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初治哮喘患者气道壁厚度与血清骨膜蛋白的相关性

Association of airway wall thickness with serum periostin in steroid-naive asthma.

作者信息

Hoshino Makoto, Ohtawa Junichi, Akitsu Kenta

机构信息

Division of Clinical Allergy, Department of Internal Medicine, Atami Hospital, International University of Health and Welfare, Atami, Japan.

出版信息

Allergy Asthma Proc. 2016 May;37(3):225-30. doi: 10.2500/aap.2016.37.3945.

Abstract

BACKGROUND

Periostin may be a useful biomarker of T-helper type 2 eosinophilic airway inflammation and has been linked to remodeling in asthma. However, the association between serum periostin and the magnitude of airway wall thickness remains unclear.

OBJECTIVE

We examined the relationship between serum periostin and airway geometry in asthma.

METHODS

Twenty-six patients with steroid-naive asthma, 30 patients with asthma treated with inhaled corticosteroids, and 46 aged-matched healthy controls were studied. Serum periostin levels, lung function, and inflammatory cell counts in sputum were measured. The following parameters of airway dimension were assessed by computed tomography: lumen area, wall area (WA), WA to total area ratio, and wall thickness.

RESULTS

Serum periostin levels were significantly elevated in patients with steroid-naive asthma compared with the controls (p < 0.01) and patients with asthma who were treated with steroids (p < 0.01). In patients who were steroid naive, serum periostin was correlated with air flow limitation (r = -0.62, p < 0.01) and the WA to body surface area (r = 0.71, p < 0.01), and sputum eosinophil percentage (r = 0.60, p < 0.01). Multivariate analysis showed that the percentage of predicted forced expiratory volume in 1 second, WA to body surface area, and sputum eosinophils were independent factors for high serum periostin.

CONCLUSION

Serum periostin may be a candidate for a novel biomarker for not only eosinophilic inflammation but as a marker for airway remodeling in asthma.

摘要

背景

骨膜蛋白可能是2型辅助性T细胞嗜酸性气道炎症的一种有用生物标志物,并且与哮喘的重塑有关。然而,血清骨膜蛋白与气道壁厚度大小之间的关联仍不清楚。

目的

我们研究了哮喘患者血清骨膜蛋白与气道几何形态之间的关系。

方法

对26例未使用过类固醇的哮喘患者、30例接受吸入性皮质类固醇治疗的哮喘患者以及46例年龄匹配的健康对照者进行了研究。测量了血清骨膜蛋白水平、肺功能和痰液中的炎症细胞计数。通过计算机断层扫描评估气道尺寸的以下参数:管腔面积、壁面积(WA)、WA与总面积之比以及壁厚。

结果

与对照组(p < 0.01)和接受类固醇治疗的哮喘患者(p < 0.01)相比,未使用过类固醇的哮喘患者血清骨膜蛋白水平显著升高。在未使用过类固醇的患者中,血清骨膜蛋白与气流受限(r = -0.62,p < 0.01)、WA与体表面积(r = 0.71,p < 0.01)以及痰液嗜酸性粒细胞百分比(r = 0.60,p < 0.01)相关。多变量分析显示,1秒用力呼气量占预计值的百分比、WA与体表面积以及痰液嗜酸性粒细胞是血清骨膜蛋白水平升高的独立因素。

结论

血清骨膜蛋白不仅可能是嗜酸性炎症的新型生物标志物候选物,还可能是哮喘气道重塑的标志物。

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