Rogala Barbara, Bozek Andrzej, Gluck Joanna, Jarzab Jerzy
Chair and Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland. Head of the Department: Prof. Barbara Rogala MD, PhD.
Chair and Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia, Zabrze, Poland. Head of the Department: Prof. Jerzy Jarzab MD, PhD.
Postepy Dermatol Alergol. 2015 Aug;32(4):274-80. doi: 10.5114/pdia.2015.53323. Epub 2015 Aug 12.
The pathogenesis of asthma remains unclear, especially in cases of the severe disease.
To explore IgE-mediated inhalant sensitization in severe asthma compared with a group of patients with chronic mild disease and evaluate the Th1/Th2 cytokine profiles in asthma by different disease severities.
One hundred and fifty-four patients (age range: 28-69) with severe chronic asthma (study group) and 141 patients with chronic mild disease (control group) diagnosed according to GINA criteria were included in the study. Seventy-eight severe asthmatics and 43 subjects with mild disease were randomly selected for serum Th1/Th2 cytokine level estimation. The groups were matched in terms of age and atopy features (skin prick tests, specific and total serum IgE).
Positive skin tests to at least one allergen were observed with comparable frequencies. Sensitization to Dermatophagoides pteronyssinus was the most prevalent positive result in both groups. An earlier onset of asthma together with a greater number of exacerbations was noted in severe asthmatics compared to patients with mild disease. Serum levels of interleukin 4 and 2 (IL-4 and IL-2) were detectable only in severe asthmatics irrespective of atopy features. The levels of interferon γ and tumour necrosis factor α were undetectable in both groups. IL-10 and IL-5 were detected in the serum of only 7 and 12 severe asthmatics, respectively.
The serum level of IL-2 and IL-4 could be perceived as a marker of severe asthma. Neither IL-2 nor IL-4 levels in the serum could differentiate allergic and non-allergic asthma.
哮喘的发病机制仍不清楚，尤其是在重症病例中。
探讨重度哮喘患者与慢性轻症患者组相比的IgE介导的吸入性致敏情况，并按不同疾病严重程度评估哮喘患者的Th1/Th2细胞因子谱。
本研究纳入了154例（年龄范围：28 - 69岁）根据全球哮喘防治创议（GINA）标准诊断为重度慢性哮喘的患者（研究组）和141例慢性轻症患者（对照组）。随机选取78例重度哮喘患者和43例轻症患者进行血清Th1/Th2细胞因子水平测定。两组在年龄和特应性特征（皮肤点刺试验、特异性和总血清IgE）方面进行了匹配。
观察到两组对至少一种变应原的皮肤试验阳性频率相当。两组中对屋尘螨致敏是最常见的阳性结果。与轻症患者相比，重度哮喘患者哮喘起病更早且发作次数更多。无论特应性特征如何，仅在重度哮喘患者中可检测到白细胞介素4和2（IL - 4和IL - 2）的血清水平。两组中均未检测到干扰素γ和肿瘤坏死因子α的水平。仅在7例和12例重度哮喘患者的血清中分别检测到IL - 10和IL - 5。
IL - 2和IL - 4的血清水平可被视为重度哮喘的标志物。血清中IL - 2和IL - 4水平均不能区分过敏性哮喘和非过敏性哮喘。
