哮喘联盟

   摘要
   研究目的：（1）研究探讨呼出气冷凝物（EBC）中尿酸盐作为哮喘儿童气道炎症及哮喘控制情况生物标志物的可能性；（2）探索呼出气冷凝物（EBC）中尿酸盐与气道炎症其他生物标志物、哮喘控制临床指标（哮喘控制测试 [ACT]，生活质量[PAQLQ]、肺功能、按需使用β激动剂的次数以及距最近一次哮喘急性发作的时间[TLE]）之间的关系。
   方法：本项横断面研究共纳入103例连续的患者（年龄在6-18岁之间），分为未控制组（[NC], n=53）和控制组（[C], n=50）。肺功能及生物标志物的检测指标包括：肺活量、嗜酸性粒细胞阳离子蛋白（ECP）、超敏C反应蛋白（hs-CRP）、呼出NO（FENO）、EBC的pH值及尿酸盐和呼出气温度（EBT）。
   结果：未控制组与控制组间在EBC中尿酸盐、EBC的pH值以及EBT方面存在统计学上的显著差异（NC vs. C: EBC 尿酸盐, 中位数 [IQR], µmol/L; 10 [6] vs 45 [29], p<0.001; EBC pH, 平均值 [SD], 7.2 [0.17] vs. 7.33 [0.16], P=0.002; EBT平均值 [SD], °C; 34.26 [0.83], vs 33.90 [0.60], p=0.014）。在未控制组，EBC中非结晶尿酸盐与TLE和FENO呈显著性相关（分别r=0.518, p<0.001; r=0.369, p=0.007,）。在全部患者中，EBC中尿酸盐与EBC pH (r=0.351, p<0.001), FEV1 (r=0.222, p=0.024), ACT (r=0.654, p<0.001), PAQLQ (r=0.686, p<0.001), 以及按需使用沙丁胺醇次数 (r=-0.527, p<0.001)均显著相关。
   结论：本项研究发现EBC中尿酸盐是哮喘控制情况和潜在性气道炎症的最好的独立预测指标。我们的结果为把EBC中尿酸盐作为儿童哮喘控制情况的一个无创性生物学指标提供了依据。
 

（苏欣 审校）
J Asthma. 2014 Nov 11:1-37. [Epub ahead of print]

 

Urates in exhaled breath condensate as a biomarker of control in childhood asthma.
 

Navratil M1, Plavec D, Bulat Lokas S, Zivković J, Turkalj M.
 

ABSTRACT
OBJECTIVE: The aim of study was (1) to investigate the possibility to use urates in exhaled breath condensate (EBC) as a biomarker of airway inflammation and control in childhood asthma and (2) to explore their association with other biomarkers of airway inflammation and clinical indices of asthma control (Asthma Control Test [ACT], quality of life [PAQLQ], lung function, prn beta-agonist use, time from last exacerbation [TLE].
METHODS: This cross-sectional study comprised 103 consecutive patients (age 6-18 years) divided in groups of uncontrolled ([NC], n=53) and controlled asthma ([C], n=50). Measured lung function and biomarkers included: spirometry, eosinophilic cationic protein (ECP), high-sensitivity C-reactive protein (hs-CRP), exhaled NO (FENO), pH and urates in EBC, and exhaled breath temperature (EBT).
RESULTS: Statistically significant differences were found between groups for EBC urates, EBC pH and EBT (NC vs. C: EBC urates, median [IQR], µmol/L; 10 [6] vs 45 [29], p<0.001; EBC pH, mean [SD], 7.2 [0.17] vs. 7.33 [0.16], P=0.002; EBT mean [SD], °C; 34.26 [0.83], vs 33.90 [0.60], p=0.014). EBC urates showed significant association with TLE and FENO (r=0.518, p<0.001; r=0.369, p=0.007, respectively) in NC, and EBC pH (r=0.351, p<0.001), FEV1 (r=0.222, p=0.024), ACT (r=0.654, p<0.001), PAQLQ (r=0.686, p<0.001), and prn salbutamol use (r=-0.527, p<0.001) in all asthmatics.
CONCLUSION: In our study EBC urates were found to be the best single predictor of asthma control and underlying airway inflammation. Our results provide evidence supporting the potential utility to use EBC urates as an additional noninvasive biomarker of control in childhood asthma.
 

J Asthma. 2014 Nov 11:1-37. [Epub ahead of print]