Cui Ai-Hua, Zhao Jing, Liu Shu-Xiang, Hao Ying-Shuang
Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, PR China.
Medicine (Baltimore). 2017 Mar;96(12):e6265. doi: 10.1097/MD.0000000000006265.
Pediatric asthma has gained increasing concerns with poorly understood pathogenesis. The purpose of this study was to explore the associations of interleukin-4 (IL-4), IL-6, and IL-12 levels in peripheral blood (PB) with lung function, cellular immune function, and children's quality of life (QOL) with moderate-to-severe asthma.
A total of 1158 children with moderate-to-severe asthma (the experimental group) and 1075 healthy children (the control group) were recruited for our study. Enzyme-linked immunosorbent assay was used to detect IL-4, IL-6, and IL-12 levels. T lymphocytes were detected by alkaline phosphatase antialkaline phosphatase, and erythrocyte immune was measured by red blood cell C 3b receptor (RBC-C3bR) rosette-forming test. The forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF) were detected, after which FEV1/forced vital capacity (FVC) was calculated before and after treatment. PedsQL3.0 was used to measure the effect of asthma on QOL of children, and the correlation between IL-4, IL-6, and IL-12 levels and the lung function and QOL was measured. Logistic regression analysis was applied to detect related factors of moderate-to-severe asthma of children.
After treatment, the decreased IL-4 and IL-6 levels and increased IL-12 level were revealed in the experimental group. The cellular immune function's disorder was significantly decreased, and an elevated CD3, CD4, CD8, and declined CD4/CD8 level was performed in T lymphocytes. RBC-C3bR was increased, and red blood cell immune complex (RBC-IC) was reduced in erythrocyte immune in comparison with those before treatment. Lung function parameters all increased. After treatment, the symptoms of asthma in children reduced with scores of increased QOL. IL-4 was positively related to RBC-IC, but negatively associated with the QOL score. IL-6 showed negative connection with CD4/CD8, RBC-C3bR, FEV1/FVC, and QOL score, and had positive connection with PEF. In addition, IL-12 was negatively correlated with PEF. The levels of IL-4, RBC-C3bR, FEV1/FVC, and PEF were independent risk factors for the prognosis of treatment for children with moderate-to-severe asthma.
This study demonstrated that IL-4, IL-6, and IL-12 levels in PB were associated with lung function, cellular immune function, and QOL in children with moderate-to-severe asthma.
儿童哮喘的发病机制尚不清楚，已引起越来越多的关注。本研究旨在探讨外周血（PB）中白细胞介素-4（IL-4）、IL-6和IL-12水平与中重度哮喘患儿肺功能、细胞免疫功能及生活质量（QOL）的相关性。
本研究共纳入1158例中重度哮喘患儿（实验组）和1075例健康儿童（对照组）。采用酶联免疫吸附测定法检测IL-4、IL-6和IL-12水平。采用碱性磷酸酶抗碱性磷酸酶法检测T淋巴细胞，采用红细胞C3b受体（RBC-C3bR）花环形成试验检测红细胞免疫。检测第1秒用力呼气容积（FEV1）和呼气峰值流速（PEF），并计算治疗前后的FEV1/用力肺活量（FVC）。采用儿童生活质量量表3.0（PedsQL3.0）评估哮喘对儿童生活质量的影响，并检测IL-4、IL-6和IL-12水平与肺功能及生活质量的相关性。应用Logistic回归分析检测儿童中重度哮喘的相关因素。
治疗后，实验组IL-4和IL-6水平降低，IL-12水平升高。细胞免疫功能紊乱明显减轻，T淋巴细胞中CD3、CD4、CD8升高，CD4/CD8降低。红细胞免疫中RBC-C3bR升高，红细胞免疫复合物（RBC-IC）降低。肺功能参数均升高。治疗后，儿童哮喘症状减轻，生活质量评分升高。IL-4与RBC-IC呈正相关，但与生活质量评分呈负相关。IL-6与CD4/CD8、RBC-C3bR、FEV1/FVC和生活质量评分呈负相关，与PEF呈正相关。此外，IL-12与PEF呈负相关。IL-4、RBC-C?3bR、FEV1/FVC和PEF水平是中重度哮喘患儿治疗预后的独立危险因素。
本研究表明，外周血中IL-4、IL-6和IL-12水平与中重度哮喘患儿的肺功能、细胞免疫功能及生活质量相关。
