Chen Jian-Hui, Qin Ling, Shi Ying-Ying, Feng Jun-Tao, Zheng Yu-Long, Wan Yu-Feng, Xu Chuan-Qin, Yang Xiao-Mei, Hu Cheng-Ping
Department of Respiratory Medicine, Xiangya Hospital of Central South University (Key Site of National Clinical Research Center for Respiratory Disease), Changsha 410008, Hunan Province, China; Department of Respiratory Medicine, Huai'an Second People's Hospital, Huai'an 223002, Jiangsu Province, China.
Department of Respiratory Medicine, Xiangya Hospital of Central South University (Key Site of National Clinical Research Center for Respiratory Disease), Changsha 410008, Hunan Province, China.
Respir Med. 2016 Dec;121:48-58. doi: 10.1016/j.rmed.2016.10.018. Epub 2016 Oct 28.
Obesity worsens asthma control partly through enhanced airway neutrophilia, altered lung mechanics and comorbidities, including obstructive sleep apnea syndrome, gastroesophageal reflux disease and depression. Although controversial, obesity may also cause poorer outcomes in acute asthma. IL-17 is associated with neutrophilic inflammation, steroid resistance and severe asthma, but its importance in the association between asthma and obesity is unknown.
To investigate the role of IL-17 in obese asthma in both acute and stable settings.
Both stable (n = 177) and acute (n = 78) asthmatics were recruited and categorized into lean (n = 77 and 39 respectively), overweight (n = 41 and 17 respectively) and obese (n = 59 and 22 respectively) groups and compared for clinical characteristics, including sputum and plasma IL-17 protein concentrations, sputum cellularity, spirometry and comorbidities. Correlations of IL-17 expression with other measures were explored.
In stable subjects, airway neutrophilia and IL-17 concentrations were most prominent in the obese, and correlated positively with each other. Significant increase in plasma IL-17 levels was also noted and associated with elevated depressive symptoms in obesity. In acute asthma, IL-17 expression, like most other clinical measures, was similar among lean, overweight and obese groups, but was higher in acute versus stable asthma subjects, with sputum IL-17 correlating positively with sputum neutrophils and negatively with FEV and plasma IL-17 showing a positive connection to airway eosinophilia during exacerbation.
IL-17 contributes to worse disease control in obese asthma through enhancing airway neutrophilia and depression, and may implicate in asthma exacerbations. Effects of adiposity on acute asthma remain uncertain.
肥胖会通过增强气道嗜中性粒细胞浸润、改变肺力学以及引发合并症（包括阻塞性睡眠呼吸暂停综合征、胃食管反流病和抑郁症）来部分地恶化哮喘控制情况。尽管存在争议，但肥胖也可能导致急性哮喘出现更差的预后。白细胞介素-17（IL-17）与嗜中性粒细胞性炎症、激素抵抗及重度哮喘相关，但其在哮喘与肥胖关联中的重要性尚不清楚。
研究IL-17在急性和稳定状态下肥胖型哮喘中的作用。
招募稳定期（n = 177）和急性期（n = 78）哮喘患者，并将其分为瘦体型（分别为n = 77和39）、超重（分别为n = 41和17）和肥胖（分别为n = 59和22）组，比较其临床特征，包括痰液和血浆IL-17蛋白浓度、痰液细胞成分、肺功能测定以及合并症情况。探讨IL-17表达与其他指标的相关性。
在稳定期患者中，气道嗜中性粒细胞浸润和IL-17浓度在肥胖患者中最为显著，且二者呈正相关。还注意到血浆IL-17水平显著升高，并与肥胖患者抑郁症状加重相关。在急性哮喘中，IL-17表达与大多数其他临床指标一样，在瘦体型、超重和肥胖组中相似，但在急性哮喘患者中高于稳定期哮喘患者，痰液IL-17与痰液嗜中性粒细胞呈正相关，与第一秒用力呼气容积（FEV）呈负相关，血浆IL-17在病情加重期间与气道嗜酸性粒细胞增多呈正相关。
IL-17通过增强气道嗜中性粒细胞浸润和抑郁情绪导致肥胖型哮喘的疾病控制更差，并可能与哮喘发作有关。肥胖对急性哮喘的影响仍不确定。
