高血清TSLP是迟发型、长病程嗜酸性粒细胞性哮喘的特征
2025/10/31
摘要
背景：胸腺基质淋巴生成素（TSLP）是2型免疫应答的主要调节因子；然而，血清TSLP与成人哮喘特征之间的关系尚未完全阐明。本研究的目的是确定成人哮喘高血清TSLP的特征，并探讨TSLP与晚发性嗜酸性哮喘表型的关系。
方法：使用TNH-Azma研究（日本30家医院1344例哮喘患者的真实世界观察队列研究）的基线数据并测量血清细胞因子。根据血清TSLP基线水平将患者分为四分位数组，并比较其临床特征。多变量回归分析用于确定与血清TSLP和与晚发型嗜酸性哮喘表型相关的细胞因子相关的临床变量。
结果：TSLP -高哮喘患者年龄大、发病晚、嗜酸性、特应性较轻；身体质量指数更高；吸烟史较多；更多的哮喘-慢性阻塞性肺病重叠，睡眠呼吸暂停综合征（SAS），高血压和心脏病。他们还表现出较低的肺功能，哮喘症状更严重，并且更频繁地口服皮质类固醇。经年龄和性别校正后的多变量回归分析显示，高TSLP水平与哮喘发病晚、哮喘持续时间长、高血压、血嗜酸性粒细胞升高、BMI、吸烟史、使用生物制剂、SAS和高Fres呈正相关，与花粉症呈负相关。在血清细胞因子中，TSLP与晚发性嗜酸性哮喘的相关性最强。
结论：高血清TSLP是晚发、长病程、嗜酸性哮喘的显著特征。具有这一特征的哮喘患者可能是特定哮喘治疗的独特目标人群。
背景：胸腺基质淋巴生成素（TSLP）是2型免疫应答的主要调节因子；然而，血清TSLP与成人哮喘特征之间的关系尚未完全阐明。本研究的目的是确定成人哮喘高血清TSLP的特征，并探讨TSLP与晚发性嗜酸性哮喘表型的关系。
方法：使用TNH-Azma研究（日本30家医院1344例哮喘患者的真实世界观察队列研究）的基线数据并测量血清细胞因子。根据血清TSLP基线水平将患者分为四分位数组，并比较其临床特征。多变量回归分析用于确定与血清TSLP和与晚发型嗜酸性哮喘表型相关的细胞因子相关的临床变量。
结果：TSLP -高哮喘患者年龄大、发病晚、嗜酸性、特应性较轻；身体质量指数更高；吸烟史较多；更多的哮喘-慢性阻塞性肺病重叠，睡眠呼吸暂停综合征（SAS），高血压和心脏病。他们还表现出较低的肺功能，哮喘症状更严重，并且更频繁地口服皮质类固醇。经年龄和性别校正后的多变量回归分析显示，高TSLP水平与哮喘发病晚、哮喘持续时间长、高血压、血嗜酸性粒细胞升高、BMI、吸烟史、使用生物制剂、SAS和高Fres呈正相关，与花粉症呈负相关。在血清细胞因子中，TSLP与晚发性嗜酸性哮喘的相关性最强。
结论：高血清TSLP是晚发、长病程、嗜酸性哮喘的显著特征。具有这一特征的哮喘患者可能是特定哮喘治疗的独特目标人群。
（北京朝阳医院呼吸与危重症医学科 顾宪民 摘译）
（中日友好医院呼吸与危重症医学科 林江涛 审校）
（Allergy. 2025 Oct 21. doi: 10.1111/all.70109.）
（中日友好医院呼吸与危重症医学科 林江涛 审校）
（Allergy. 2025 Oct 21. doi: 10.1111/all.70109.）
High Serum TSLP Is Characteristic of Late-Onset, Long-Duration, Eosinophilic Asthma
Maho Suzukawa, Ken Ohta, Hiroyuki Tashimo, Osamu Narumoto, Hiroya Hashimoto, Toshiyuki Kita, Hazuki Takato, Hiroyuki Nagase, Konomi Kobayashi, Masao Yamaguchi, Masahiro Abe, Ryoji Ito, Takeo Endo, Hidetoshi Yanai, Kenji Chibana, Nobuyuki Hizawa, Yasushi Tanimoto, Koichi Takagi, Tsuyoshi Oguma, Norihiro Harada, Hironori Sagara, Aika Kato, Shohei Takata, Yuko Komase, Kentaro Hyodo, Kazuto Matsunaga, Kazuyuki Tsujino, Akio Niimi, Kentaro Wakamatsu, Hisatoshi Sugiura, Yumi Sakakibara, Mitsuhiro Kamimura, Yoko Shibata, Goh Tanaka, Keitaro Nakamoto, Shinji Tamaki, Yoshiaki Minakata, Takanori Numata, Akiko M Saito, Nobuyuki Kobayashi, Masami Taniguchi; TNH‐Azma Research Group (TARG)
Abstract
Background: Thymic stromal lymphopoietin (TSLP) is a master regulator of type 2 immune responses; however, the associations between serum TSLP and the characteristics of adult asthma have not been fully clarified. The aim of this study was to determine the characteristics of adult asthma with high serum TSLP and explore TSLP's association with the late-onset eosinophilic asthma phenotype.
