Halász A, Cserháti E, Kósa L, Cseh K
First Department of Pediatrics, Semmelweis Medical University, Svábhegy Children's Hospital, Budapest.
Allergy Asthma Proc. 2003 Mar-Apr;24(2):111-8.
The aim of the study was to investigate the activation of inflammatory mediators interleukin (IL)-4, IL-5, and IL-8; immunoglobulin E (IgE); and eosinophil cationic protein (ECP) and to evaluate the regulatory role of the tumor necrosis system (TNF) system in bronchial hyperreactivity. Adults who had suffered from bronchial asthma in childhood but who had been symptom free for at least 3 years were examined together with their children who did not have asthma. The serum concentrations of TNF-alpha, soluble TNF receptor 1 (sTNF-R1), TNF-R2, IL-4, IL-5, IL-8, ECP, and IgE were studied in symptom-free adults (n = 22) and their children (n = 22) with bronchial hyperreactivity. Nonhyperreactive individuals with a similar medical history (adults, n = 17; children, n = 20) served as controls. Significantly elevated serum TNF-alpha (X +/- SD: 5.13 +/- 1.37 pg/mL versus 3.91 +/- 0.61 pg/mL; p < 0.0001), sTNF-R1 (X +/- SD: 1.37 +/- 0.28 ng/mL versus 1.16 +/- 0.13 ng/mL; p = 0.0002), and sTNF-R2 (X +/- SD: 0.78 +/- 0.42 ng/mL versus 0.43 +/- 0.41 ng/mL; p = 0.0001); IL-4 (X +/- SD: 4.05 +/- 1.02 pg/mL versus 3.34 +/- 0.84 pg/mL; p = 0.0016); IgE (X +/- SD: 390.1 +/- 361.4 KU/L versus 130.2 +/- 166.1 KU/L; p = 0.0001); and ECP (X +/- SD: 17.57 +/- 11.03 micrograms/L versus 10.65 +/- 6.01 micrograms/L; p = 0.0016) concentrations were measured in the subjects with bronchial hyperreactivity as compared with the nonhyperreactive group. Significant positive linear correlations were observed for the bronchial hyperreactive group between the concentrations of TNF-alpha and ECP, TNF-alpha and sTNF-R1, TNF-alpha and IL-8, sTNF-R1 and ECP, sTNF-R1 and IL-8, and sTNF-R2 and IL-8. Moreover, the TNF-alpha and sTNF-R2 levels correlated with the airway reactivity in the hyperreactive group. We suggest that the elevated cytokine levels indicate activation of the immune system in individuals who were previously asthmatic, but recovered, and are now symptom free and in their children with nonasthmatic bronchial hyperreactivity. The TNF system may play a key role in the pathomechanism of bronchial hyperreactivity.
该研究的目的是调查炎性介质白细胞介素(IL)-4、IL-5和IL-8、免疫球蛋白E(IgE)以及嗜酸性粒细胞阳离子蛋白(ECP)的激活情况,并评估肿瘤坏死因子(TNF)系统在支气管高反应性中的调节作用。对童年时期患过支气管哮喘但至少3年无症状的成年人及其未患哮喘的子女进行了检查。研究了无症状成年人(n = 22)及其患有支气管高反应性的子女(n = 22)血清中TNF-α、可溶性TNF受体1(sTNF-R1)、TNF-R2、IL-4、IL-5、IL-8、ECP和IgE的浓度。具有相似病史的非高反应性个体(成年人,n = 17;儿童,n = 20)作为对照。与非高反应性组相比,支气管高反应性受试者血清中TNF-α(X±SD:5.13±1.37 pg/mL对3.91±0.61 pg/mL;p < 0.0001)、sTNF-R1(X±SD:1.37±0.28 ng/mL对1.16±0.13 ng/mL;p = 0.0002)、sTNF-R2(X±SD:0.78±0.42 ng/mL对0.43±0.41 ng/mL;p = 0.0001)、IL-4(X±SD:4.05±1.02 pg/mL对3.34±0.84 pg/mL;p = 0.0016)、IgE(X±SD:390.1±361.4 KU/L对130.2±166.1 KU/L;p = 0.0001)和ECP(X±SD:17.57±11.03 μg/L对10.65±6.01 μg/L;p = 0.0016)浓度显著升高。在支气管高反应性组中,观察到TNF-α与ECP、TNF-α与sTNF-R1、TNF-α与IL-8、sTNF-R1与ECP、sTNF-R1与IL-8以及sTNF-R2与IL-8浓度之间存在显著的正线性相关性。此外,TNF-α和sTNF-R2水平与高反应性组的气道反应性相关。我们认为,细胞因子水平升高表明既往患过哮喘但已康复、目前无症状的个体及其患有非哮喘性支气管高反应性的子女的免疫系统被激活。TNF系统可能在支气管高反应性的发病机制中起关键作用。