Department of Pediatrics, Institute of Allergy, Severance Hospital, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
Pediatr Allergy Immunol. 2018 Feb;29(1):42-49. doi: 10.1111/pai.12827. Epub 2017 Nov 29.
Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is known to play a role in the pathogenesis of various inflammatory diseases. However, no study has been performed on childhood asthma.
Ninety-five children with asthma and 78 controls aged 5-18 years were included. Sputum induction, pulmonary function test (PFT), and methacholine challenge test were performed. The subjects were divided into the eosinophilic airway (EA) and non-EA (NEA) groups based on sputum analysis and into the high and low TWEAK groups according to the TWEAK cutoff level (263.0 pg/mL). TWEAK in induced sputum supernatant was measured through enzyme-linked immunosorbent assay.
Children with asthma had higher TWEAK levels than healthy controls (493.0 [157.1-904.3] vs 118.2 (67.5-345.5) pg/mL, P < .001). Sputum TWEAK levels were significantly correlated with PFT parameters reflecting airway obstruction. This association was particularly prominent in subjects with NEA inflammation. Significant differences in FEF (maximum mid-expiratory flow, % predicted; P = .017), AX (reactance area; P < .001), R5-R20 (difference between resistance at 5 and 20 Hz; P = .025), and X5 (reactance at 5 Hz, % predicted; P < .001) were noted between the high and low TWEAK groups within the NEA group. Sputum TWEAK level also showed significant positive correlations with asthma severity (r = .358, P = .001) and control status (r = .470, P < .001), distinctively in subjects with NEA inflammation.
Airway TWEAK may play a role in small airway inflammation especially in children with non-eosinophilic asthma.
肿瘤坏死因子样凋亡弱诱导剂（TWEAK）在各种炎症性疾病的发病机制中起作用。然而，尚未对儿童哮喘进行研究。
纳入 95 例哮喘患儿和 78 例年龄在 5-18 岁的对照者。进行痰诱导、肺功能测试（PFT）和乙酰甲胆碱激发试验。根据痰分析将受试者分为嗜酸性气道（EA）和非嗜酸性气道（NEA）组，并根据 TWEAK 截断值（263.0 pg/mL）分为高和低 TWEAK 组。通过酶联免疫吸附试验测量诱导痰上清液中的 TWEAK。
哮喘患儿的 TWEAK 水平高于健康对照组（493.0[157.1-904.3] vs 118.2[67.5-345.5] pg/mL，P<0.001）。痰 TWEAK 水平与反映气道阻塞的 PFT 参数显著相关。这种相关性在 NEA 炎症患者中尤为明显。在 NEA 组中，两组间 FEF（最大呼气中期流量，预计百分比；P=0.017）、AX（电抗面积；P<0.001）、R5-R20（5 和 20 Hz 之间的阻力差异；P=0.025）和 X5（5 Hz 时的电抗，预计百分比；P<0.001）存在显著差异。痰 TWEAK 水平与哮喘严重程度（r=0.358，P=0.001）和控制状态（r=0.470，P<0.001）呈显著正相关，在 NEA 炎症患者中更为明显。
气道 TWEAK 可能在小气道炎症中起作用，尤其是在非嗜酸性粒细胞性哮喘患儿中。
