Further evidence for association of YKL-40 with severe asthma airway remodeling
Further evidence for association of YKL-40 with severe asthma airway remodeling
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DOI：
10.1016/j.anai.2022.03.016
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发表时间：
2022-05-23
影响因子：
5.9
通讯作者：
Konno, Satoshi
中科院分区：
文献类型：
--
作者：
Kimura, Hirokazu;Shimizu, Kaoruko;Konno, Satoshi
背景：几丁质酶样蛋白YKL-40与哮喘患者肺量测定的气流受限和气道重塑有关。目前尚不清楚YKL-40是否与气道和实质的形态学变化或与严重哮喘中气流受限的未来进展相关。目的：评估循环YKL-40水平与气道和实质的形态学变化以及气流受限的纵向进展的相关性。这些患者是北海道严重哮喘队列研究（n = 127）的参与者，包括吸烟者。本研究分为两部分。在分析1中，我们分析了循环YKL-40水平和几个哮喘相关指标之间的关联，包括近端壁面积百分比、气道复杂性（气道分形维数）和横截面实质（指数D）的计算机断层扫描衍生指标（n = 97）。在分析2中，我们评估了循环YKL-40水平对1秒用力呼气量（FEV 1）下降的影响，并进行了5年的纵向随访（n = 103）。（r = 0.25，P = 0.01; r =-0.22，P = 0.04），但不具有指数D。FEV 1的平均年变化为-33.7（+/- 23.3）mL/y，循环YKL-40水平是与年FEV 1下降相关的显著独立因素（β =-0.24，P =.02），即使在控制指数D后结论：YKL-40在哮喘气道重塑中的作用可能与哮喘气道重塑的发生有关。(C)2022年美国过敏，哮喘和免疫学学院。爱思唯尔公司出版All rights reserved.
Background: The chitinase-like protein YKL-40 is associated with airflow limitation on spirometry and airway remodeling in patients with asthma. It remains unclear whether YKL-40 is associated with morphologic changes in the airways and parenchyma or with future progression of airflow limitation in severe asthma.Objective: To evaluate the association of circulating YKL-40 levels with morphologic changes in the airways and parenchyma and with longitudinal progression of airflow limitation.Methods: The patients were participants in the Hokkaido Severe Asthma Cohort Study (n = 127), including smokers. This study consisted of 2 parts. In analysis 1, we analyzed associations between circulating YKL-40 levels and several asthma-related indices, including computed tomography-derived indices of proximal wall area percentage, the complexity of the airways (airway fractal dimension), and the parenchyma (exponent D) crosssectionally (n = 97). In analysis 2, we evaluated the impact of circulating YKL-40 levels on forced expiratory volume in 1 second (FEV1) decline longitudinally for a 5-year follow-up (n = 103).Results: Circulating YKL-40 levels were significantly associated with proximal wall area percentage and airway fractal dimension (r = 0.25, P = .01; r = -0.22, P = .04, respectively), but not with exponent D. The mean annual change in FEV1 was -33.7 (+/- 23.3) mL/y, and the circulating YKL-40 level was a significant independent factor associated with annual FEV1 decline (beta = -0.24, P =.02), even after controlling for exponent D (beta = -0.26, P = .01).Conclusion: These results provide further evidence for the association of YKL-40 with the pathogenesis of airway remodeling in severe asthma. (C) 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.