年轻受试者中伴有牛奶超敏反应的非2型哮喘亚组的特征分析。
Characterization of a subgroup of non-type 2 asthma with cow's milk hypersensitivity in young subjects.
作者信息
Tsolakis N, Nordvall L, Janson C, Rydell N, Malinovschi A, Alving K
机构信息
1Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, 751 85 Uppsala, Sweden.
2Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
出版信息
Clin Transl Allergy. 2019 Feb 22;9:12. doi: 10.1186/s13601-019-0250-2. eCollection 2019.
BACKGROUND
Asthma with atopy is often characterized by type 2 inflammation but less progress has been made in defining non-type 2 asthma. We have previously identified a subgroup of young non-atopic asthmatics with perceived food hypersensitivity and poor asthma control.
OBJECTIVE
Our aim was to further characterize this subgroup of non-type 2 asthmatics, including the use of a broad panel of inflammation-related proteins.
METHODS
Sex- and age-matched subjects (10-35 years old) were divided into three groups with regard to history of asthma and atopy: non-atopic asthmatics with perceived cow's milk hypersensitivity but with IgE antibodies < 0.35 kU/L (NAA; n = 24), non-atopic controls with IgE < 0.35 kU/L (NAC; n = 24), and atopic asthmatics with IgE ≥ 0.35 kU/L (AA; n = 29). Serum or plasma were analysed using the multi-allergen tests Phadiatop and fx5 (ImmunoCAP), a multiplex immunoassay comprising 92 inflammation-related proteins (Proseek Inflammation), and an ELISA for human neutrophil lipocalin (S-HNL). Fraction of exhaled nitric oxide (FeNO), blood eosinophil (B-Eos) count, C-reactive protein (CRP), airway responsiveness to methacholine (PD), and asthma-related quality of life (mAQLQ) were also measured.
RESULTS
NAA had lower FeNO ( < 0.001) and B-Eos count ( < 0.001), but scored worse on mAQLQ ( = 0.045) compared with AA. NAA displayed higher levels of matrix metalloproteinase-1 (MMP-1) compared with both NAC ( = 0.011) and AA ( = 0.001), and lower PD compared with NAC ( < 0.001). In NAA, S-HNL correlated negatively with PD (rho = - 0.048, < 0.05) and CRP correlated negatively with mAQLQ (rho = - 0.439, < 0.05).
CONCLUSION
In a subgroup of non-atopic young asthmatics with perceived cow's milk hypersensitivity we observed poor asthma-related quality of life, airway hyperresponsiveness, and clinically relevant non-type 2 inflammation. MMP-1 was elevated in this group, which deserves further studies.
背景
伴有特应性的哮喘通常以2型炎症为特征，但在定义非2型哮喘方面进展较少。我们之前已经确定了一组年轻的非特应性哮喘患者，他们存在食物过敏感知且哮喘控制不佳。
目的
我们的目的是进一步描述这一非2型哮喘亚组的特征，包括使用一系列广泛的炎症相关蛋白。
方法
根据哮喘和特应性病史，将年龄和性别匹配的受试者（10 - 35岁）分为三组：存在牛奶过敏感知但IgE抗体<0.35 kU/L的非特应性哮喘患者（NAA；n = 24）、IgE<0.35 kU/L的非特应性对照者（NAC；n = 24）以及IgE≥0.35 kU/L的特应性哮喘患者（AA；n = 29）。使用多过敏原检测Phadiatop和fx5（ImmunoCAP）、包含92种炎症相关蛋白的多重免疫测定法（Proseek Inflammation）以及人中性粒细胞明胶酶相关脂质运载蛋白酶联免疫吸附测定（S - HNL）对血清或血浆进行分析。还测量了呼出一氧化氮分数（FeNO）、血液嗜酸性粒细胞（B - Eos）计数、C反应蛋白（CRP）、对乙酰甲胆碱的气道反应性（PD）以及哮喘相关生活质量（mAQLQ）。
结果
与AA相比，NAA的FeNO（<0.001）和B - Eos计数（<0.001）较低，但在mAQLQ上得分更差（= 0.045）。与NAC（= 0.011）和AA（= 0.001）相比，NAA的基质金属蛋白酶 - 1（MMP - 1）水平更高，与NAC相比，NAA的PD更低（<0.001）。在NAA中，S - HNL与PD呈负相关（rho = - 0.048，<0.05），CRP与mAQLQ呈负相关（rho = - 0.439，<0.05）。
结论
在一组存在牛奶过敏感知的非特应性年轻哮喘患者中，我们观察到哮喘相关生活质量较差、气道高反应性以及临床上相关的非2型炎症。该组中MMP - 1升高，值得进一步研究。
Zotero 插件