Shen Yuelin, Qin Qiang, Xu Zhifei, Shen Kunling
Department No. 2 of Respiratory Medicine, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, People's Republic of China.
Department No. 1 of Respiratory Medicine, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, People's Republic of China.
Int Immunopharmacol. 2014 Sep;22(1):120-5. doi: 10.1016/j.intimp.2014.05.029. Epub 2014 Jun 26.
A number of previous works have shown that leukotriene (LT) concentration emerged disease severity-dependent increases in both exhaled breath condensate and urine of sleep-disordered breathing (SDB) patients. However, few studies have investigated how circulating level of LTs contributes to systemic inflammation of SDB, and the relationship between LT production, leukocyte count and high sensitivity C-reactive protein (hsCRP) level in SDB disease remains controversial.
Prospective, observational study that included standard questionnaires, physical examinations and polysomnography. Serum leukotriene B4 (LTB(4)) and cysteinyl leukotrienes (cysLTs) were determined by means of enzyme-linked immunosorbent assays.
A total of 166 children with SDB and 45 control subjects were recruited. SDB children had increased serum levels for both LTB(4) and cysLTs as well as neutrophil (Neu) count and hsCRP than the control group, and all the inflammatory parameters emerged disease severity-dependent increases. LT production correlated significantly with Neu count and hsCRP level. In the regression model, both apnea-hypopnea index and body mass index z-score were significant predictors of LTB(4) and cysLTs (p < 0.001).
The activated systemic inflammatory response as reflected by serum elevations of LTs, Neu counts and hsCRP is present in children with SDB, and the magnitude of inflammation emerged disease severity-dependent. The level of LTs is significantly associated with circulating Neu counts and hsCRP values in SDB.
此前的多项研究表明，睡眠呼吸障碍（SDB）患者的呼出气冷凝液和尿液中的白三烯（LT）浓度会随着疾病严重程度的增加而升高。然而，很少有研究探讨循环中的LT水平如何导致SDB的全身炎症，并且SDB疾病中LT产生、白细胞计数与高敏C反应蛋白（hsCRP）水平之间的关系仍存在争议。
一项前瞻性观察性研究，包括标准问卷调查、体格检查和多导睡眠监测。采用酶联免疫吸附测定法测定血清白三烯B4（LTB4）和半胱氨酰白三烯（cysLTs）。
共招募了166名SDB儿童和45名对照受试者。与对照组相比，SDB儿童的LTB4和cysLTs血清水平以及中性粒细胞（Neu）计数和hsCRP均升高，并且所有炎症参数均呈现出与疾病严重程度相关的增加。LT产生与Neu计数和hsCRP水平显著相关。在回归模型中，呼吸暂停低通气指数和体重指数z评分均是LTB4和cysLTs的显著预测因子（p<0.001）。
SDB儿童存在由LT、Neu计数和hsCRP血清升高所反映的活化全身炎症反应，并且炎症程度呈现出与疾病严重程度相关的变化。SDB中LT水平与循环中的Neu计数和hsCRP值显著相关。
