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重组人latrophilin 3抗体治疗小儿哮喘的临床疗效

Clinical efficacy of recombinant human latrophilin 3 antibody in the treatment of pediatric asthma.

作者信息

Liu Maohua, Zhang Jingxiu, Liu Chengjun

机构信息

Department of Pediatric Internal Medicine Ward 1, Yishui Central Hospital of Linyi, Linyi, Shandong 276400, P.R. China.

Department of Pediatric Internal Medicine Ward 3, Yishui Central Hospital of Linyi, Linyi, Shandong 276400, P.R. China.

出版信息

Exp Ther Med. 2018 Jan;15(1):539-547. doi: 10.3892/etm.2017.5376. Epub 2017 Oct 25.

Abstract

Pediatric asthma is a chronic pulmonary inflammatory disease featuring hypersecretion of mucus and inflammation in the airway, resulting in dysfunction of the airway smooth muscle. Previous evidence demonstrated that latrophilins, a novel family of receptors, present a beneficial effect on airway smooth muscle cells. In the present study, the therapeutic effects of recombinant human latrophilin 3 (rhLPHN3) antibody (Ab) in patients with pediatric asthma were investigated, and the molecular mechanism underlying the function of LPHN3 in the treatment of asthma in clinical practice was examined. A total of 342 pediatric asthma cases were recruited and randomly divided into three groups, receiving treatment with rhLPHN3 Ab (n=134), salbutamol (n=108) or montelukast (n=100) by nasal aerosolization. Each group received the respective clinically tested dose for 16 weeks. Inflammatory factors interleukin (IL)-10, IL-17, IL-4, matrix metallopeptidase-9 (MMP-9), interferon-γ (IFN-γ) and transforming growth factor-β (TGF-β) levels in peripheral blood mononuclear cells were analyzed prior to and post treatment. The clinical outcomes revealed that pathological alterations were significantly improved following treatment with rhLPHN3 Ab for patients with pediatric asthma when compared with those receiving salbutamol and montelukast. It was also observed that rhLPHN3 Ab downregulated the plasma concentration levels of IL-10, IL-17, IL-4 and MMP-9, and upregulated IFN-γ and TGF-β levels in the three groups. In addition, clinical data demonstrated that rhLPHN3 Ab significantly promoted E-selectin and mucin 5AC expression, as well as improved the activation of nuclear factor (NF)-κB p65 DNA binding activity and the phosphorylation levels of protein kinase A. Furthermore, rhLPHN3 Ab markedly improved adhesion and proliferation of airway smooth muscle cells, which led to promotion of the contraction of these cells. In conclusion, these clinical data suggest that rhLPHN3 Ab serves an important role in the inhibition of inflammatory mediators through downregulation of NF-κB signaling pathway, which contributes to airway remodeling and bronchodilation in patients with pediatric asthma.

摘要

小儿哮喘是一种慢性肺部炎症性疾病,其特征为气道黏液分泌过多和炎症,导致气道平滑肌功能障碍。先前的证据表明,促离子型受体(latrophilins)这一新型受体家族对气道平滑肌细胞具有有益作用。在本研究中,研究了重组人促离子型受体3(rhLPHN3)抗体(Ab)对小儿哮喘患者的治疗效果,并探讨了LPHN3在临床治疗哮喘中发挥作用的分子机制。共招募了342例小儿哮喘病例,并随机分为三组,分别通过鼻腔雾化吸入rhLPHN3 Ab(n = 134)、沙丁胺醇(n = 108)或孟鲁司特(n = 100)进行治疗。每组接受各自经临床测试的剂量,持续16周。在治疗前后分析外周血单个核细胞中炎症因子白细胞介素(IL)-10、IL-17、IL-4、基质金属蛋白酶-9(MMP-9)、干扰素-γ(IFN-γ)和转化生长因子-β(TGF-β)的水平。临床结果显示,与接受沙丁胺醇和孟鲁司特治疗的患者相比,rhLPHN3 Ab治疗小儿哮喘患者后病理改变明显改善。还观察到,rhLPHN3 Ab下调了三组中IL-10、IL-17、IL-4和MMP-9的血浆浓度水平,并上调了IFN-γ和TGF-β水平。此外,临床数据表明,rhLPHN3 Ab显著促进E-选择素和黏蛋白5AC的表达,并改善核因子(NF)-κB p65 DNA结合活性的激活以及蛋白激酶A的磷酸化水平。此外,rhLPHN3 Ab显著改善气道平滑肌细胞的黏附与增殖,从而促进这些细胞的收缩。总之,这些临床数据表明,rhLPHN3 Ab通过下调NF-κB信号通路在抑制炎症介质方面发挥重要作用,这有助于小儿哮喘患者的气道重塑和支气管扩张。

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