小儿支气管哮喘发作期中医证型与PI3K/Akt-miR-126通路的相关性分析  

Correlation Analysis of TCM Syndrome Types and PI3K/Akt-mi R-126 Pathway in Children with Bronchial Asthma during Attack Stage

作　　者：王文亮[1] 李红[1] 徐甘霖[1] 赵灵平 Wang Wenliang;Li Hong;Xu Ganlin;Zhao Lingping(Shenzhen Children′s Hospital,Guangdong,Shenzhen 518026,China)

机构地区：[1]广东省深圳市儿童医院,广东深圳518026

出　　处：《中国中医急症》2022年第11期1928-1932,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20201310)。

摘　　要：目的 探讨小儿支气管哮喘发作期中医证型与磷脂酰肌醇3-激酶/蛋白激酶B-微小RNA-126(PI3K/Akt-miR-126)通路的相关性。方法 选取2020年1月至2021年12月深圳市儿童医院收治的76例哮喘发作期儿童作为哮喘组,进行中医辨证。选入同期30例体检健康儿童作为对照组。测定两组外周血单核细胞miR-126、PI3K、Akt1表达,血清炎症因子水平,哮喘控制测试(ACT)评分,并进行统计分析。结果 两组miR-126、PI3K、Akt1、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)表达从高至低依次为寒哮型>热哮型>对照组(均P<0.01);且寒哮型的ACT评分低于热哮型(P<0.01)。不同中医证型(热哮型、寒哮型)哮喘患儿miR-126与PI3K、AKT1、IL-6、IL-1表达均呈正相关;与ACT评分均呈负相关(均P<0.01)。排除传统因素(性别、年龄、病程)的影响,多元线性回归分析进一步显示热哮型或寒哮型miR-126与ACT评分仍呈负相关(均P<0.01)。二分类Logistic回归分析显示,miR-126>2.01、PI3K>2.08、Akt1>3.00为热哮型组发病的危险因素(均P<0.01);miR-126>3.22、PI3K>5.01、Akt1>5.27为寒哮型组发病的危险因素(均P<0.01)。结论 不同中医证型小儿哮喘发作期均与外周血单核细胞PI3K/Akt-miR-126通路的过度激活相关,且该通路在寒哮型的激活程度高于热哮型。Objective:To investigate the correlation between TCM syndrome type and PI3K/Akt-miR-126 pathway in children with bronchial asthma attack stage. Methods:76 children with asthma in Shenzhen Children′s Hospital from January 2020 to December 2021 were selected as asthma group to conduct TCM syndrome differentiation. 30 healthy children were selected as the control group.The expressions of miR-126,PI3K and Akt1 in peripheral blood monocytes,the levels of serum inflammatory factors and asthma control test(ACT) score in each group were determined,and statistical analysis was conducted. Results:The expressions of miR-126,PI3K,Akt1,IL-6 and IL-1 in each group were in the order of cold type >heat type >control group(all P< 0.01). The ACT score of cold type was lower than that of heat type(P< 0.01).miR-126 was positively correlated with PI3K,AKT1,IL-6 and IL-1 expression in asthmatic children with different TCM syndrome types(heat asthma type and cold asthma type),and negatively correlated with ACT score(all P< 0.01).Excluding the influence of traditional factors(gender,age and course of disease),multiple linear regression analysis further showed that miR-126 of hot asthma or cold asthma was still negatively correlated with ACT score(all P< 0.01).Binary Logistic regression analysis showed that miR-126 >2.01,PI3K >2.08 and Akt1 >3.00 were the risk factors of the fever type group(all P<0.01). miR-126 >3.22,PI3K >5.01 and Akt1 >5.27 were risk factors of cold asthma group(all P< 0.01). Conclusion:The overactivation of PI3K/Akt-miR-126 pathway in peripheral blood monocytes is correlated with the onset of asthma in children with different TCM syndrome types,and the activation degree of this pathway was higher in cold asthma than in heat asthma.

关 键 词：哮喘 儿童 中医证型 磷脂酰肌醇3-激酶/蛋白激酶B-微小RNA-126通路 哮喘控制测试 

分 类 号：R725.6[医药卫生—儿科]