儿童哮喘气道炎症和气道重塑的无创性标记物
2010/02/01
为评价促炎及促重塑介质与儿童哮喘严重程度和哮喘控制间的关系，本试验在35例哮喘儿童中检测诱导痰液的上清液中的IL-8, MMP-9及TIMP-1水平、痰液嗜酸性粒细胞含量及呼气一氧化氮含量（FeNO），其中包括12例间歇发作哮喘患者（IA）和23例中度哮喘患者（MA）及9名对照儿童（C）。对哮喘患者随访1年，并2次收集痰液。生物标记物水平与哮喘加重次数相关。
结果显示，与对照组儿童相比，MA和IA组患儿的诱导痰液中IL-8, MMP-9, TIMP-1水平、嗜酸性粒细胞含量及FeNO显著增加。痰液细胞核内NF-κB p65亚单位增加，表明气道存在炎症。在MA患儿中，FeNO检测、痰液嗜酸性粒细胞及IL-8水平与一年随访期内哮喘的加重呈正相关。根据FeNO、痰液嗜酸性粒细胞和IL-8浓度及哮喘加重次数，我们找到中度哮喘的2个不同分型。本研究显示，尽管患者采用常规的ICS治疗，一些IA患儿及MA患儿的气道仍存在炎症。
我们认为，有必要在儿童哮喘患者中进行大样本的前瞻性研究，以证实检测诱导痰液中的特异性标志物、FeNO、评价亚临床的气道炎症及疾病控制的重要性。
（陈欣 审校）
Pediatr Allergy Immunol. 2009 Dec;20(8):780-90. Epub 2009 Sep 25.
Non-invasive markers of airway inflammation and remodeling in childhood asthma.
Gagliardo R, La Grutta S, Chanez P, Profita M, Paternò A, Cibella F, Bousquet J, Viegi G, Gjomarkaj M.
Institute of Biomedicine and Molecular Immunology, Unit of Immunopathology and Pharmacology of the Respiratory System, Italian National Research Council, 90146 Palermo, Italy.
To evaluate the relationship between pro-inflammatory and pro-remodeling mediators and severity and control of asthma in children, the levels of IL-8, MMP-9, TIMP-1 in induced sputum supernatants, the number of sputum eosinophils, as well as FeNO, were investigated in 35 asthmatic children, 12 with intermittent (IA) and 23 with moderate asthma (MA), and 9 controls (C). The patients with asthma were followed for 1 yr and sputum was obtained twice during the follow-up. Biomarker levels were correlated with the number of exacerbations. We found that IL-8, MMP-9, TIMP-1 and the numbers of eosinophils in induced sputum, as well as FeNO, were increased in children with IA and MA in comparison to C. The ongoing inflammation was confirmed by increased nuclear p65 NF-kappaB subunit localization in sputum cells. In MA, FeNO measurements, sputum eosinophils and IL-8 levels, positively correlated with the occurrence of disease exacerbations during a 1-yr follow-up. According to FeNO, sputum eosinophils and IL-8 sputum concentrations, and the number of exacerbations, two distinct phenotypes of MA were identified. This study shows that the presence of bronchial inflammation is detectable in the airways of some IA, as well as in the airways of MA, despite the regular ICS treatment. This study also proposes the need to perform large prospective studies to confirm the importance of measuring specific biomarkers in induced sputum, concomitantly to FeNO analyses, to assess sub-clinical airway inflammation and disease control in children with asthma.
Gagliardo R, et al.Pediatr Allergy Immunol. 2009 Dec;20(8):780-90. Epub 2009 Sep 25.
结果显示，与对照组儿童相比，MA和IA组患儿的诱导痰液中IL-8, MMP-9, TIMP-1水平、嗜酸性粒细胞含量及FeNO显著增加。痰液细胞核内NF-κB p65亚单位增加，表明气道存在炎症。在MA患儿中，FeNO检测、痰液嗜酸性粒细胞及IL-8水平与一年随访期内哮喘的加重呈正相关。根据FeNO、痰液嗜酸性粒细胞和IL-8浓度及哮喘加重次数，我们找到中度哮喘的2个不同分型。本研究显示，尽管患者采用常规的ICS治疗，一些IA患儿及MA患儿的气道仍存在炎症。
我们认为，有必要在儿童哮喘患者中进行大样本的前瞻性研究，以证实检测诱导痰液中的特异性标志物、FeNO、评价亚临床的气道炎症及疾病控制的重要性。
（陈欣 审校）
Pediatr Allergy Immunol. 2009 Dec;20(8):780-90. Epub 2009 Sep 25.
Non-invasive markers of airway inflammation and remodeling in childhood asthma.
Gagliardo R, La Grutta S, Chanez P, Profita M, Paternò A, Cibella F, Bousquet J, Viegi G, Gjomarkaj M.
Institute of Biomedicine and Molecular Immunology, Unit of Immunopathology and Pharmacology of the Respiratory System, Italian National Research Council, 90146 Palermo, Italy.
To evaluate the relationship between pro-inflammatory and pro-remodeling mediators and severity and control of asthma in children, the levels of IL-8, MMP-9, TIMP-1 in induced sputum supernatants, the number of sputum eosinophils, as well as FeNO, were investigated in 35 asthmatic children, 12 with intermittent (IA) and 23 with moderate asthma (MA), and 9 controls (C). The patients with asthma were followed for 1 yr and sputum was obtained twice during the follow-up. Biomarker levels were correlated with the number of exacerbations. We found that IL-8, MMP-9, TIMP-1 and the numbers of eosinophils in induced sputum, as well as FeNO, were increased in children with IA and MA in comparison to C. The ongoing inflammation was confirmed by increased nuclear p65 NF-kappaB subunit localization in sputum cells. In MA, FeNO measurements, sputum eosinophils and IL-8 levels, positively correlated with the occurrence of disease exacerbations during a 1-yr follow-up. According to FeNO, sputum eosinophils and IL-8 sputum concentrations, and the number of exacerbations, two distinct phenotypes of MA were identified. This study shows that the presence of bronchial inflammation is detectable in the airways of some IA, as well as in the airways of MA, despite the regular ICS treatment. This study also proposes the need to perform large prospective studies to confirm the importance of measuring specific biomarkers in induced sputum, concomitantly to FeNO analyses, to assess sub-clinical airway inflammation and disease control in children with asthma.
Gagliardo R, et al.Pediatr Allergy Immunol. 2009 Dec;20(8):780-90. Epub 2009 Sep 25.
上一篇：
儿童期经常性夜间觉醒与非过敏性哮喘有关
下一篇：
阿奇霉素可以减轻过敏性哮喘模型小鼠非感染性气道炎症
