An Jin, Lee Ji-Hyang, Sim Ju Hee, Song Woo-Jung, Kwon Hyouk-Soo, Cho You Sook, Moon Hee-Bom, Kim Chang-Keun, Kim Tae-Bum
Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Allergy Clin Immunol Pract. 2020 Sep;8(8):2681-2688.e1. doi: 10.1016/j.jaip.2020.03.035. Epub 2020 Apr 15.
Although several biomarkers have been proposed for eosinophilic asthma, biomarkers for reflecting asthma control status remain controversial. Eosinophil-derived neurotoxin (EDN), a degranulated eosinophil protein, is an emerging biomarker in asthmatic patients.
This study analyzed serum EDN concentrations in asthmatics and compared its performance with that of blood eosinophil count as an indicator of asthma control status.
We enrolled 75 uncontrolled asthmatics, 56 controlled asthmatics, and 43 healthy controls from Asan Medical Center. Serum EDN levels (ng/mL) were measured using an enzyme-linked immunosorbent assay kit. The predictability of EDN for asthma control status was analyzed by univariate and multivariable logistic regression analyses. A receiver operating characteristic (ROC) curve analysis was conducted to compare the performances of a serum EDN level and blood eosinophil count as indicators of uncontrolled asthma status.
The mean serum EDN level in the uncontrolled asthma group was higher than that in the controlled asthma and healthy groups (103.2 ± 60.2 vs 60.8 ± 49.7 vs 49.6 ± 28.3 ng/mL, P < .001). Serum EDN level was the significant parameter related to asthma control status in univariate and multivariable analysis (both P < .001). Serum EDN levels correlated with blood eosinophil counts (r = 0.510, P < .001). However, in the ROC analysis, serum EDN level showed a significantly better performance for predicting uncontrolled asthma status (area under the curve, 0.726 vs 0.628, P = .024).
Serum EDN levels significantly differed between patients with controlled and uncontrolled status in adult asthmatics. To our knowledge, this is the first study to identify EDN as a better indicator of asthma control status than blood eosinophil count.
尽管已提出多种用于嗜酸性粒细胞性哮喘的生物标志物，但反映哮喘控制状态的生物标志物仍存在争议。嗜酸性粒细胞衍生神经毒素（EDN）是一种脱颗粒的嗜酸性粒细胞蛋白，是哮喘患者中一种新兴的生物标志物。
本研究分析了哮喘患者血清EDN浓度，并将其作为哮喘控制状态指标的性能与血嗜酸性粒细胞计数进行比较。
我们从峨山医学中心招募了75例未控制的哮喘患者、56例已控制的哮喘患者和43名健康对照者。使用酶联免疫吸附测定试剂盒测量血清EDN水平（ng/mL）。通过单变量和多变量逻辑回归分析来分析EDN对哮喘控制状态的预测能力。进行受试者工作特征（ROC）曲线分析，以比较血清EDN水平和血嗜酸性粒细胞计数作为未控制哮喘状态指标的性能。
未控制哮喘组的平均血清EDN水平高于已控制哮喘组和健康组（103.2±60.2 vs 60.8±49.7 vs 49.6±28.3 ng/mL，P<.001）。在单变量和多变量分析中，血清EDN水平都是与哮喘控制状态相关的显著参数（均P<.001）。血清EDN水平与血嗜酸性粒细胞计数相关（r = 0.510，P<.001）。然而，在ROC分析中，血清EDN水平在预测未控制哮喘状态方面表现出明显更好的性能（曲线下面积，0.726 vs 0.628，P =.024）。
在成年哮喘患者中，已控制和未控制状态患者的血清EDN水平存在显著差异。据我们所知，这是第一项将EDN鉴定为比血嗜酸性粒细胞计数更好的哮喘控制状态指标的研究。
