter Kistler, Marek Kowalski, Heikki Lukkarinen, Maria Pasioti, Ge Tan, Michael Villiger, Luo Zhang, Nan Zhang, Mübeccel Akdis, Nikolaos G Papadopoulos, Cezmi A Akdis
Abstract
BACKGROUND:The impact of physical activity on immune response is a hot topic in exercise immunology, but studies involving asthmatic children are scarce.
OBJECTIVE:Our aims were to examine whether there were any differences in the level of physical activity and daily TV attendance, to assess its role on asthma control and immune responses to various immune stimulants.
METHODS:Weekly physical activity and daily television attendance were obtained from questionnaires at inclusion of the PreDicta study. PBMC cultures were stimulated with phytohemagglutinin (PHA), R848, poly I:C and zymosan. A panel of cytokines was measured and quantified in cell culture supernatants using luminometric multiplex immunofluorescence beads-based assay.
RESULTS:Asthmatic preschoolers showed significantly more TV attendance than their healthy peers (58.6% vs. 41.5% 1-3h daily and only 25.7% vs. 47.2% ≤ 1h daily) and poor asthma control was associated with less frequent physical activity (PA) (75% no or occasional activity in uncontrolled vs. 20% in controlled asthma; 25% ≥ 3 times weekly vs. 62%). Asthmatics with increased PA exhibited elevated cytokine levels in response to polyclonal stimulants, suggesting a readiness of circulating immune cells for type 1, 2 and 17 cytokine release compared to subjects with low PA and high TV attendance. This may also represent a proinflammatory state in high PA asthmatic children. Low physical activity and high TV attendance were associated with a decrease in proinflammatory cytokines. Proinflammatory cytokines were correlating with each other in in vitro immune responses of asthmatic children, but not healthy controls, this correlation was more pronounced in children with sedentary behavior.
CONCLUSION:Asthmatic children show more sedentary behavior than healthy subjects, while poor asthma control is associated with a substantial decrease in physical activity. Our results suggest that asthmatic children may profit from regular exercise, as elevated cytokine levels in stimulated conditions indicate an immune system prepared for responding strongly in case of different types of infections. However, it has to be considered that a hyperinflammatory state in high PA may not be beneficial in asthmatic children.
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哮喘的不同表型：临床发现和实验动物模型
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呼出气一氧化氮与哮喘和常年性致敏相关的上呼吸道炎症性疾病相关性的横断面研究
