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T(H)2 样趋化因子模式与复发性呼吸道乳头瘤病患者的疾病严重程度相关。

T(H)2-like chemokine patterns correlate with disease severity in patients with recurrent respiratory papillomatosis.

机构信息

Elmezzi Graduate School of Molecular Medicine, Manhasset, New York, USA.

出版信息

Mol Med. 2012 Dec 6;18(1):1338-45. doi: 10.2119/molmed.2012.00284.

Abstract

Recurrent respiratory papillomatosis (RRP), characterized by the recurrent growth of benign tumors of the respiratory tract, is caused by infection with human papillomavirus (HPV), predominantly types 6 and 11. Surgical removal of these lesions can be required as frequently as every 3 to 4 wks to maintain a patent airway. There is no approved medical treatment for this disease. In this study, we have characterized the T(H)2-like chemokine profile (CCL17, CCL18, CCL20, CCL22) in patients with RRP and asked whether it was modulated in patients who had achieved significant clinical improvement. CCL17, CCL18 and CCL22 messenger RNAs (mRNAs) were increased in papillomas compared with clinically normal laryngeal epithelium of the RRP patients. Overall, CCL20 mRNA expression was not increased, but there was intense, selective CCL20 protein expression in the basal layer of the papillomas. Patients with RRP expressed more CCL17 (p = 0.003), CCL18 (p = 0.0003), and CCL22 (p = 0.007) in their plasma than controls. Plasma CCL18 decreased over time in three patients enrolled in a pilot clinical trial of celecoxib, and the decrease occurred in conjunction with clinical improvement. There was a significant correlation between sustained clinical remission in additional patients with RRP and reduced levels of CCL17 (p = 0.01), CCL22 (p = 0.002) and CCL18 (p = 0.05). Thus, the change in expression of these three plasma T(H)2-like chemokines may, with future studies, prove to serve as a useful biomarker for predicting disease prognosis.

摘要

复发性呼吸道乳头瘤病(RRP)的特征是呼吸道良性肿瘤的反复生长,由人乳头瘤病毒(HPV)感染引起,主要为 6 型和 11 型。为了保持气道通畅,这些病变可能需要每 3 到 4 周进行一次手术切除。目前尚无针对这种疾病的批准的药物治疗方法。在这项研究中,我们对 RRP 患者的 T(H)2 样趋化因子谱(CCL17、CCL18、CCL20、CCL22)进行了特征描述,并询问了在取得显著临床改善的患者中其是否发生了变化。与 RRP 患者的临床正常喉部上皮相比,乳头状瘤中 CCL17、CCL18 和 CCL22 的信使 RNA(mRNA)增加。总体而言,CCL20 mRNA 表达没有增加,但在乳头状瘤的基底层存在强烈的选择性 CCL20 蛋白表达。RRP 患者的血浆中 CCL17(p=0.003)、CCL18(p=0.0003)和 CCL22(p=0.007)的表达高于对照组。在参加塞来昔布临床试验的 3 名患者中,血浆 CCL18 随时间推移而下降,且下降与临床改善同时发生。在其他 RRP 患者中,持续的临床缓解与 CCL17(p=0.01)、CCL22(p=0.002)和 CCL18(p=0.05)水平降低有显著相关性。因此,这三种血浆 T(H)2 样趋化因子的表达变化可能随着未来的研究,成为预测疾病预后的有用生物标志物。

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