Urinary and exhaled biomarkers of exercise-induced bronchoconstriction in atopic asthmatic children
Urinary and exhaled biomarkers of exercise-induced bronchoconstriction in atopic asthmatic children
复制标题
DOI：
10.1002/ppul.24419
复制
发表时间：
2019-09-01
影响因子：
3.1
通讯作者：
Villa, Maria Pia
中科院分区：
文献类型：
--
作者：
Barreto, Mario;Capi, Matilde;Villa, Maria Pia
背景 运动引起的支气管收缩（EIB）反映了哮喘控制不佳。评估与 EIB 相关的非侵入性生物标志物有助于监测儿科患者。目的 测试呼气和尿液生物标志物，以评估特应性哮喘儿童的 EIB。方法 在 45 名特应性患者（11.1 +/- 1.8 岁，25 名男性）中，我们测量了呼出一氧化氮分数 (FENO)、其肺泡 (CaNO) 和支气管 (J'awNO) 成分（根据气道喇叭形和轴向 NO 扩散 (TMAD) 进行校正）、尿腺苷和 8-羟基-2'-脱氧鸟苷 (8-OxodG) 浓度、血液浓度在跑步机运动挑战前进行嗜酸性粒细胞计数、总免疫球蛋白 E、皮肤点刺试验和基线肺活量测定。四十名健康对照受试者仅参与基线测量。结果患者的 FENO 和尿腺苷浓度高于健康对照。挑战后，18名患者（40%）出现EIB；这些患者的 CaNO、CaNO TMAD 和尿腺苷水平高于无 EIB 的患者。两组的基线肺活量测定、FENO、JawNO、JawNO TMAD、尿 8-OxodG、过敏和血液嗜酸性粒细胞计数相似。在多元线性回归中，FEV1 的下降由 CaNO TMAD、尿腺苷和血液嗜酸性粒细胞计数解释，而 FEF25-75 的下降由 CaNO TMAD 和血液嗜酸性粒细胞计数解释。 CaNO TMAD >= 10.5 ppb 和尿腺苷 >= 406 nmol/mmol Cr 均预测 FEV1 下降 >= 10%，而只有 CaNO TMAD >= 10.5 ppb 预测 FEF25-75 >= 26% 下降。结论 外周气道 NO 浓度与尿腺苷在评估 EIB 方面具有互补性，是特应性表型儿科患者哮喘控制的有前景的工具。
Background Exercise-induced bronchoconstriction (EIB) reflects poor asthma control. Assessing noninvasive biomarkers associated with EIB could help to monitor patients in the pediatric age. Aims To test exhaled and urinary biomarkers for assessing EIB in atopic asthmatic children. Methods In 45 atopic patients (11.1 +/- 1.8 years, 25 males) we measured the fractional exhaled nitric oxide (FENO), its alveolar (CaNO), and bronchial (J'awNO) components corrected for the trumpet shape of the airways and axial NO diffusion (TMAD), concentrations of urinary adenosine and 8-hydroxy-2'-deoxyguanosine (8-OxodG), blood eosinophils count, total immunoglobulin E , skin prick tests, and baseline spirometry before a treadmill exercise challenge. Forty healthy control subjects participated solely to baseline measurements. Results Patients yielded higher FENO and urinary adenosine concentrations than healthy controls. After the challenge, 18 patients (40%) had EIB; these patients had higher levels of CaNO, CaNO TMAD, and urinary adenosine than patients without EIB. Baseline spirometry, FENO, JawNO, JawNO TMAD, urinary 8-OxodG, allergy, and blood eosinophil counts were found similar in both groups. In multiple linear regression, the fall in FEV1 was explained by CaNO TMAD, urinary adenosine and blood eosinophil count, whereas the fall in FEF25-75 was explained by CaNO TMAD and blood eosinophil count. Both CaNO TMAD >= 10.5 ppb and urinary adenosine >= 406 nmol/mmol Cr predicted a fall in FEV1 >= 10%, while only CaNO TMAD >= 10.5 ppb predicted a fall in FEF25-75 >= 26%. Conclusion Concentrations of peripheral airway NO are complementary with urinary adenosine for assessing EIB and promising tools of asthma control in pediatric patients with the atopic phenotype.