小儿哮喘和特应性皮炎患者呼出气冷凝物中的细胞因子和pH值

Exhaled breath condensate cytokines and pH in pediatric asthma and atopic dermatitis.

作者信息

Brunetti Luigia, Francavilla Ruggiero, Tesse Riccardina, Fiermonte Patrizia, Fiore Francesca Paola, Loré Maria, Margiotta Marcella, Armenio Lucio

机构信息

Department of Biomedicina dell'Eta' Evolutiva, Pediatric Unit S.Maggiore, University of Bari, Bari, Italy.

出版信息

Allergy Asthma Proc. 2008 Sep-Oct;29(5):461-7. doi: 10.2500/aap.2008.29.3152.

Abstract

Some studies have proposed exhaled breath condensate (EBC) as a noninvasive tool for monitoring airway inflammation in children. Moreover, atopic dermatitis (AD) has been considered a risk factor for the development of asthma. This study was designed to assess the EBC pH and the exhaled concentration of cytokines produced by T-helper (Th) 1, Th2, and T regulatory cells in asthmatic children and AD and to verify if their concentrations are affected by a short course of treatment with inhaled corticosteroids (ICS). We assessed the mean levels of pH, interferon (IFN) gamma, interleukin (IL)-4, and IL-10 in EBC of children with asthma (n=20) and AD (n=12) and healthy controls (n=20) by enzyme-linked immunosorbent assay (ELISA). Variations of pH and cytokine concentration in response to ICS (flunisolide, 500 microg/day, for 2 weeks), were also investigated in asthmatic patients. We found that the mean condensate pH value in patients with asthma and AD was significantly lower when compared with that of controls (6.9+/-0.2 and 7.0+/-0.2 versus 7.4+/-0.4; p<0.0001) and it significantly increased in asthmatic patients after treatment (7.2+/-0.2 versus 6.9+/-0.2; p=0.003). In addition, the IL-4/IFN-gamma ratio was significantly higher in children with asthma and in those with AD when compared with controls (9.72+/-2.00 and 9.70+/-2.0 versus 8.04+/-2.6; p<0.001) and that it decreased in asthmatic patients after ICS (6.4+/-5.4 versus 9.72+/-2.00; p<0.01). We observed that exhaled IL-10 levels were significantly higher in children with asthma compared with those of controls (18.8+/-8.9 versus 4.2+/-1.0; p<0.002). IL-10 did not significantly increase after treatment with steroids. No such finding was documented in children with AD. Our data suggest that EBC IL-10 levels are different in asthmatic patients compared with healthy children, but they are insensitive markers in monitoring therapy with ICS. Moreover, children with AD show an EBC pH and an exhaled pattern of Th2/Th1 cytokines similar to that of asthmatic patients.

摘要

一些研究提出,呼出气冷凝物(EBC)可作为监测儿童气道炎症的一种非侵入性工具。此外,特应性皮炎(AD)被认为是哮喘发病的一个危险因素。本研究旨在评估哮喘儿童、AD患儿以及健康对照者的EBC pH值和辅助性T(Th)1、Th2及调节性T细胞产生的细胞因子的呼出浓度,并验证吸入糖皮质激素(ICS)短期治疗是否会影响它们的浓度。我们通过酶联免疫吸附测定(ELISA)评估了哮喘患儿(n = 20)、AD患儿(n = 12)及健康对照者(n = 20)的EBC中pH值、干扰素(IFN)-γ、白细胞介素(IL)-4和IL-10的平均水平。还研究了哮喘患者使用ICS(氟尼缩松,500μg/天,共2周)后pH值和细胞因子浓度的变化。我们发现,哮喘患者和AD患者的冷凝物平均pH值与对照组相比显著更低(分别为6.9±0.2和7.0±0.2,对照组为7.4±0.4;p<0.0001),且哮喘患者治疗后pH值显著升高(从6.9±0.2升至7.2±0.2;p = 0.003)。此外,哮喘患儿和AD患儿的IL-4/IFN-γ比值与对照组相比显著更高(分别为9.72±2.00和9.70±2.0,对照组为8.04±2.6;p<0.001),且哮喘患者使用ICS后该比值降低(从9.72±2.00降至6.4±5.4;p<0.01)。我们观察到,哮喘患儿呼出的IL-10水平与对照组相比显著更高(分别为18.8±8.9和4.2±1.0;p<0.002)。使用类固醇治疗后IL-10没有显著升高。AD患儿未观察到此类结果。我们的数据表明,与健康儿童相比,哮喘患者的EBC中IL-10水平不同,但它们在监测ICS治疗时是不敏感的标志物。此外,AD患儿的EBC pH值以及Th2/Th1细胞因子的呼出模式与哮喘患者相似。

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