Methods: Baseline data of the TNH-Azma study (a real-world observational cohort study conducted in Japan on 1344 patients with asthma from 30 hospitals) was used and serum cytokines were measured. Patients were stratified into quartile groups based on the baseline serum TSLP levels, and their clinical characteristics were compared. Multivariable regression analyses were used to determine clinical variables associated with serum TSLP and cytokines associated with the late-onset eosinophilic asthma phenotype.
Results: Patients with TSLP-high asthma were older, late-onset, eosinophilic, and less atopic; had a higher BMI; more smoking history; and more asthma-COPD overlap, sleep apnea syndrome (SAS), hypertension, and heart disease. They also exhibited lower lung function with worse asthma symptoms and were more frequently on oral corticosteroids. Multivariable regression analyses adjusted for age and sex demonstrated that a high TSLP level was positively associated with later asthma onset, longer asthma duration, hypertension, higher blood eosinophils, BMI, smoking history, use of biologics, SAS, and high Fres, and was negatively associated with pollinosis. Among the serum cytokines, TSLP exhibited the strongest association with late-onset, eosinophilic asthma.
Conclusion: High serum TSLP is a distinctive feature of late-onset, long-duration, eosinophilic asthma. Patients with asthma with this feature may be a unique target population for specific asthma therapy.
Maho Suzukawa, Ken Ohta, Hiroyuki Tashimo, Osamu Narumoto, Hiroya Hashimoto, Toshiyuki Kita, Hazuki Takato, Hiroyuki Nagase, Konomi Kobayashi, Masao Yamaguchi, Masahiro Abe, Ryoji Ito, Takeo Endo, Hidetoshi Yanai, Kenji Chibana, Nobuyuki Hizawa, Yasushi Tanimoto, Koichi Takagi, Tsuyoshi Oguma, Norihiro Harada, Hironori Sagara, Aika Kato, Shohei Takata, Yuko Komase, Kentaro Hyodo, Kazuto Matsunaga, Kazuyuki Tsujino, Akio Niimi, Kentaro Wakamatsu, Hisatoshi Sugiura, Yumi Sakakibara, Mitsuhiro Kamimura, Yoko Shibata, Goh Tanaka, Keitaro Nakamoto, Shinji Tamaki, Yoshiaki Minakata, Takanori Numata, Akiko M Saito, Nobuyuki Kobayashi, Masami Taniguchi; TNH‐Azma Research Group (TARG)
Abstract
Background: Thymic stromal lymphopoietin (TSLP) is a master regulator of type 2 immune responses; however, the associations between serum TSLP and the characteristics of adult asthma have not been fully clarified. The aim of this study was to determine the characteristics of adult asthma with high serum TSLP and explore TSLP's association with the late-onset eosinophilic asthma phenotype.
Methods: Baseline data of the TNH-Azma study (a real-world observational cohort study conducted in Japan on 1344 patients with asthma from 30 hospitals) was used and serum cytokines were measured. Patients were stratified into quartile groups based on the baseline serum TSLP levels, and their clinical characteristics were compared. Multivariable regression analyses were used to determine clinical variables associated with serum TSLP and cytokines associated with the late-onset eosinophilic asthma phenotype.
Results: Patients with TSLP-high asthma were older, late-onset, eosinophilic, and less atopic; had a higher BMI; more smoking history; and more asthma-COPD overlap, sleep apnea syndrome (SAS), hypertension, and heart disease. They also exhibited lower lung function with worse asthma symptoms and were more frequently on oral corticosteroids. Multivariable regression analyses adjusted for age and sex demonstrated that a high TSLP level was positively associated with later asthma onset, longer asthma duration, hypertension, higher blood eosinophils, BMI, smoking history, use of biologics, SAS, and high Fres, and was negatively associated with pollinosis. Among the serum cytokines, TSLP exhibited the strongest association with late-onset, eosinophilic asthma.
Conclusion: High serum TSLP is a distinctive feature of late-onset, long-duration, eosinophilic asthma. Patients with asthma with this feature may be a unique target population for specific asthma therapy.
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