哮喘联盟

   摘要
   背景：哮喘是一种高流行性的慢性肺部疾病，常发生于儿童早期。新生气道致病菌的定植如流感嗜血杆菌、卡他莫拉菌和肺炎双球菌与之后的儿童期哮喘风险增加有关。我们假设儿童哮喘患者在婴儿期对致病菌免疫反应异常。
   目的：旨在评估无症状性婴儿对细菌性免疫反应和之后7岁时哮喘发展的关系。
   方法：对“哥本哈根儿童哮喘的前瞻性研究”的出生队列研究进行预期随访，且7岁时就已经诊断为哮喘。6个月后使用PBMCs分离和储存的方法对292例婴儿H流脑、M卡他莫拉菌属和S肺炎球菌的免疫反应进行分析。根据细胞因子产生和T细胞激活的模式评估免疫反应。
   结果：婴儿期哮喘7岁时对致病菌的免疫反应存在差异（P=.0007）。特别是预期哮喘的受试者IL-5（P = .008），IL-13（P = .057），IL-17（P = .001），和 IL-10 (P = .028)的产生存在异常，但T细胞激活或外周T细胞合成没有差异。
   结论：学龄期哮喘患儿存在婴儿期对致病菌的异常免疫反应。定植于早年气道致病菌的异常免疫反应，可能导致慢性气道炎症和儿童哮喘。
 

（林江涛 审校）
J Allergy Clin Immunol. 2014 Mar 4. pii: S0091-6749(14)00110-9. doi: 10.1016/ j.jaci. 2014.01.010. [Epub ahead of print]

 

Children with asthma by school age display aberrant immune responses to pathogenic airway bacteria as infants.
 

Larsen JM1, Brix S2, Thysen AH1, Birch S3, Rasmussen MA4, Bisgaard H5.
 

ABSTRACT
BACKGROUND: Asthma is a highly prevalent chronic lung disease that commonly originates in early childhood. Colonization of neonatal airways with the pathogenic bacterial strains Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae is associated with increased risk of later childhood asthma. We hypothesized that children with asthma have an abnormal immune response to pathogenic bacteria in infancy.
OBJECTIVE: We aimed to assess the bacterial immune response in asymptomatic infants and the association with later development of asthma by age 7 years.
METHODS: The Copenhagen Prospective Studies on Asthma in Childhood birth cohort was followed prospectively, and asthma was diagnosed at age 7 years. The immune response to H influenzae, M catarrhalis, and S pneumoniae was analyzed in 292 infants using PBMCs isolated and stored since the age of 6 months. The immune response was assessed based on the pattern of cytokines produced and T-cell activation.
RESULTS: The immune response to pathogenic bacteria was different in infants with asthma by 7 years of age (P = .0007). In particular, prospective asthmatic subjects had aberrant production of IL-5 (P = .008), IL-13 (P = .057), IL-17 (P = .001), and IL-10 (P = .028), whereas there were no differences in T-cell activation or peripheral T-cell composition.
CONCLUSIONS: Children with asthma by school age exhibited an aberrant immune response to pathogenic bacteria in infancy. We propose that an abnormal immune response to pathogenic bacteria colonizing the airways in early life might lead to chronic airway inflammation and childhood asthma.
 

J Allergy Clin Immunol. 2014 Mar 4. pii: S0091-6749(14)00110-9. doi: 10.1016/ j.jaci. 2014.01.010. [Epub ahead of print]