Airway reversibility in asthma and phenotypes of Th2-biomarkers, lung function and disease control
Airway reversibility in asthma and phenotypes of Th2-biomarkers, lung function and disease control
复制标题
哮喘气道可逆性和 Th2 生物标志物表型、肺功能和疾病控制
DOI：
10.1186/s13223-018-0315-0
复制
发表时间：
2018-12
影响因子：
2.7
通讯作者：
Mo Biwen
中科院分区：
文献类型：
--
作者：
Wei Jianghong;Ma Libing;Wang Jiying;Xu Qing;Chen Meixi;Jiang Ming;Luo Miao;Wu Jingjie;She Weiwei;Chu Shuyuan;Mo Biwen
背景：成人哮喘患者支气管扩张剂的可逆性高与其独特的临床特征有关。本研究旨在比较高气道可逆性（HR）和低气道可逆性（LR）哮喘患者的辅助性T细胞2（Th 2）相关生物标志物、肺功能和哮喘控制情况。根据患者对支气管扩张剂的肺功能反应（HR =支气管扩张剂后1秒用力呼气量（FEV 1）≥ 20%）将患者分为HR和LR亚组。检测患者血液嗜酸性粒细胞计数和血清IgE水平，这是辅助性T细胞（Th）-2表型的生物标志物。哮喘控制测试（ACT）被用来评估哮喘控制后的第一个月的初始treatment.ResultsA共265例哮喘患者进行了为期1个月的初始治疗后。HR组显示较高水平的Th 2-高生物标志物（血嗜酸性粒细胞计数（10^9/L）：0.49 ± 0.28 vs 0.36 ± 0.19，P < 0.01; IgE（ng/ml）：1306 ± 842 vs 413 ± 261，P < 0.01），基线肺功能降低（FEV1%pred：51.91 ± 19.34%vs60.42 ± 19.22%，P < 0.01; FEF 25-75：0.76 ± 0.37vs1.00 ± 0.67，P < 0.01; FEF 25 -75%pred：哮喘控制率（ACT评分：22 ± 4 vs 20 ± 4，P = 0.01）明显优于LR组（21.15 ± 10.09 vs 29.06 ± 16.50%，P <0.01）。HR与第一个月初始治疗后不受控制的哮喘风险降低相关（调整OR：0.12 [95%置信区间：0.03-0.50]）。此外，HR可能表明在第一个月的初始治疗后哮喘得到控制。这一发现可能有助于哮喘内源型的鉴定。
BackgroundHigh bronchodilator reversibility in adult asthma is associated with distinct clinical characteristics. In this study, we aim to make a comparison with T-helper 2 (Th2)-related biomarkers, lung function and asthma control between asthmatic patients with high airway reversibility (HR) and low airway reversibility (LR).MethodsPatients with asthma diagnosed by pulmonologist according to Global Initiative for Asthma guidelines were recruited from the outpatient department of our hospital from August 2014 to July 2017. Patients were divided into HR and LR subgroups based on their response to bronchodilators of lung function (HR = Δforced expiratory volume in one second (FEV1) postbronchodilator ≥ 20%). Blood eosinophil count and serum IgE level, which are biomarkers of T-helper (Th)-2 phenotypes, were detected for patients. Asthma Control Test (ACT) was used to assess asthma control after the first-month initial treatment.ResultsA total of 265 patients with asthma were followed 1 month after initial treatment. HR group shows a higher level of Th2-high biomarkers (blood eosinophil count (10^9/L): 0.49 ± 0.28 vs 0.36 ± 0.19, P < 0.01; IgE (ng/ml): 1306 ± 842 vs 413 ± 261, P < 0.01), lower baseline lung function (FEV1%pred: 51.91 ± 19.34% vs 60.42 ± 19.22%, P < 0.01; forced expiratory flow (FEF)25–75: 0.76 ± 0.37 vs 1.00 ± 0.67, P < 0.01; FEF25–75%pred: 21.15 ± 10.09% vs 29.06 ± 16.50%, P < 0.01), and better asthma control (ACT score: 22 ± 4 vs 20 ± 4, P = 0.01) than LR group. HR was associated with a decreased risk of uncontrolled asthma after the first-month initial treatment (adjusted OR: 0.12 [95% confidence intervals: 0.03–0.50]).ConclusionsHR is a physiologic indicator of lower lung function and severe small airway obstruction, and is more related with an increased level of Th2-biomarkers than LR. Moreover, HR may indicate controlled asthma after the first-month initial treatment. This finding may contribute to identification of asthma endotype.
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DOI：
10.1590/s1806-37132010000100009
发表时间：
2010
期刊：
Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
影响因子：
--
作者：
M. T. Rodrigues;Daniel Fiterman-Molinari;S. Barreto;J. Fiterman
通讯作者：
M. T. Rodrigues;Daniel Fiterman-Molinari;S. Barreto;J. Fiterman
影响因子：
9.6
作者：
Busse, William W.;Holgate, Stephen T.;Nirula, Ajay
通讯作者：
Nirula, Ajay
影响因子：
76.2
作者：
Price, David B.;Rigazio, Anna;Pavord, Ian D.
通讯作者：
Pavord, Ian D.
影响因子：
2
作者：
Lutfi, Mohamed Faisal
通讯作者：
Lutfi, Mohamed Faisal
影响因子：
3.1
作者：
Khusial RJ;Sont JK;Loijmans RJB;Snoeck-Stroband JB;Assendelft PJJ;Schermer TRJ;Honkoop PJ;ACCURATE Study Group
通讯作者：
ACCURATE Study Group