Gogate Shaila, Katial Rohit
National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA.
Curr Opin Allergy Clin Immunol. 2008 Apr;8(2):154-7. doi: 10.1097/ACI.0b013e3282f60f61.
Markers of disease status that provide a numerical measure of disease activity, biomarkers, have come into more routine use in medicine. This is evidenced by troponin and brain natriuretic peptide when measuring cardiac function or glomerular filtration rate in relation to kidney function. Similar markers to assess inflammation in the asthmatic lung have emerged as possible tools to guide treatment. Three biomarkers, fractional exhaled nitric oxide, sputum eosinophils and leukotriene E4 in the urine and exhaled breath condensate, have been heavily investigated.
Recent literature indicates that exhaled nitric oxide, sputum eosinophils and leukotriene E4 in the urine, and exhaled breath condensate could serve as good markers of inflammation in the asthmatic airway. These markers, when combined with conventional measures of lung function--forced expiratory flow in 1 s, peak flow or methacholine challenge--will be of benefit in improving asthma control in the pediatric population.
Exhaled nitric oxide and urinary leukotriene E4 are relatively easy to attain in the clinical setting. Sputum eosinophils are an excellent tool for assessing inflammation, however sputum induction can be challenging for a young child. Despite small limitations, all three biomarkers are potentially valuable when used in conjunction with conventional methods for airway control.
能够提供疾病活动数值衡量的疾病状态标志物，即生物标志物，在医学中已得到更常规的应用。这在测量心脏功能时的肌钙蛋白和脑钠肽以及测量肾功能时的肾小球滤过率方面得到了体现。类似的用于评估哮喘肺部炎症的标志物已成为指导治疗的可能工具。三种生物标志物，呼出气一氧化氮分数、痰液嗜酸性粒细胞以及尿液和呼出气冷凝物中的白三烯E4，已得到大量研究。
近期文献表明，呼出气一氧化氮、痰液嗜酸性粒细胞、尿液中的白三烯E4以及呼出气冷凝物可作为哮喘气道炎症的良好标志物。这些标志物与传统肺功能测量指标（1秒用力呼气流量、峰值流量或乙酰甲胆碱激发试验）相结合，将有助于改善儿童哮喘的控制。
在临床环境中，呼出气一氧化氮和尿液白三烯E4相对容易获取。痰液嗜酸性粒细胞是评估炎症的优秀工具，然而对于幼儿来说，诱导痰液可能具有挑战性。尽管存在一些小的局限性，但这三种生物标志物与传统气道控制方法联合使用时都具有潜在价值。
