HMGB1在支气管哮喘和慢性阻塞性肺疾病患者中的表达及其意义  

Levels of HMGB1 in induced sputum from patients with asthma and chronic obstructive pulmonary disease

作　　者：程哲[1] 康燕[1] 吴秋歌[1] 代灵灵[1] 宋永娜[1] 夏杰[1] 司纪明[1] 陈春艳[1] 

机构地区：[1]郑州大学第一附属医院呼吸与危重症医学科河南省高等学校临床医学重点学科开放实验室,450052

出　　处：《中华医学杂志》2011年第42期2981-2984,共4页National Medical Journal of China

摘　　要：目的探讨支气管哮喘及慢性阻塞性肺疾病（COPD）患者诱导痰中高迁移率组蛋白B1（HMGB1）的表达及其与气道炎症的关系。方法按标准纳入慢性持续期哮喘患者57例，稳定期的COPD患者30例，对照组（健康体检者）20例；完成哮喘控制问卷后，分别进行肺功能检测和诱导痰检查，记录第1秒用力呼气容积（FEV1）占预计值的百分比（FEV，％预计值），行诱导痰中性粒细胞分类计数，酶联免疫吸附法检测诱导痰HMGB1水平。结果哮喘组、COPD组诱导痰HMGB1水平分别为（291±55）、（511±39）ng/L，显著高于对照组的（61±5）ng/L（均P〈0．01）；在107例研究对象中，HMGB1的表达与FEV1％预计值呈反比；COPD组诱导痰HMGB1水平显著高于哮喘组（P〈0．01）。嗜酸粒细胞哮喘组与非嗜酸粒细胞哮喘组HMGBl水平分别为（290±55）、（292±54）ng/L，差异无统计学意义（P〉0．05）。Ⅱ、Ⅲ级COPD患者HMGB1水平分别为（526±29）、（541±29）ng／L，显著高于Ⅰ级的（471±18）ng／L（均P〈0．01）。轻、中、重度持续期哮喘患者诱导痰中性粒细胞比例分别为（27±2）％、（36±4）％、（49±4）％，HMGBl水平分别为（227±16）、（312±14）、（347±11）ng/L，差异均有统计学意义（均P〈0．01）。哮喘及COPD患者诱导痰中HMGB1与中性粒细胞比例均呈正相关（r值分别为0．880和0．132，均P〈0．01）。年龄、性别、嗜酸粒细胞比例均不是影响HMGBI表达的显著性因素，诱导痰中性粒细胞比例和FEV1％预计值与HMGB1表达水平关系显著（t=-3．059，P：0．005）。结论HMGB1在支气管哮喘及COPD患者诱导痰中呈高表达，对气道炎症有增强作用。Objective To explore the relationship between the sputum levels of high mobility group protein B1 （HMGB1） and airway inflammation in bronchial asthma and chronic obstructive pulmonary disease （COPD） patients. Methods A total of 57 patients with persistent asthma [ per Global Initiative for Asthma （GINA） guidelines ], 30 patients with stable COPD [ stratified by Global Initiative for COPD （GOLD） status ] and 20 control subjects were recruited. After completing an asthma control questionnaire, spirometry was performed before sputum induction. The ratio of forced expiratory volume in the first second （FEV1 ）/predictive value （FEV1% Pre） and neutrophil differential count in induced sputum were recorded. The concentrations of HMGB1 in the supernatant of sputum were measured by ELISA （enzyme-linked immunosorbent assay）. Results The sputum concentrations of HMGB1 in the asthmatics and COPD patients were significantly higher than those of the control subjects [ （291 _＋55） and （511 ＋39） vs （61 _＋5） ng/L, all P 〈 0.01 ]. And they were significantly negatively correlated with FEV1% Pre in all subjects. The levels of HMGB1 in induced sputum of COPD patients were significantly higher than those of asthmatics and healthy controls （ P 〈 0. 01 ）. No significant difference existed in the levels of HMGB1 between patients with eosinophilic and noneosinophilie asthma [ （290± 55 ） vs （292 ± 54） ng/L, P 〉 0. 05 ]. The HMGB1 levels with COPD stage II and stage lllwere significantly higher than those with stage Ⅰ[ （526 ±29） and （541 ±29） vs （471 ± 18） ng/L ]. The differences of sputum neutrophil percentage were statistically significant in mild, moderate and severe asthma [ （ 27 ± 2） %, （36 ±4） %, （49 ±4） % ]. And the sputum levels of HMGB1 were significantly higher in the patients with moderate and severe asthma [ （312± 14） vs （347± 11 ） ng/L ]. And the levels of HMGB1 in asthmatic and COPD patients were positively correlated wit

关 键 词：哮喘 肺疾病 慢性阻塞性 HMGB蛋白质类 痰 

分 类 号：R562.25[医药卫生—呼吸系统] R563.9[医药卫生—内科学]