哮喘患者初始抗炎治疗前后炎症状态的变化  

Changes of inflammation before and after initial anti-inflammatory therapy in asthma patients

作　　者：安霞[1,2] 叶伶[1] 龚颖[1] 杨冬[1] 李丽[1] 金美玲[1] 

机构地区：[1]复旦大学附属中山医院呼吸科,上海200032 [2]山东泰山医学院附属医院呼吸科,泰安271000

出　　处：《复旦学报（医学版）》2013年第5期545-549,共5页Fudan University Journal of Medical Sciences

基　　金：上海市重点学科建设项目资助(B115);中央高校基本科研业务费专项资金(10FX088)~~

摘　　要：目的通过检测新发哮喘患者血清和诱导痰中TGF-β1、IL-17、IL-23及其他气道炎症指标,并与健康对照组相比,比较吸入激素治疗前后上述指标的变化,以明确哮喘患者TGF-β1、IL-17、IL-23表达的意义及气道炎症的变化。方法采用病例对照方法,选取2011年5月至12月新发哮喘患者25例,同期选取27例健康人作为对照,检测两组人群血清中TGF-β1、IL-17、IL-23的表达水平及ACT评分、肺功能、呼出气一氧化氮(fractional exhaled nitric oxide,FENO)水平,比较两组间各项指标的差异。采用自身前后对照方法,给予哮喘患者以吸入型糖皮质激素(布地奈德200μg bid)治疗3个月,比较治疗前后各项指标的差异。结果 (1)与健康对照组相比,哮喘组血清TGF-β1的表达水平显著高于对照组;血清IL-17、IL-23的表达水平差异无统计学意义。(2)哮喘患者治疗前后对比,治疗后血清TGF-β1的表达水平较治疗前明显降低;治疗后血清IL-17、IL-23与治疗前比较差异无统计学意义。治疗后痰上清中TGF-β1、IL-17、IL-23的表达与治疗前比较差异均无统计学意义。治疗后ACT评分显著优于治疗前;治疗后FEV1%显著高于治疗前;治疗后FENO显著低于治疗前。结论(1)TGF-β1在新发哮喘中较对照组明显升高,ICS治疗后较治疗前下降;表明TGF-β1是重要的气道炎症指标。(2)FENO是无创监测气道炎症的重要指标,ICS治疗后FENO较治疗前明显降低。ObjectiveTo compare the levels of inflammation parameters,including TGF-β;1, IL-,IL-23 in serum and induced sputum,between new-onset asthma patients and healthy people,so as to confirm their changes and significance after treatment of inhaled corticosteroids （ICS）. Methods Twentyfive new onset asthma patients during May to Dec.,2011 were recruited in ICS treated group,meanwhile 27 healthy people were selected as controls.The demographic characteristics of the two groups were recorded,their serums were collected to test the expression of TGF beta1,IL-17 and IL-23 before and after the treatment of ICS （Budesonide,200 ＆mu;g bid） for three months.Asthma control test （ACT） scores,pulmonary functions,fractional exhaled nitric oxide （FENO） levels,blood regular tests,and total IgE of serum were also monitored. Results Compared with healthy control group,the serum levels of TGFβ;1 and IgE of newonset asthma patients were higher than those in control group.There were no significant differences in expression of IL-17 and IL-23 between the two groups. After treatment, the serum levels of TGF beta1 were lower than those before treatment.There were no statistically significances in serum levels of IL-17,IL-23 and levels of TGF-β;1,IL-17,IL-23 in sputum supernatant.The levels of FENO in patients were significantly decreased after ICS treatment. Conclusions TGF-β;1 might be an important index for airway inflammation and remodeling. FENO is a noninvasive and important indicator for monitoring airway inflammation in asthma.

关 键 词：TGF-β1 IL-17 IL-23 哮喘 气道炎症 气道重塑 

分 类 号：R562.25[医药卫生—呼吸系统]