重度哮喘合并支气管扩张患者痰中TGFβ1、VEGF和IFN-γ升高
2024/06/26
摘要
背景：支气管扩张症是重度哮喘最常见的合并症之一。然而，哮喘促进这种疾病发生和进展的机制尚不明确。本研究旨在分析伴和不伴支气管扩张的哮喘患者的炎症表型，并量化促炎和重塑细胞因子的表达。
方法：研究对象包括55例重度哮喘合并支气管扩张患者(AB组)和45例无支气管扩张的重度哮喘患者(AC组)。采集诱导痰标本，通过细胞分类计数确定细胞类型。采用免疫组织化学法检测痰上清液中促炎和支气管重塑细胞因子(IL-8、中性粒细胞弹性蛋白酶、TGFβ1、VEGF、IFN-γ、TNF-α、GM-CSF)水平。
结果：两组哮喘患者均以中性粒细胞性炎症为主。哮喘合并支气管扩张患者(AB组)的TGFβ1、VEGF和IFN-γ水平显著高于对照组(15 vs 24pg/ml, p=0.014;183 vs 272pg/ml, p=0.048;0.85 vs 19pg/ml, p<0.001)。AB组的粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平显著低于AC组(1.2 vs 4.4pg/ml, p<0.001)。IL-8、中性粒细胞弹性蛋白酶和TNF-α在各组间差异无统计学意义。
结论：TGFβ1和VEGF细胞因子水平升高可能提示哮喘合并支气管扩张患者气道重塑激活。哮喘患者的炎症类型没有因有无支气管扩张而异。
Increased TGFβ1, VEGF and IFN-γ in the Sputum of Severe Asthma Patients With Bronchiectasis
Donghai Ma, Xavier Muñoz, Iñigo Ojanguren, Christian Romero-Mesones, David Soler-Segovia, Diego Varona-Porres, María-Jesús Cruz
Abstract
Background: Bronchiectasis is one of the most common comorbidities in severe asthma. However, the mechanisms by which asthma promotes the development and progress of this condition are not well defined. This study aimed to analyze the inflammatory phenotypes and quantify the expression of proinflammatory and remodeling cytokines in asthma patients with and without bronchiectasis.
Methods: The study sample comprised individuals with severe asthma and bronchiectasis (group AB, n=55) and a control population of individuals with severe asthma without bronchiectasis (group AC, n=45). Induced sputum samples were obtained and cell types determined by differential cell count. Proinflammatory and bronchial remodeling cytokines (IL-8, neutrophilic elastase, TGFβ1, VEGF, IFN-γ, TNF-α, and GM-CSF) were analyzed by immunoassay in sputum supernatant.
Results: Neutrophilic inflammation was the primary phenotype in both asthma groups. Higher levels of TGFβ1, VEGF and IFN-γ were observed in asthma patients with bronchiectasis (group AB) than in controls (group AC) (15 vs 24pg/ml, p=0.014; 183 vs 272pg/ml, p=0.048; 0.85 vs 19pg/ml, p<0.001, respectively). Granulocyte-macrophage colony-stimulating factor (GM-CSF) levels were significantly lower in the AB group than in the AC group (1.2 vs 4.4pg/ml, p<0.001). IL-8, neutrophil elastase and TNF-α did not present significant differences between the groups.
Conclusions: Raised levels of TGFβ1 and VEGF cytokines may indicate airway remodeling activation in asthma patients with bronchiectasis. The type of inflammation in asthma patients did not differ according to the presence or absence of bronchiectasis.
背景：支气管扩张症是重度哮喘最常见的合并症之一。然而，哮喘促进这种疾病发生和进展的机制尚不明确。本研究旨在分析伴和不伴支气管扩张的哮喘患者的炎症表型，并量化促炎和重塑细胞因子的表达。
方法：研究对象包括55例重度哮喘合并支气管扩张患者(AB组)和45例无支气管扩张的重度哮喘患者(AC组)。采集诱导痰标本，通过细胞分类计数确定细胞类型。采用免疫组织化学法检测痰上清液中促炎和支气管重塑细胞因子(IL-8、中性粒细胞弹性蛋白酶、TGFβ1、VEGF、IFN-γ、TNF-α、GM-CSF)水平。
结果：两组哮喘患者均以中性粒细胞性炎症为主。哮喘合并支气管扩张患者(AB组)的TGFβ1、VEGF和IFN-γ水平显著高于对照组(15 vs 24pg/ml, p=0.014;183 vs 272pg/ml, p=0.048;0.85 vs 19pg/ml, p<0.001)。AB组的粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平显著低于AC组(1.2 vs 4.4pg/ml, p<0.001)。IL-8、中性粒细胞弹性蛋白酶和TNF-α在各组间差异无统计学意义。
结论：TGFβ1和VEGF细胞因子水平升高可能提示哮喘合并支气管扩张患者气道重塑激活。哮喘患者的炎症类型没有因有无支气管扩张而异。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Arch Bronconeumol. 2024 Jun 7:S0300-2896(24)00221-7. doi: 10.1016/j.arbres.2024.05.036.)
(Arch Bronconeumol. 2024 Jun 7:S0300-2896(24)00221-7. doi: 10.1016/j.arbres.2024.05.036.)
Increased TGFβ1, VEGF and IFN-γ in the Sputum of Severe Asthma Patients With Bronchiectasis
Donghai Ma, Xavier Muñoz, Iñigo Ojanguren, Christian Romero-Mesones, David Soler-Segovia, Diego Varona-Porres, María-Jesús Cruz
Abstract
Background: Bronchiectasis is one of the most common comorbidities in severe asthma. However, the mechanisms by which asthma promotes the development and progress of this condition are not well defined. This study aimed to analyze the inflammatory phenotypes and quantify the expression of proinflammatory and remodeling cytokines in asthma patients with and without bronchiectasis.
Methods: The study sample comprised individuals with severe asthma and bronchiectasis (group AB, n=55) and a control population of individuals with severe asthma without bronchiectasis (group AC, n=45). Induced sputum samples were obtained and cell types determined by differential cell count. Proinflammatory and bronchial remodeling cytokines (IL-8, neutrophilic elastase, TGFβ1, VEGF, IFN-γ, TNF-α, and GM-CSF) were analyzed by immunoassay in sputum supernatant.
Results: Neutrophilic inflammation was the primary phenotype in both asthma groups. Higher levels of TGFβ1, VEGF and IFN-γ were observed in asthma patients with bronchiectasis (group AB) than in controls (group AC) (15 vs 24pg/ml, p=0.014; 183 vs 272pg/ml, p=0.048; 0.85 vs 19pg/ml, p<0.001, respectively). Granulocyte-macrophage colony-stimulating factor (GM-CSF) levels were significantly lower in the AB group than in the AC group (1.2 vs 4.4pg/ml, p<0.001). IL-8, neutrophil elastase and TNF-α did not present significant differences between the groups.
Conclusions: Raised levels of TGFβ1 and VEGF cytokines may indicate airway remodeling activation in asthma patients with bronchiectasis. The type of inflammation in asthma patients did not differ according to the presence or absence of bronchiectasis.
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通过生物信息学分析和机器学习识别哮喘和抑郁症的共同潜在诊断标志物
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严重哮喘生物疗法的安全性：WHO药物警戒数据库中报告的疑似不良反应分析
